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8/18/2019 07-Physiology, 45 Notes to Pg
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45 NOTES TO PG
—Dr. Ankit Yadavendra, M.B.B.S., Dr.V.M.G.M.C., Solapur
7 PHYSIOLOGY
viscosity measure-Osborn viscometer
pulse-Dudgeon sphygmograph
Surf Tension-STalagmometer
orexin-wakefulness, appetite, Alz ds
ACh secret eye-Amacrine cell
ANS
↑M1-stom( HCl)
↓ ↓M2-AV>SA node( conduct vel, ventricle rate)
↑ ↑M3-sm m(EDRF-vasodil), bronchospasm, GIT( motility), freq micturition, salivary,lacrimal, sweat gld, constrictor pupillae, ciliary m
CELL
cell memb
fluid mosaic/Singer Nicolson model
lipid wt:prot wt=1:1
SA-carb:lipid:prot=3%:42%:55%
↑ ↑lipid bilayer-self sealing, hydrophobic-MI-phospholipid, FA- fluidity
cholesterol-fluidity buffer
→↓ t emp>Tm fluidity
→↑ t emp dipole movem
prot
extracell-Ig
transmemb(integral)-glycophorin, IgG superfamily
periph(on inner layer)-spectrin, ankyrin
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intracell-Hb
filament
micro-weakest, endo,exocytosis-actin
intermed-join microtubule& microfilament- laminin, keratin, vimentin, desmin, GFAP,
peripherin, neurofilament microTubule-sTrongest, mitotic spindle, separation of genetic material-tubulin
molecular prot
ATPase
→ kinesin-axoplasm trpt +ve end microtubule
dynein
→ cytosolic-move vesicle –end of microtubule
axonemal-power ciliary& flagellar prot
myosin-m contract
GTPase dynamin-endocytosis
jnal region b/n 2cell
desmoSome/macula adherenS-tensile Strength in Skin, gum, cx
gap jn/connexon(hemich=6connexin)-bidirect free passage of material b/n
2electrically coupled cell, 3μ, no synapt delay-heart
tight jn prot/zonula occludens
occludens
claudins
Jn Adhesion Molecule(JAM)
BBB,stom wall,UB wall
focal adhesion molecule-generate intracellular signal when subject to stress
gap jn prot
connexins(6subunit)
cell adhesion molec(CAM)
Cadherin(Ca depend cell adhesion molecule)
integrin-leucocyte adhes to endoth cell
selectin-leucocyte rolling
IgG superfamily-ICAM,PECAM
tpt prot
pore(aquaporin,perforin)-always open
ch-intermittent open
voltag gated-Na ch in n memb(blocked by tetrodoxin, saxidoxin)
ligAnd gated-ionotropic recept, GABA-A(Cl), nAChR-fast
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metaBotropic recept-cNG gated, GABA-B, mAChR, cGMP gated(rods)
time gated-slow Ca ch(Purkinje fibre)
mech gated-touch recept(skin)
carrier
facilitated diffusion
sec active tpt-GLUT,SGLT pump
P-ATPase, E1-E2 ATPase, Na-K ATPase, SERCA
V-ATPase H+ trpt
F-ATPase
study of ch
patch clamp technique
best –ve feedback mech-temp regulat> osmoregulat
urea tpt
UTA1,2,3,4-kidn
UTAB-RBC
→ →prot synth in ribosome on RER initial folding of polypeptide chain in RER cis end
→ →of Golgi app storage, conc, process, packaging, sorting in Golgi app trans end
→ → →Golgi app secret vesicle in cytosol cell memb exocytosis
exocytosis/cell vomiting/reverse pinocytosis/emeiocytosis
constitutive-continuous(mucus secretion, IgA secretion)
Ca ATP
docking prot
syntaxin(key snare prot)
synaptobrevin
μ snare prot
SNAP-25
endocytosis
constitutive-continuous, no sp signal req(vit uptake)
Ca
ATP clathrin(LDL uptake, ion uptake in GI cell)
caveolin(endoth cell for absorption of nutrition,FA)
dynamin/pinchase
ligand-recept complex in pinocytosis dissociate in endosome d/t acidic pH of vesicle
vesicular tpt(cytopempsis)
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permeability across cell memb
H2O> indole> glycerol= urea> Try> glu> Cl> K> Na
total body H2O(60%)
ICF(40%)
ECF(20%) interstitial fluid(15%)
plasma(5%)
spaces-pleural,pericardium(1.5%)
compartment-indicator
TBW-D2O>tritium oxide, antipyrine, aminopyrine
ECF-inulin(most accurate), sucrose, mannitol, Na thioSO4, Na22, I125 iothalmate
plaSma vol-EvanS blue(T1824), sr albumin label with I125
bld cell vol-Cr51 label RBC
interstitial fl vol=ECF–pl vol ICF=TBW–ECF
bioimpedance spectroscopy
RBF-PAH
GFR-most accurate(inulin), MC(creatinine)
Na-K pump
fn-cell vol regulat>RMP
heterodimer
α(larger)
ECF side-K bind site, ouabain(digitalis) binding site
ICF side-Na binding site, ATP binding site, phosphorylat site(Asp376)↑T3,T4- no.
