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Sensory deficits depend on the site of lesion, type of disease process and the severity of the disease. The steps are same as those of mouth-to-mouth respiration except that the mouth of the patient is closed and the rescuer breathes into the nostrils of the subject. Prostate gland enlarges and secretion increases from prostate and bulbourethral gland. They produce chemicals that help in formation of short chain fatty acids, which help in growth of the intestinal mucosa. Changes in the Luteal Phase (Secretory Phase) Ovarian Changes Luteal phase starts after ovulation. In last few weeks of pregnancy, due to increased level of estrogen, uterine muscle cells synthesize more connexin, the protein that form gap junctions. Calcium Channel Blockers Calcium channel blockers like verapamil (a phenyl alkylamine derivative) and diltiazem (a benzothiazepine) inhibit calcium entry into the cells by interacting with spe cific binding sites on the 1subunit of the L-type of voltage-dependent calcium channel. However, diagnosing diseases in the initial stage 902 Section 10: Respiratory System. The phase of rapid ejection is differentiated from the phase of reduced ejection by two important features: i. Ovarian factors: Anovulation (absence of release of ovum from the ovary) causes infertility. It should be noted that when a phrenic nerve is damaged, the portion of diaphragm of that side moves up rather than coming down during inspiration. However, some actions of steroid hormones manifest more rapidly than the transcription process. Physiological Effects Effects on Milk Synthesis and Secretion the primary function of prolactin is to stimulate milk synthesis and secretion (therefore, the name prolactin). Individual muscles are affected depending on the mus cles supplied by that particular nerve. Release Inhibiting Hormones Growth Hormone Inhibiting Hormone (Somatostatin) Somatostatin is a peptide having 14 amino acids. Changes in Sperm in Female Genital Tract Sperms undergo changes in the female genital tract that make them able to fertilize the egg. Dopamine is usually preferred in cardiogenic shock, as it maintain renal perfusion. In this control system, increase in hormone concentration in plasma stimulates further secretion of that hormone so that the hormone concentration increases steadily to reach a peak plasma level: 1. Scientist contributed Antonio Mario Valsalva (1667-1723), an early Italian anatomist and physiologist who had his research focused on the anatomy of the ears and ear functions. Structure and functions of pancreatic acini, Amount of pancreatic secretion/day, Composition pancreatic juice and function of each constituent pancreatic secretion, Name pancreatic enzymes and tell their functions, Mechanism of gastric secretion, What are the Phases of pancreatic secretions and how are they regulated, What are the stimuli for different phases of pancreatic secretion, What are the effects of parasympathetic and sympathetic stimulation on pancreatic secretion, Classify pancreatic function tests, Procedure and normal values of important pancreatic function tests, Causes of acute and chronic pancreatitis, What is cystic fibrosis and which ion channel is defective in this disease. Thoracoabdominal Breathing this is predominant in females and children, as in them the movement of the chest wall is prominent during res piration. Postsynaptic density is the cluster of receptors for transmitter embedded within the postsynaptic membrane. However, isolated hypoaldosteronism with normal cortisol production occurs in following conditions: 1. Classification of hormones, Pathways of hormone synthesis, Types of feedback control of hormone secretion, Negative feedback mechanism of hormone control, Hormone signaling mechanisms, Intercellular communications, Types of hormone actions, are usual Short Questions in exams. Release of oocyte (ovulation) at the end of proliferative phase of the menstrual cycle. In spatial summation, instead of repeated stimulation by the same input, two or more separate inputs arrive simultaneously at the postsynaptic membrane. However, there are few tissues like brain (only the neural tissue of the brain) that are devoid of nociceptors. The function of the arterial system is to deliver oxygenated blood from lungs and nutrients from intestine to the tissues.