↑aldosterone- no.,activity
↑insulin- activity
↓ANF,dopamine- activity
hypokalemia
hyperpolarisation
hyperkalemia
↓depolarization, excitat heart stop in diastole
hypercalcemia
Ca-memb stabilising
heart stop in systole
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hypocalcemia
↑excitability
Cl ch(anim,bact)-dimer
epith Na ch-trimer
K ch,aquaporin-tetramerCl ch(human),lig gate ACh ch-pentamer
RBC memb at rest most permeable-Cl
RBC RMP(–10mV) d/t-Na K pump
neuron RMP(–70mV) d/t-K
neuron RMP close to-K
neuron RMP equal to-Cl
organ max hydrostatic press-kidn(46mmHg)
organ with max Kf(ultrafiltration constant)-Kidnmax permeable capillary-liver
CVS
cardiac m(striated,involunt)
↑intercalated disc-Zline- cell adhesion, provide electromech tethering
gap jn-fnal syncytium
sarcotubular system-Zline
voltage sensor-dihydropyridine
Ca source-ECF(maj)+ sarcopl reticulum
↓unphosphorylated phospholamban- SERCA
1T tubule/sarcomere along Z line elasticity-titin
myosin heavy light chain
α,β-fetal heart
α-adult atrium
β-adult ventr
internodal path(AMP-BWT)
Ant-Bachman
Mid-Wenkebach
Post-Thorelbundle of His-gives lt br, continues as rt br
gate cell merge with-Purkinje fibre
ventr AP
RMP=–90mV
0-depolarisat-Na influx
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1-early repolarisat-K efflux
2-plateau-Ca influx
3-late repolarisat-K efflux
4-hyperpolarisat-delayed closure K ch
SAnode AP RMP=–60mV
↓0-depolarisat- K efflux, opening funny ch(Na>K), Ca influx(Ca ch-main)
3-repolarisat-K efflux
4-prepotential phase-delay closure K ch
↑ → ↑ → → ↓ → ↑sympath- Gprot cAMP phosphorylat prot depolar time HR
↓ →↑ →↓ → ↓parasympath-( cAMP depolar time), (open KACh ch in ph4 slope of ph4) HR
→ ↓ → ↓CNX slope of prepotent(pacemaker potential) HR
→Purkinje fibre-prepotent AP
Depolarisat heart(DAN)
→ → → →1st-SA AV atria ventr(1st-lt upper part intervent septum rt), Apex,
eNdocardium
→last-base epicardium
repolarisat
→ventr(1st-base,epicard last-apex,endocard)
part-conduction speed(m/s)
SA node=0.05
AV node=0.05 bundle His=1
Purkinje fibre=4
part-impulse(gen/s)
SA node=80-100
AV node=40-60
Purkinje fibre=15-40
↑+cHRonotropic- HR
↑+Dromotropic- conDuction↑+inoTRopic- conTRactility
↑+bathmotropic- excitability
→adenosine affer arteriole constrict(A1), coronary vasodilatat
vasomotor centre
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nucleus tractus solitarius
cauDalVLM(meD)-Depressor
rostralVLM(lat)-pressor
↓ ↑ stimul-cortex, limbic syst, pain, chemorecept, pO2, pCO2, MAP
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↓TSH-postoperative, a/c illness
↓Wolf Chaikoff effect- organic bind of I2
thyroxin binding prot
freeT3=0.2%, freeT4=0.02%
thy bindin globulin(maj thy h bind prot)
thyroxin binding albumin thyrox bindin prealbumin(transthyretin)
paracrine regulat
factor release by 1cell act on adjac cell
↓pancreat somatostain- insulin secret
autocrine regulat
factor release by a cell act on same
IGF1-chondrocyt,breast epit,gonad cell
↓ANP- HR,BP
sec messenger for GnRH-phospholipaseC
hormesis
dose response phenom
↑ ↓low dose- , high dose-
J/invert U shape
effect of chemotactic peptide on neutrophil adhesion
proopiomelanocortin(285AA)
ACTH,MSH βlipoprot h
γlipoprot h
βendorphin
CLIP(CorticotropLike Intermlobe Peptide)
P metab
↓NaPiIIa-absorpt in PCT- by PTH