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Guanylin Structure and Source this is a polypeptide hormone containing 15 amino acids. Significance of Rapidly Adapting Receptors Rapidly adapting receptors play important role in detecting pathological processes that involve irritation, congestion and inflammation of airways. Angiotensin receptor antagonists: Angiotensin antagonist such as losartan prevents the action of angiotensin on blood vessel. The fundamental mechanisms involved in attaining this goal are ventilation, diffusion and perfusion. Diuretics Thiazide diuretics are frequently used in the treatment of hypertension. When the hormone to be measured is a peptide, the molecule is commonly labeled with a radioactive iodine atom (125I or 131I) that can be easily attached to the tyrosine residue of peptide chain, and if the hor mone is a steroid (that lack tyrosine residue), labeling is done by radioactive carbon (14C) or hydrogen (3H). These enzymes hydrolyze the peptides produced by pancreatic proteases into oligopeptides and amino acids. Name the sympathetic ganglia and give the segmental distribution of sympathetic fibers to various visceral organs. Neurons of sympathetic and parasympathetic systems are affected in metabolic diseases. The other cortical motor areas include premotor cortex (lateral part of area 6), supplementary motor area (medial part of area 6), primary somatosensory cortex (area 3, 1, and 2) and parietal cortex (area 5 and 7). Age and Initiating Stimulus Age of Onset of Puberty the age of onset of puberty varies depending on various factors like socioeconomic and environmental conditions and genetic constitutions. The disease is characterized by narrow pupil with no reaction to light due to interruption of light reflex pathway which is as follows: Chapter 33: Control of Autonomic Functions and Applied Aspects 311 for which part of the colon proximal to it presents huge dilation with stagnant fecal matter. A spinal animal is the animal (usually performed in a cat) in which influence of brain on spinal cord is removed by making a section below the medulla. Note, work of breathing is increased in both restrictive and obstructive disorders though the pattern of change in energy spent is different in both conditions. Bilirubin bound to albumin (albumin-bilirubin complex) is not excreted in urine, as albumin molecule is large enough not to get filtered in renal glomeruli. Direct Methods the blood pressure is measured directly by placing a can nula in the artery and connecting the cannula to a mercury manometer or a pressure transducer. The axons arise from these cell bodies and descend down to terminate on the capillary bed in the poste rior pituitary. However, capillaries do constrict directly due to the presence of pericytes and few myosin like filaments in their walls. Sympathetic stimulation to sweat glands causes secretion of a watery fluid, and evaporation of body heat. This division results in production of two structures: one is the daughter cell, called secondary oocyte containing 23 chromosomes, and the other is the first polar body. Conduction is Rapid in Ventricles the impulse spreads rapidly into the ventricular mus cles via HisPurkinje system (the His bundle, the bundle branches and the Purkinje fibers). Radiation (Conduction): From the site of maximum intensity, auscultation is performed in different directions to detect whether the murmur is localized or conducted to other parts. He discovered chondrin and glutin, studied digestion and recognized cellular characteristics. Chapter 57: Thyroid Gland 489 General Effects on Basal Metabolism the metabolism of a cell depends on the rate of its oxy gen consumption. Chyme results from grinding of food into smaller particles and mixing of food with gastric secretion. However, along with increased secretion of adrenal androgens, other adrenocortical hormones are secreted in larger quantity. They receive unusually high blood flow, which is highest in the body per unit-weight of the tissue. However, few nonspeci fic proteins are also involved in the process of hormone transport. A high concentration of androgen in luminal fluid is essential for production and maturation of spermatozoa. Tubular exchange of water and electrolytes finally determines the volume and composition of urine. In skeletal muscle: Ischemia, necrosis, hemorrhage, injection of irritating solution and injury of the connective tissue sheath.