NaPiIIb-absorpt in duod,SI
NaPiIIc-absorpt in PCT
GH-early division spermatogenesis
↑-exercise, fasting, stress
↓-REM sleep
↑ →age
↓h-aldosterone, calcitonin, GH, prolactin, renin, E
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↑h-PTH, FSH, LH, NE
—h-cortisol, epinephrine, insulin, T3,T4, testosterone, GLP1)
PTH(84AA polypeptide)
↓ →↑sr Ca++ sr PTH
action↑ -Ca resorp fr bone, Ca reabsorp fr DCT
→ → → → → →liver angiotensinogen(α2globulin) (JGcell renin) angiotensin I (ACE)
→ → → →angiotensin II (aminopeptidase) angiotensin III (angiotensinase) active
fragm
→ → ↑ → ↑aldosterone cytoplasm recept transcription of mRNA in ren tubule synth of
Aldosterone Induced Prot(ATP)/NaK ATPase& βsubunit of amiloride sensitive Na ch
mineralocorticoid recept-DCT, cortical CD, sal gld, colon, brain(hippocamp), myocard, periph vasc
resist, brown adipose ts, sweat gld
↑ ↑- hyperkalemia> angiotensin II> ACTH> hyponatremia
vassopressin recept(GPCR)
V1/1A-Ca,IP3-glycogenolysis(liver), vasoconstrict, PLT aggregat, intest contraction
↑ ↑V2-cAMP- H2O reabs fr CD, release factorVIII& vWF
↑V3/1B-Ca,IP3- ACTH
erythropoietin
synth-peritubular capillary(juxtatubular interstitial cell) in renal cortex(85%)+perivenular hepatocyte liver(15%)
insulin secret
↑ ↑- glucagon, pl glu
↓ ↑- sympath stim, somatostatin, salicylate
GIT
taste
↑bitter-GPCR, intracell Ca(IP3DAG)
salty-amiloride sensit Na ch↑ →sour- intracell H+ close K ch
↑ →sweet-GPCR, cAMP close K ch
umami-Glu recept(MSG, diNaGMP, diNaI MP)
electrical activity of sm m
RMP=–50-–60mV
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basic electric rhyth-d/t oscillat in activity of Na-K pump(variable freq)=5-15mV
max freq-duod(12/min), min freq-caecum(2/min)
enteric NS
intrinsic
MYenteric/Auerbach plex-Motility SubmucoS/MeiSSner plex-Secret, bld Supply
extrinsic
parasymp
sympath
→Migrating MOTor compLex(MOTiLin)-fasting, ring of contract-body of stom dist
ileum, fn-clearing action, occur>2h after last meal, cycle=5cm/min×90min
massive active contraction-colon during defecation
max postprand motility-sigmoid colon> descend colon> transv colon
pacemaker cell of GIT-interstitial cell of Cajal-midportion of stom
pacemaker potential SI-duod Revers peristalsis-Rectum
segmentation/mixing contraction
promote progressive mixing of food particle
duod
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gastrin
↑HCl,delay gastric emptying
CCK
↑ ↑CCK- prod of prot digest
↑ ↓GB contract, pancr enz secret, secretin action, satiety, NTsecretin
↑HCO3 in bile& pancr juice GIP(Glu dep Insulinotropic Peptide)
↑insulin
ghrelin
↑ghrelin-sleep deprive, anorexia
↑ ↑ ↑orexigenic, fat deposition, choice of food, memory, GH
salivary secretion
HCO3, amylase, lingolipase(Ebner gld on tongue dome), lysozyme, kallikriene, K(max
amount) phase-cephalic(MI), oral, gastric
gastric secretion
→ →pepsin, G-lipase, HCl(MI)(bactericidal, pepsinogen pepsin, Fe+++ Fe++)
phase-cephalic,gastric,intest
intest secretion
Paneth/ZYMOgEn-lysOZYME
N-Neurotensin
L-gLucagon
→disaccharidase, di&tripeptidase, enterokinase(trypsinogen trypsin)
colon secretion
K(max conc)
bile salt
amphipathic nature
→emulsificat fat in SI detergent action
bile uptake by hepatocyte-Na dep
absorption stom-weak acid, weak base, salicylate,alcohol