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After the publication of our Textbook and Practical Book of Physiology, the students and teachers in Physiology across the globe have been requesting to write a comprehensive book in Physiology that can offer a holistic concept of functions, integration, dysfunctions of body systems, and physiological basis of management and prevention of diseases. Acute O2 Toxicity Gases are inhaled under high pressure to maintain chest and abdominal expansion during deep sea diving. The pulmonary blood vessels with blood in them constitute about 40% of the total weight of the lungs. These supramedullary centers are not important for regulation of cardiovascular functions under normal conditions. This is because cortisol suppresses immunity and spreads infection (person may die due to severe infection). For example, during vigor ous exercise cardiac output increases enormously that increases blood flow and pressure in pulmonary circu lation. Secondary Hyperparathyroidism Secondary hyperparathyroidism occurs in chronic renal disease and rickets. Similarly, many hormones have multiple actions on seve ral other tissues simultaneously. Factors Affecting Peripheral Resistance Peripheral resistance is determined by two main factors: Caliber of blood vessel and viscosity of blood. He had pioneered in the study of functions hypothalamus, pituitary and the hypothalamo-pituitary-adrenocortical axis. Lateral pressure is the side pressure that is exerted constantly on the wall of the tube. Though visceral, metabolic cells of ovary and Sertoli due of testis to synthesize and secretethat are mainly produces in liver. In adults, this reflex does not operate unless tidal volume is much greater than the normal inspiration. Spinal reflexes produce immediate change in motor output that leads to rapid responses. Moreover, the effect of norepine phrine is mediated by adenylyl-cyclase system, which takes longer time to exert its effect. When a substance is removed in urine, a certain volume of plasma is cleared (freed) of that substance. In severe cases, surgical weakening of the sphincter by myotomy (incision of the esophageal muscle) is per formed. In examinations, "Describe the mechanism and significance of intestinal motitlites" may come as a Long Question. Note atria wall is thinnest (2 mm), right ventricular wall is medium thick (5 mm), left ventricular wall is thickest (10 mm). Understand the role of various components of neuraxis in regulation of posture and movement. The primary aim of all these changes is to divert blood from splanchnic and cutaneous circulation to the exercising (active) muscles, while maintaining the cerebral and coronary blood flow. Transport of Amine and Peptide Hormones Amino acidderived and peptide hormones readily dissolve in the plasma and do not require special mechanism for their transport. Sympathetic Vasoconstrictor System Noradrenergic fibers supplying blood vessels are vasoconstrictor in nature. Treatment the treatment is by administration of calcium or vitamin D tablets, or in worst case estrogen therapy. It enhances intermolecular coupling (coupling reac tion), and thyroglobulin synthesis and secretion into the colloid. The point of appearance of the oscillation gives systolic pressure and the point of disappearance of the oscillations gives diastolic pressure. Chronic lung disease (rare) the common mechanisms of cardiac arrest or cessation of heart functions are cardiac asystole and ventricular fibrillation.

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The physiologic significance of hiccup is not known, though it occurs during fetal life and postnatal life. However, this does not happen as surface tension is constant per unit surface area. Triplegia occurs most often as a transitional condition in the development of or partial recovery from tetraplegia. Other examples are oxytocin secretion during parturi tion, release of oxytocin during breastfeeding and release of melatonin in response to darkness. Dietary Modification As salt accumulation causes water retention and increases blood volume, restriction of salt in the diet decreases blood pressure in hypertensive patients. Pubertal maturation of testes in males and ovaries in females fail to occur (hypogonadotropic hypogonadism). The visual defects are due to the effect of the pituitary tumor that enlarges the sella turcica and compresses on optic chiasma. Stage of Shock As soon as the section is made, animal enters into the stage of shock (spinal shock). The highly acidic chyme directly inhibits gastrin secre tion from G cells, and stimulates somatostatin secre tion from D cells of stomach. Such an innervation that ensures activation of a set of motor neuron and inhibition of another set of motor neuron is called reciprocal innervation, and the inhibition of antagonist muscle is called reciprocal inhibition. Thus, cerebellum plays a critical role in motor control by integrating sensory and motor information in the brain. The process of phosphorylation-dephosphorylation of cellular proteins is important in control of some ligand signaling pathway, which is referred to as phosphate timer. Physiological Primary Amenorrhea Amenorrhea occurs in many physiological conditions. Now a days, implantation of electronic pacemaker is the usual treatment of complete heart block. The cardiovascular changes include profound bradycardia and hypotension induced by vagal stimulation and withdrawal of resting sympathetic vasoconstrictor tone. Pseudohermaphroditisms A pseudohermaphrodite is an individual with genetic constitution and gonad of one sex, but the external genitalia of the other sex. Diffusing capacity not only depends on the diffusion properties of the alveolocapillary membrane, but also on hematocrit and capillary blood volume. Antral granulosa cells: Granulosa cells lining the antral cavity are called antral granulosa cells (Discus proligerous). As described above, the receptors are slowly adapting stretch receptors in lung parenchyma and airways and afferent and efferent pathways are vagus nerve. In chronic case, the dead infarcted tissue forms scar tissue and becomes electrically silent. Sympathetic stimulation increases heart rate, conduction velocity, myocardial contractility and cardiac output. Muscles of upper respiratory tract: Contraction of alae nasi, levator palati, cheek muscles and other Chapter 104: Mechanics of Breathing 889 1. Na+, K+, and Cl- are cotransported out of the thick segments of the ascending limb. Thus, transmission of impulse in the pain pathway in the dorsal horn is inhibited. Note that the preganglionic axons (in addition to synapse with postganglionic neurons in the paravertebral ganglion at the same level) ascend or descend to the several spinal segments and then synapse with the postganglionic neuron. The middle and inferior cervical ganglia innervate structures in the chest, including the trachea, esophagus, heart and lungs. Capacitation When spermatozoa are ejaculated into the female genital tract, they undergo further maturation called capacitation.

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Easy post processing of the spectrum with an auto matic calculation of low and highfrequency power components with easy identification of the central fre quency of each components. Following ovulation, due to progesterone effect, the mucous become thick and fern pattern is not observed in smear of the mucous. By acting on bone and intestine, it increases phosphate influx but this is counter balanced by its action on kidney where it increases phosphate efflux. Interestingly, deoxycorticosterone (another mineralocorticoid) secretion remains high. As we know that when the cardiac dipole is perpendicular to a particular lead, the net deflection of that lead is zero. The sarcoplasmic reticulum is present in close association with T tubular system forming a diad that contains one T tubule and one cistern. Thus a battery of liver function tests is employed for accurate diagnosis, to access the severity of damage, to judge prognosis and to evaluate therapy. Vitamin D Deficiency (Rickets and Osteomalacia) Deficiency of vitamin D causes rickets in children and osteomalacia in adults. The secretion of large intestine is not considered so important physiologically as it does not help in digestion. Visceral afferent fibers of the nerve supply of sphincter papillae and ciliary muscles. Sympathetic stimulation diverts blood from the splenic circulation to the hepatic or systemic circulation. The pressure on the hair distorts and stimulates the associated afferent endings in the hair follicle. In contrast, a subject with deep and slow breathing will have adequate alveolar ventilation though the minute ventilation does not change much. Pontine Reticulospinal Tract Origin Pontine reticulospinal tract originates from nucleus reti cularis pontis oralis and nucleus reticularis pontis caudalis located in the pontine reticular formation. Barry J Marshall (Born 1951) J Robin Warren (Born 1937) the Nobel Prize in Physiology or Medicine 2005 was awarded jointly to two Australian physicians Barry J. Serotonin is also a circulating chemical secreted by many cells (enterochromaffin cells, platelets, basophils, etc. In parasympathetic system (craniosacral outflow), preganglionic fibers are very long as ganglions are located close to the organs. This happens as some alveoli due to 908 Section 10: Respiratory System various reasons have little or no blood supply. Changes in Blood Volume There is rapid and significant increase in total blood volume in pregnancy. In sympathetic system, preganglionic neurons are shorter than postganglionic neurons. As a result, circulating blood volume increases and blood pressure returns to normal. In fetus, the cardiovascular regulatory mechanisms operate mainly by the local factors. Second Order of Neurons They are either located in the spinal cord or in the brainstem. Gastric empty ing occurs by three mechanisms: peristaltic contraction, antral contraction, and retropulsion. For example, a bruit is auscultated over an arterial constriction, or a murmur is heard over a stenotic cardiac valve. It occurs usually due to panhypopituitarism that causes failure of maturation of gonads. Pyloric glands: Present in the pyloricantral region and consist mainly of mucous neck cells that secrete mucous and G cells that secrete gastrin. Thus, at the base of the lung, there is a larger change in volume for the same pressure change, which ensures greater expansibility.