duod-Fe++(max), Ca, Na, Cl, vit, FA, AA, SO4, sugar
jejunum-carb, prot, fat(long chain), alcoh(max), FA(max), Na(max),
H2O(max-5500ml), Ca(max), vitB9(max), Ab
dist ileum-90%bile salt(max), vitB12(max)
colon-5%bile salt, electrolyte, H2O(1000ml), short chain FA(by colonic bact)
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Fe(prox duod)
→ → → →food(ferric Fe+++) absorb(ferrous Fe++) tpt(Fe+++) store(Fe++)
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↑-ACh,neostigmine,SCh,morphine
↓-NO,VIP,atropine
GI peristalsis
↑-ACh,subsP
↓-VIP,NO,ATP
KIDNEY
↑ ↓Angiotens II act on Eff arteriole, (low conc)- GFR, (high conc)- GFR
↓Epinephrine-act on Aff arteriole, GFR
(A attack E, E attack A)
renal handling of diff subst
not filt-prot
freely filt, not reabs, not secret-inulin
freely filt, compl reabs-glu, AA, HCO3(MI buffer, 24mEq/l) freely filt, partl reabs-electrol, urea(52%), H2O(99.5%)
freely filt, compl secret-PAH(low conc)
freely filt, partl secr-PAH(high con), creat
glomerulotubul balance, max H+ secret by-PCT
acidification urine-CD
1st part kidn affect in hypoxia-medulla
GFR max-3rd decade
pacemaker ureter-minor calyces
DCT secrete-NH3
collecting duct
P(Principal) cell-Na reabsorpt, ADH stimulat H2O reabsorpt
I(Intercalated) cell-H+ secret, HCO3– tpt
Ca
99% reabsorb=65%PCT+ 25-30%thick ascend limb Henle loop+ 4-9%DCT,CD
free H2O clearance
urine is hyPOtonic with plasm-POsitive
urin hypertonic with pl-–ve isotonic=0
aquaporin
1-basolat&apical memb PCT, thin desc limb loop Henle
2-lumin memb CD
3-basolat memb CD
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4-basolat memb CD,brain
5-sal,lacrim,resp
9-WBC,liver,lung,spleen
JG apparatus(cortic nephr)
JG cell-tunica med of affer arteriole, secrete renin macula denSa/modif tubular epith cell, beginning of DCT, Sensor for Na&Cl
Lacis/extraglom mesangial cell-take up immune complex in GNephritis
countercurrent mech
muLtipLier-Loop HenLe(create interstit hyperosmolarity-max=1200mosmol/l), driven
by conc of Na
exChange-vasa reCta(maintain medullary hyperosmol)
glu abs in kidn
prox PCT-SGLT2,GLUT2 distal PCT-SGLT1,GLUT1
GLUT1-constitutively express
GLUT2-glu exit
GLUT3-neuron
GLUT4-insulin dep,m,adipose ts
GLUT5-fru
SGLT1-GIT(1Na:2glu)
SGLT2-kidn(1Na:1glu)
SGLT3-kidn(1Na:1glu)
NS
BBB d/t-tight jn b/n endoth cell> astrocyte
CNS-1oligodendrocyte:20axon
PNS-1Schwann cell-b/n 2node Ranvier
AP in spinal motor neuron arise in-init seg(high Na ch per unit area)> axon hillock
AP in sens neuron arise in-init node of Ranvier(max Na ch per unit area)
AP
cathode ray oscilloscope-patch clamp techn RMP=–70mV
firing level=–55mV
depolar-Na influx
overshoot=+30mV(close to equilibrium potential Na)
↓ ↑repolar- Na permeability, delay K permeab(K efflux)
↓afterdepolar-slight K effux rate
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hyperpolar=–71-–72mV
cell with K efflux depolar-haircell cochlea
cell with Ca efflux depol-heart(SA node)
Na-2gate(M-activat, H-deactivat), 3possible state
K-1gate(M)
demyelinat upto 3node Ranvier-stop AP propagation in n
refractory period
→ ⅓absolute-depolarisat repolarisat
⅓ →relative- repolarisat start of afterdepolarisation
fastest velocity
n-low Ra(resist), high Rm(memb resist), low Cap
node Ranvier-low Rm, high cap