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Hence, ideally, births of male and female children should have been in equal proportion. They are mainly involved in the control of functions of various organ systems, hemostasis, and metabolisms and play an important role in inflammation. As hypothalamo-pituitary axis is subjected to various influences, menstrual cycle can easily be affected by stress and psychosocial and environmental factors. Therefore, feeding (hyperglycemia) increases and fasting (hypoglycemia) decreases insulin synthesis and secretion. Digitalis acts by inhibiting sodium potassium pump activity on the myocardial cells. Vibrations set up due to this rapid inrush of blood into the ventricle produces third heart sound, which is recorded in the early part of this phase in the phonocardiogram. Factors Affecting Pulmonary Blood Flow Factors that affect pulmonary blood flow are: 1. Neurotransmitter substances are also released from neurons supplying a muscle or a gland. It can be measured by measuring the concentration of the substance in urine and the plasma concentration of the substance. The fibers carrying the sensation of crude touch are placed anteriorly and therefore called anterior or ventral spinothalamic tract. Extensor muscles are the most important components of posture regulating system as they maintain erect posture of the body by keeping the limbs extended. Blood Supply Thyroid gland has rich blood supply, which is maximal among all endocrine organs. Examples are glucagon stimulating insulin secretion, angiotensin stimulating aldosterone secretion, somatosta tin inhibiting growth hormone secretion and so on. Modification of Bile in Gallbladder Bile is continuously synthesized and secreted from liver and is stored in the gallbladder. However, activities originating in the sensory pathways also indirectly influence motor neuron discharge by activating the descending influences. Venous admixture occurs either due to a shunt or to a low ventilationperfusion ratio. As hormones act on different body systems for differ ent actions, some of the actions are complementary and some are antagonistic. Thickness of alveolar-capillary membrane: the thickness of alveolar-capillary membrane is normally 0. Changes in Blastocyst Enlargement of blastocyst (before implantation) results in rupture of zona pellucida. They also control growth and development and all aspects of metabolism (Flowchart 55. Permeability of epithelium of proximal tubule to water is extremely high, due to the presence of aquaporin1 in the cell membranes. From posterior wall of the abdomen testis first descends into the inguinal region and then from there into the scrotum. Renal Control of Calcium and Phosphate Reabsorption of calcium and phosphate from kidney contributes significantly to their plasma concentration. The secretion of adrenal androgen increases at puberty, reaches peak at about 20 years of age and then declines slowly to reach a low level in old age. According to electrochemical properties and ability to sustain exercise, muscles are classified into fast twitch-fatigue resistant, slow twitch-fatigue resistant, fast twitch-fatigable and slow twitch-fatigable types. Understand the importance of trigeminal system in learning physiology of pain and analgesia. Uterine muscular movements and ciliary activity may aid in migration of sperms within the uterus. Therefore, hypothalamus is the main neural structure for the inte gration of visceral homeostatic mechanisms.

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Sertoli cells synthesize transferrin, an iron-transport protein that helps in development of sperms. Autonomic nervous system and peripheral nerves are also involved in the disease process. The mucous membrane of stomach is thick and thrown into large folds, called gastric rugae. This occurs due to decreased gradient of potassium ion concentration (though they still produce action potentials). They are located at the bifurcations of the common carotid arteries near the base of the skull on both sides. During expiration, relaxation of diaphragm brings back its dome shape and decreases thoracic cage capacity. High Output vs Low Output Failure In high output failure, heart pumps abnormally large quantities of blood to deliver adequate oxygen to the tissues. Neurophysiological evidences indicate that motor neuron excitability is depressed after spinal transection. This means, irrespective of the site of application of the stimulus in the sensory pathway, the sensation evoked is felt at the nerve endings (the receptors). Oncotic pressure at the afferent arteriolar end is 20 mm Hg and at the efferent arteriolar end is 35 mm Hg. Recently it has been discovered that the chemosensitive neurons are also located in or around the other brain-stem nuclei such as nucleus tractus solitarius, nucleus ambiguous, nucleus ceruleus and hypothalamus. Hypothalamus, via its endocrine influences also controls thirst, appetite, energy store, body fat composition, immu nity, behavior and visceral functions. As the pulmonary vascular resistance is very high (because fetal lungs are collapsed), only a small quan tity of blood reaches left atrium through the pulmo nary veins. The fibers cross over to the oppo site side only at the spinal cord segments through their termination on the interneurons. Stroke Volume Stoke volume increases by about 30%, which peaks at about 24 weeks of pregnancy. Features of Autonomic Dysfunctions Autonomic dysfunctions manifest as multiple organ dysfunc tions as autonomic nerves innervate many visceral organs. It inhibits absorption of glucose, and triglycerides from the mucosal epithelial cells of intestine. Usually, hypoxia occurs in tissue poisoning as produced by cyanides or similar poisons. A component of pertussis toxin decreases adenylyl cyclase activity by activating inhibitory G protein. Therefore, cortisol should not be prescribed in acute infections like pneumonia, cholecystitis, pancreatitis, active tuberculosis etc. Chapter 48: Gastric Motility 405 Gastroduodenal Junction the junction between the stomach and duodenum is called gastroduodenal junction. Examples of monoplegia are crural (leg) monoplegia that occurs due to trauma, myelitis, discprolapse or tumor of thora columbar segments of the spinal cord or brachial (arm) Physiological Basis 1. Therefore, autonomic dysfunctions are common in metabolic diseases such as diabetes, obesity, hypertension, hyperlipidemia, hyper and hypothyroidism, etc. Topographical Organization There is a topographical organization of motoneurons in the spinal cord with regard to the target muscles they innervate. A close relationship exists between the coronary blood flow and the oxygen consumption of myocardium. Techniques for Fetal Sex Diagnosis In addition to amniocentesis, there are two other techniques of fetal diagnosis: chorionic villus sampling, and ultrasound. Retropulsion is very effective in mixing and grinding the larger food particles into smaller ones. Hypothyroidism in Children (Cretinism) Cretinism is the hypothyroidism in children.

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It plays a vital role in calcium and phosphate homeostasis in addition to its other important functions. During normal breathing, inspiration is brought about by activation of inspiratory muscles, especially the diaphragm. Cortisol decreases circulating lymphocyte count by decreasing mitotic activity of lymphocyte precursors. Therefore, use of prostaglandin inhibitors usually gives relief from dysmenorrhea. Note the presence of centripetal obesity, moon face, buffalo hump, pendulous abdomen with stria over it, poor muscle development and thin limbs, easy bruisability, poor wound healing (infections). When the pressure inside is increased, expiration takes place due to compression and when the pressure is reduced below atmospheric pressure, inspiration takes place. It accumulates urine with out much rise in pressure in it and empties its content at appropriate time following suitable rise in pressure. Another term, neuromodulator is used to mark the chemicals, which are used to modify the activities of the postsynaptic neurons. The one of the branches of Ia fiber directly terminates monosynaptically on the homonymous motor neurons. Bladder is emptied after 15 minutes, 30 minutes, 60 minutes and 120 minutes, and excretion of the phenol red is noted in each sample. However, due to lack of feedback regulation by the baroreceptor reflex, wide swing in pressure occurs in various conditions. As tubular fluid in the loop enters the deeper layers of medulla, it is more concentrated that creates increas ing gradient of osmolality along the axis of the loop, called axial gradient. Small-dense vesicles contain catecholamines and large-dense vesicles contain neuropeptide. Airflow in Airways Flow occurs through a tube when the pressure diffe rence exists at both ends of the tube. The inflammatory responses include: dilation of capillaries, increased capillary permeability, migration of granulocytes to the site of injury and killing of the