→rheobase-min strength current response→utilisation time-time taken by rheobase response
→chronaxie=time 2×rheobase response
lesser chronaxie-more excitable ts
n
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IV(C)-slow pain, touch, press
myelinated-conduct vel=6×diam
unmyelinated-CV=√diam
fastest conduct-propriocept
suscept to(PHir Laya ABC BABa)
Press-A>B>C
Hypox-B>A>C
Local anaes-C>B>A
order of block-aut> sens[temp(cold> hot)> pain> touch> press> propriocept)> motor]
order of recovery-motor> sens> autonomic
reflex
asynaptic
axon reflex → blunt inj(Lewis triple response) red rxn (hist)+ FLare(axon reFLex)+ wheal(hist+
bradykinin)
monosynaptic
DTR
↑ stimul- m LEngth
recept-m spindLE
affer-IA,II
centre-spinal cord
effer-Aα
response-m contract, maintain m tone
no. of synapse=1 bisynaptic
inverse sTrEtch reflex
↑ stimul- m TENsion
recept-Golgi TENd org(1GTO/13-15m fibre)
affer-Iβ
centre-spinal cord
effer-Aα
response-m relaxat
no. of synapse=2
m spindle
intrafusal m fibre(Aγ)
nuclear bag(1-3)
dyNamic-aNNular spiral ending(IA)
Static-flower Spray ending(IA,II)
nuclear chain(4-5)
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static(IA,II)
extrafusal fibre(Aα-contraction)
axonotmesis-motor march
degeneration& regeneration of n Wallerian degeneration(CAM)-change in distal stump+ prox stump upto 1node of R
24-48h-Chromatolysis(n cell body swell, Nissle granule disapp)
upto3d-distal stump carries AP
3-6d-Axonal degenerat distal stump
6-10d-Myelin degenerat
10d-oil droplet in empty tube
15d-repair start-sprouting fr prox tube, Schwann cell proliferat
80d-repair completed(80% diam)
axoplasmic tpt Ca
ATP
microtubule(α&βtubulin)
molecular motor-kinesin, dyenin, myo V
fast(kinesin)
→ Antegrade(400mm/d) Assembl(+) end
→ retrograde(200mm/d) disassembl(–) end-rabies virus(3mm/h), TT, nGF
slow(dyenin-antegrade)
0.5-10mm/d
microfilament
neurofilament-maintain diam of axon
receptor-sensation
Rapidly adapting(RMP)
Meissner corpuscle-fine touch, low freq vibration(80Hz)
PaciniaN corpuscle-vibratioN
Slowly adapting(SMR)
Merkel disc-crude touch, pressure, texture, fine touch
Ruffini end organ-crude touch, sustain pressure, jt position
other free n ending-touch, pain, pressure
hair end organ-movem of object on body
Krause end bulb-cold
thermal receptor
Aδ&C-cold, C-warmth
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10°C—24°C(max activat)—40°C
overlap-30-40°C
response to cold
→ ↑ →environm temp
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I-ACh
II-amine-hist, epinephrine, D, NE, 5HT
III-AA-Glu, GABA, Gly
IV-small molecule-NO, adenosine
transmission in sympath ganglia fast EPSP-ACh(ms)
slow EPSP-AChM1(s)
slow IPSP-AChM2(s)
late slow EPSP-GnRH(min)
sweat gld secret-sweat+VIP
NM ds
presynaptic-tetanospasmin, botulinum toxin, Lambert Eaton synd
postsynaptic-myasth gravis, strychnine
decortication
damage to corticoretic tract-mod rigidity
decerebration
damage to corticoretic& basal ganglia tract-severe rigidity
sk m(striate,voluntary)
contractile prot
AcTin(polymer of f-actin, 2strand in double helix, ATPase activit)
myosin II
regulating prot tropomyosin(1molecule cover 1active site on actin)
troponin(I-actIn, T-Tropomyosin, C-Ca)
struct prot
actinin(bind actin to Z-line)
titin(largest prot, 3million Dalton, attach Z-line to M-line, elasticity to m)