organisms or the insulting agents by the granulocytes, mainly neutrophils (for details, refer Chapter 19). The heart rate decreases because the membrane is hyperpolarized and the slope of prepotential is decreased (becomes relatively flat). It is seen in meningitis, diseases affecting medulla of the brain, increased intra cranial pressure, morphine poisoning and damage to the brainstem. The muscularis externa (outer longitudinal and inner circular muscles) is well developed. This makes the intrapleural pressure more negative that helps in expan sion of the lungs due to which the air is sucked in. Defecation reflex also regains, but reflex contraction of rectum does not empty it completely. The commonest of all is the common cold that manifests mainly in the form of acute nasopharyngitis with the features of increased nasal secretions, sneezing, mild and temporary nasal obstruction due to nasopharyngeal mucosal edema, and mild increase in body temperature. Isometric hand grip and Cold pressor test are the best sympathetic reactivity tests. This is also sometimes seen in patients with excess secretion of gastric acid in which decreased duodenal pH inhibits pancreatic lipase. The first cell division takes place in 24 hours to produce two unequal sized cells, the structure called blastomere. The pathways containing less number of interneurons stimulate the motor neuron early (as the impulses arrives at motor neuron early), and the pathways containing more interneurons stimulate the motor neurons later (as the impulses arrive at motor neuron later through these pathways). Globin is the protein component, which is degraded into amino acids that enter the amino acid pool of the body and are reutilized whenever required. The presynaptic axon terminal, postsynaptic membrane and the synaptic cleft form the synapse. T tubules are more developed in ventricular myocytes than the atrial myocytes, and the diameter of T tubule in ventricular muscle cell is more than double the diameter of T tubules in skeletal muscle cell. System of Capillary Network the system of capillary network originates from arterioles and metarterioles. Via its influence on sympathetic output, hypothalamus controls secretions of adrenal medulla (hypothalamosympatho-adrenal-axis).

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This becomes possible due to the activation of selective estrogen receptor modulators in specific tissues. Development of brain occurs maximally in last six months of fetal life and first six months of post natal life. Appreciate the arrangement of arterial supply and venous drainage in renal circulation. More number of breasts can develop in the milk line starting from axilla to the groin. The diluted volume of large fluid that enters rete testis and epididymis unless absorbed adequately results in infertility. This facilitates the blastocyst attachment to endometrium via surface glycoprotein. Important Note Indications and contraindications of cortisol use: Cortisol is used in the treatment of many diseases and also contraindicated for other diseases. There fore, deficiency of insulin in childhood (as in diabetic children) decreases their height, growth, and matura tion. The increase in plasma volume occurs at the earliest, as early as first month of gestation. Physiological Actions Bradykinin resembles histamine in its physiological functions: 1. By making rapid and transient movements, phasic stretch reflex ensures immediate corrections of spinal motor output in the moment-to-moment motor control. However, the thinnest pain fibers (C fibers) form a discrete bundle in the spinal cord, the tract of Lissauer. Through bulbospinal pathway, vasomotor center pro jects to the intermediolateral gray column of the spinal cord from where sympathetic fibers originate. Theca externa cell lie in a single layer and provide mechanical support to the follicle from outside. It is especially observed, if the inflammatory process that produces pain also involves the peritoneum. It serves as a pathway for the return of reabsorbed water and solutes to the circulatory system. Lateral corticospinal tract controls the skilled volun tary movements of the body. The fibers are myelinated but lose their myelin sheath before entering the epidermis. Thus, ovarian events via hormonal feedback mechanisms control the hypothalamus and anterior pituitary secretions. They pour their secretion into the mouth cavity by means of submandibular ducts (ducts of Wharton). Usually, they are categorized as flexors-extensors, adductors-abductors, pronators-supinators depending on the movement of body parts they perform. In the third phase of deglutition, when food bolus enters esophagus, a ring of contraction appears just cephalad to the bolus, which pushes the bolus towards stomach. Osmolality of duodenal content: the chyme entering into duodenum has higher osmolality. Tissues suffer from hypoxia when supply of adequate O2 to them is decreased or when they fail to utilize the available O2. Dendrites and cell bodies are the main parts of the neuron for receiving information and therefore form the receiving or receptor zone of the neuron. Time of Surfactant Synthesis in Fetal Life Lungs are among the last organs to develop during intra uterine life. The primary function of ovary is to develop ovarian follicles and release ovum at the time of ovulation, and to secrete steroid hormones that control various reproductive and metabolic functions. A better example is the redness of the forearm of a person immediately following his blood pressure measurement by sphygmomanometry.

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Effects on Blood Cells Though, cortisol influences all the three formed elements of blood, the impact is more on leucocytes. Control of Heart Functions the heart is innervated by parasympathetic and sympa thetic fibers. These patients invariably have microalbuminuria, increased fibrinogen, increased plasminogen activator inhibitor 1, elevated plasma uric acid and increased sympathetic activity. It becomes turbid when kept in a container for a long time as urea is converted to ammonium carbonate by the action of bacteria, which makes the urine alkaline and results in precipitation of calcium and magnesium phosphates. Therefore, it is desirable to spend some time in taking soup and starters before taking a major meal. Mesangial cell contraction distorts the capillary lumen and decreases the area available for filtration. P2X receptors are ligand-gated ion channel receptors that have seven subtypes: P2X1 to P2X7. The frequency of action potential spike, which determines the strength of muscle contraction, depends on excitability of the smooth muscles. Nonsinus Hair Follicle these are associated with spray like terminals resembling Ruffini endings. Therefore, a significant venoconstriction occurs even at mild sympathetic stimulation that increases venous return adequately. Diameter of blood vessels depends primarily on the vasomotor tone, which is the sympathetic vasoconstrictor tone. Oxygen content of Hb (HbO2 content) is the amount of oxygen actually bound to hemoglobin, whereas oxygen capacity of Hb (HbO2 capacity) is the amount of oxygen that can potentially bind with Hb. During acute stress, a general state of arousal and vigilance is maintained by catecholamines. The interstitial space oncotic pressure and peritubular capillary hydrostatic pressure oppose this process. It is divided into anterior spinothalamic tract that carries the sensation of crude touch, and lateral spinothalamic tract that carries the sensation of pain and temperature. Direct communication occurs between cells via gap junc tion (electrical synapses). Any condition that decreases hormone binding by decreas ing the concentration of proteins available for binding or by any other mechanism, increases the hormone 438 Section 6: Endocrine Physiology Table: 52. Treatment of Hypothyroidism Thyroid hormone replacement is the mainstay of treat ment. Argentaffin cells: As the intracytoplasmic granules stain positively with silver salts by reduction reaction (agyrophil cells, on the other hand, require the addition of exogenous reducing substances for staining) d. Gluconeogenesis: It also stimulates gluconeogenesis by activating gluconeogenic enzymes, especially phosphoenolpyruvate carboxykinase. Therefore, gradually the male should know the time of orgasm of his partner and should learn to maintain penile erection till then. Essentially, adrenal medulla represents an enlarged and specialized sympathetic ganglion in which the postganglionic fibers are embedded and modified to become the endocrine cells. The products of granulosa cells stimulate the formation of spindle (pre-theca) cells. The major receptors are mechanoreceptors, thermoreceptors, nociceptors, chemoreceptors and photoreceptors. Structural Organization the parasympathetic system is the craniosacral outflow of autonomic nervous system. However, in spite of more food intake, glucose is not utilized by the cells due to deficiency of insulin. Note these neurons from myenteric plexus and submucosal plexus innervate smooth muscle cells, secretory cells and epithelial cells. Hepatic metabolism of Cpeptide is negligible; therefore its concentration in plasma directly reflects the b-cell activity. Thus, lesion at these levels causes loss of pain and temperature on the opposite half of the face and body without affecting other sensations (as the medial lemnis cus is spared). Preganglionic sympathetic fibres for head and neck arising from 1st thoracic segment ascend through cer vical part of sympathetic chain.