desmin(attach Z-line to plasma memb)
sarcolemmal prot
→ laminin(EC matrix, attach αdystroglycan)
→ αdystroglycan(connect laminin βdystroglycan)
Bet dystroglycan(within memB)→ syntropin(attach βdystroglycan on inner side memb)
→ dystrophin-(connect syntropin actin) Duchenne(absent)-Becker(less) m dystrophy
sarcoglycan(outer side cell memb)-limb girdle dystrophy
perlecan(EC matrix, endoth cell)
sarcospan(within memb)
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2T tubule/sarcomere(at jn of I&A band)
DHPR(T tubule), RYR(L tubule)
1thick filam surround by-6thin filam
1thin filam surround by-3thick filam
thin:thick=2:1
1thick filam=500myosin molecule 1thin filam=7actin+3troponin+1tropomyosin
Sarcomere-Struct unit m
motor unit-fnal unit m
sarcotubular syst-AI jn
voltage sensor-voltage gated Ca ch
Ca source-sarcopl reticulum
H(Hexagon) zone-only myosin
pseudoH zone-reversal of polarity of myosin head(no myosin head)
A(Anisotropic,dArk) band-myosin+over lapping actin I(Isotropic,lIght) band-actIn
Z line-b/n 2sarcomere, centre of I band
M(Myomesin) line-centre of A band
sarcomere=½I+A+½I
during contract
↓ I-
↓ H-
A-no change
Z lines-come closer
M line-more prominent
CM(Contraction M) band-at 1.5μ CZ(Contract Z) band-at 1.25μ
walk along theory-1ATP-1cycle
Huxley sliding filament/Rachet/walk along theory
→ → →cross bridge power stroke ATP hydrolysis recocking
type1 m(SOR1)
Small,Slow
Oxidative metab
Red longer twitch
more mitoch
more Mb
slow sustain contract
delay fatiguability
standing-ATP store=7-8s
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type2a m
mod oxidat metab
mod glycolysis
walking
type2b m
fast fatiguable running
energy supply
100m-85% glycolysis
2mile-20% glycolysis
marathon-5% glycolysis
at optimum lth sarcomere-max overlap b/n actin&myosin, max no.actin-myosin
cross bridge, max tension
slow twitch motor unit
recruit 1st,100-500m fibre, innervat by αmotor neuronfast motor unit
1000-2000m fibre, αmotor neuron
sm m(unstriate, involuntary)
prot-actin, myosin, tropomyosin(relation prot), calmodulin(Ca binding prot), no
troponin
sinGle unit(Gap jn+)-GIT
multiunit(gap jn–)-iris, ciliary body
contract of sm m
→ → ↑ →Ca influx Ca calmodulin complex myosin light chain kinase phosphorylation
→ ↑ →myosin head myosin ATPase actin-myosin cross bridge format(latch mech)relaxat
phosphatase/dephosphorylase enzyme
thin:thick=15:1
no Z line,dense bodies
ascend tract
post column(fine touch, vibrat, conscious propriocept, 2pt discriminat, localisat,
stereognosis, ability to judge ° of press)
fasciculus Cuneatus(tract of BurdaCh)-UL
fasciculus Gracilis(tract of Gall)-LL→ 1st order-DRG(recept i/l medulla)
→ 2nd order-i/l medulla c/l thalamus(VPL)
→ 3rd order-c/l thalamus c/l postcentral gyrus(BA-3,2,1)
sensory homunculus(grotesque figure of Penfield& Rasmussen)-max-lip,
min-genitalia
ant spinothalamic tract(crude touch, itch, tickle, sexual, detection of press)
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lat spinothalamic(pain, temp)
→ 1st order-DRG(recep i/l dorsal horn)
→ 2nd order-i/l dors horn c/l thal(VPL)
→ 3rd order-c/l thalam c/l cortex
spinocerebellar(unconscious proprioception)
dorsal(uncross) ventral(cross)
internal arcuate fibre medulla-internal arcuate fibre
Fast pain
sharp/prick/stab, epicritic, good, Aδ fibre, mech/therm stimulus, NT-Glu, lat
spinothalamic tract(lamina Five substantia gelatinosa)
slow pain
dull/diffuse/aching/burning, protopathic, bad, autonomic sympath, C fibre, ischem,
NT-substance P, tract goes to reticular formation(sleep wake cycle), periaqueduct
grey, periventr hypothal(ANS) terminate in thalamus(lamina II of substantiagelatinosa of Rolando)
endogen pain inh
endogenous opioid(enkephalin, endorphin)-at site of stimulus, dorsal horn, rostral
site
gate control theory of Melzac& Wall-large diam Aβ inh C fibre
descend pain inh pathw-periaqueduct grey, raphe magnus(5HT), enkephalin
thalamus
sens relay nuclei
non-specific midline
intralaminar
→ ant thal nuclei-Papez circuit-emotion, learning, short long term memory
conversion
specific
VPL-somatic sensation
VPM-taste
LGB-visual sens
MGB-audit sens
ventroant, ventrolat-proc msg fr basal ganglia& cerebellum
Papez circuit
→ →med temp lobe/hippocampus mammillary body of hypothalamus
→ → →(mammilothalamic tr) ant thalam nucl basal forebrain (amygdala/limbic
syst-window ),(neocortex-stored)
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descending tract
med,axial m,tone&posture
ant corticospinal
tectospinal
vestibulospinal
reticulospinal ponS(Stim)
medulla(inh)
lat,dist m,fine skill movem
lat corticospinal(pyramidal)
rubrospinal/alternat pathw
hypothalamus(TRβ2 recept)
response to cOld-pOst
response to heAt-Ant
osmoreceptor-ant hunger-lat
↑thirst( 10mosmol/l)-lat(preoptic nucl)
rage-lat
satiety-ventromed(cocaine amphet regulated transcript)
reward-med forebrain bundle, nucleus accumbens(drug addict-D3), ventromed
self stimul-med forebrain bundle
agGREssive resp-periaqueductal GREy
Punishment-Periaqueductal grey
Circadian rhythm-supraChiasmatic
sleep-preoptic
sexual-Antmost(mAl)& postmost(fem) portion
brain area involving self stimulation
ventral tegmentum
med forebrain bundle
nucleus accumbens(D3)
frontal cortex
cerebellum(3part, 4nuclei, 5cell)
→lat med-DEGF
neo/cerebrocerebellum-Dentate nucleus(largest), motor planning palaeo/spinocerebellum-Emboliform(dist m)& Globosus nucl
archae/vestibulocerebellum-Fastigius nucl(oldest), floculonodular lobe-postural
balance
cell(GBSPG)
Granular(E)
basket(I)
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stellate(I)
purkinje(I)
golgi(I)
afferent fibre
→ → inf oLIvary nucl (cLImbing fibre) +Purkinje cell
→ → → → other affer input (Mossy fibre) +granular cell (parallel fibre) Purkinje cell greatest populat of neuron-cerebellum
silent area of brain-cerebellum(does not show evoke potential)
fnal unit-Purkinje cell, deep nuclei
vermis-maintain stand& walking posture
feed forward inh-basket, Purkinje cell
connection/tract of cerebellum(RO DEV MainCabSeThaVaha IC SauDinRaha)
afferent(cerebell peduncl)
inf-Reticulocerebellar, Olivocerebellar, Dorsal spinocerebellar, Ext arcuate fibr,
Vestibulocerebellar Middl-Cerebropontocerebellar
Sup-Tectocerebellar, Ventr spinocerebellar
Efferent(cerebell peduncle)
Inf-Cerebellovestibular
Sup-Dentatorubrothalamocortical, Reticulospinal
Brodman area-fn
3,1,2(somat sensor, postcentral gyrus)-gen conscious, touch, pain, temp
4(prim motor)-initiat of movem
6,8(premotor)-fineness movem, volunt eye movem
7(visuosensory, postcalcarine sulcus, occipit lobe)-visual sensepercept-homonymous hemianopia+ macular sparing
9,10,11,12(prefrontal)-intelligence, memory, ego, self respect, social behav,
personality
18,19(visuopsychic, parastriate, occipit lobe)-correlation of visual impulse with past
memory
22(Wernicke-sup temp gyrus)-audit agnosia/word deaf
41,42(prim auditary-lt temp lobe)-process semantic in speech& vision
44,45(Brocca-inf frontal gyrus)
brain fibre-connection association-different cortic area in same hemisphere
commissural-correspond area in 2cerebral hemisphere
projection-cerebral cortex with lower level
basal ganglia(CPPG)
1)Caudate nucleus
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2)Putamen
3)Globus pallidus/pallidum
internum
externum
4)substantia nigra
pars compacta pars reticulata
5)subthalamic nucl/body of Luy(excitat, glutamate)
striatum=1+2
lentiform nucleus=2+3
amygdala nucleus-med temp lobe
nucleus tractus solitarius(medulla)
NT-Glu, ACh, GABA, opioid
GVA → tonsil, pharynx, post tongue, carotid body& sinus CNIX
→ pharynx, larynx, trach, esoph, thorac&abd viscera CNX
SVA
⅔ → ant tongue CNVII
⅓ → post tongue CNIX
→ postmost tongue, epiglottis CNX
integrat centre-postural reflex
spinal cord-m tone,+ve supporting rxn, crossed extensor reflex
medulla-tonic labyrinthine reflex, tonic neck reflex
midbrain-righting reflex cerebral cortex-hopping& placing rxn, long loop stretch reflex
Little Albert study-conditional stimulus to produce conditional reflex
↑nGF- ANS neuron growth
BBB
substance cross-H2O, CO2, O2, lipid soluble subst, free steroid h, glu(GLUT1)
cant cross-prot, polypeptide, prot bound steroid h, H+, HCO3
after spinal shock wears off
1st reflex-bulbocavernous( flexor withdrawal> stretch reflex
CSF absorpt
↑->112mmH2O
↓-
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no-
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sO2—pO2
95-97
90-60
75-40
+ve cooperativity(DOTR)
→ DeoxyHb OxyHb→ Tense Relax
Hill coeff
n=1-no cooperativity
n>1-+ve cooperat
noxyHb
↓Hb affinity for CO- by HisE7
diffusion capacity of O2
↑-exercise, pulm hge, asthma, CHF
↓ ↑-ILD, sarcoid, berylium poisoni, secret of PDGF by alveolar epith
hypoxia
→pulm arteriole-activat K ch vasoconstrict
syst arteriole-vasodilat
zone
standing
II-Pa>Palv>Pv(waterfall zone)
III-Pa>Pv>Palv
recumbent-zoneIII
matching of ventilat perfusion lung-lat decubitus, awake, close chest
resp centr
medulla pacemaker-preBottzinger complex-generate resp rhythm
DRG(nucl tract solitarius)-I-quiet resp
sect at lower medulla-apnoea
↑ VRG(nucl ambiguous&retroambiguous )-I&E- requirem
sect at upp medull-norm resp+ irregular rhythm+ gasping
pons
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↓ Pneumotaxic(nucl Parabrachialis, upper pons)- depth of insp
↑ midsectio(bel pnemotax)- depth,slow
↑ apneustic(lower pons)- depth of insp
↓ CNX- depth of insp
strong vagal stim-apnoea
↑ b/l vagotomy- depth,slow midsection+b/l vagotomy-apneusis
resp chemorecept
periph
↓ ↑ pO2(MI,satO2
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Rx-treatment SCC-squamous cell carcinoma, sr-serum, Sx-surgery, sz-seizure tm-tumour, ts-tissue UL-upper limb, u/l-unilateral vag-vagina, VC-vocal cord, vel-velocity, vert-vertebra, vit-vitamin, vol-volume w-week, wt-weight
Xr-X ray y-year #-fracture °-degree
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