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Though visceral, metabolic cells of ovary and Sertoli due of testis to synthesize and secretethat are mainly produces in liver. When the individual dives into the sea, he is exposed to a high pressure, which is proportional to the depth to which he dives. One contributing factor may be the free mobility of the ribs at sternocostal and costovertebral joints in females compared to males. He also studied the mechanism of secretion, showing the relation of blood capillaries to glandular structures. Most of the hormones signal target tissues located far away from the gland via this route. The muscles that oppose the movement (increase the angle at the joint) are called as antagonists. The blood pressure rise is due to increased sympathetic activity and heart rate rise is due to decreased parasympathetic activity. Studying the prevalence of respiratory diseases in the community or respiratory industrial hazards. Secretion in Acinus of Gland In the gland acini, the secretion is called primary secretion in which amylase concentration is more. Molecular Layer this layer contains interneurons that are basket cells and stellate cells. The decrease in flow rate in duct increases bicarbonate concentration as time to add more bicarbonate increases, and therefore, this increases pH. Sometimes atrial arrhythmias such as flutter or fibrillation are also seen in hyperthyroidism, especially in elderly people. The noradrenergic sympa thetic fibers overgrow into the dorsal root ganglia of sen sory nerves from the injured area. Efferent Pathways and Effector Organs Efferent fibers for baroreceptors are sympathetic fibers and vagus nerve. These leads record differences of potential between any given position on the chest and on one extremity. Increased temperature Afterload Afterload is the peripheral resistance, which is inversely proportional to cardiac output. The fibers traverse along the adventitial surface of the blood vessels to reach the heart. Parasympathetic Nuclei the cranial outflow of parasympathetic system originates from cranial nerve nuclei that are located in the brain stem. However, relative bradycardia at 30th beat depends also on the sympathetic reactivity. Role of Membrane Proteins Normally, small synaptic vesicles recycle in the presynaptic nerve terminal. This antibacterial blockage protects the growing embryo if conception has occurred. The sensory inputs arising from different body parts first relay in the thalamus before projecting to the cortex. Important Note O2 therapy is harmful in states of depressed respiratory centers: Though O2 therapy is beneficial in most forms of hypoxic hypoxia; it is harmful to subjects with depressed respiratory centers. Some important examples of these pathways are corticospinal, rubrospinal, vestibulospinal, and reticulospinal tracts. Because of this myelination, action potential is conducted in a saltatory fashion in myelinated fibers, which is much faster than the transmission of impulse in unmyelinated fibers. However, constant removal of H+ by the action of urinary buffers from the tubules makes it possible for further acid secretion.

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Dynamic lung compliance is measured by continuously recording the change in intrapleural pressure and lung volume. The uterine endometrium undergoes hyperplasia and hypertrophy and increases in size and thickness. Afferent nerves from the carotid bodies travel to the brainstem in the glossopharyngeal nerves. Absorption of these vitamins requires intactness of the mechanisms for absorption of fat, which depends on 426 Section 5: Gastrointestinal System 3. Understand the physiology of colonic movements, colonic reflexes, and their functions. Thus, hypothalamus through its extensive neuroendocrine connections, controls major body functions. After recording of few normal tidal respirations, subject inhales to total lung capacity (deep inspiration with maximum effort) and holds his breath. Other Types of Shock Distributive Shock In this condition, capacity of the vascular bed is increased suddenly by marked acute vasodilation. The enterokinase secreted from mucosal cells of duodenum and jejunum converts trypsinogen into trypsin, which then acts as an enzyme to convert other proteases. Lesion above pons does not affect respiration, which indicates that the controlling centers are located mainly in pons. There are few vessels that directly connect the arterioles and venules, bypassing the capillaries. Therefore, transfusion of stored blood decreases oxygen transport, especially when transfused into hypoxic patients. It occurs either due to decreased cardiac output or decreased blood flow secondary to some other causes. The contraction of mesangial cells decreases the area available for filtration and relaxation of mesangial cells increases the area for filtra tion. A normal heart beats in a perfectly regular rhythm as the interbeat intervals remain virtually constant. The nonspecific nuclei (intraluminal and midline group) interact with reticular formation and cortex for arousal mechanisms. Chemicals liberated at the neuromuscular junctions are also called neurotransmitters. Note that with increased number of action potential on a slow wave increases the magnitude of contraction and contraction does not occur in the absence of action potential. Innervation of Coronary Blood Vessels the coronary blood vessels are supplied by sympathetic and parasympathetic fibers. This occurs due to regularity in rhythmic discharge of the Chapter 86: Properties of Cardiac Muscle Table 86. Therefore, unless the disease process significantly affects the adequate length of intestine, malabsorption does not develop. If the head is turned to one side, the limb of that side (the jaw limb) is extended while the contralateral limb (occipital limb) is flexed. Consequently, during inspiration, a larger share of tidal volume goes to the base of the lungs. Excessive and chronic stimulation of this system leads to leanness, degeneration ad decay, and underutilization of it leads to lethargy and adiposity. Capillary Exchange Substances are transported across the capillaries by three ways: diffusion, vesicular transport that includes endocytosis and exocytosis, and filtration. Especially in an examination, due to shortage of time, if a student draws a good schematic diagram and gives a brief answer with the help of flowcharts, even if he fails to give a descriptive answer, he gets good marks invariably. Chapter 130: Regulation of Posture and Movement 1081 Frontal Eye Field this is the area 8. What is asphyxia, what are its stages, what are the features of asphyxia in different stages, Define hypercapnia and state its causes, Define hypercapnia and state its causes, what is respiratory acidosis, what is respiratory alkalosis, what is periodic breathing, what is Cheyne-Stokes respiration, in what conditions is it seen, what is Kussmaul breathing, in what conditions is it seen, what is Biots respiration, in what conditions is it seen, what is sleep apnea syndrome, what is sudden infant death syndrome, what is hysteric hypernea, what is Ondines curse, in what conditions is it seen. Docking is the process by which vesicles attach with the membrane and priming is the process by which the vesicles become ready to discharge their content in response to a stimulus.

Diseases

• Podder-Tolmie syndrome
• Hemangioma, capillary infantile
• White sponge nevus
• Short rib-polydactyly syndrome, Beermer type
• Exstrophy of the bladder
• Pickardt syndrome
• Deafness mesenteric diverticula of small bowel neuropathy
• Scott Bryant Graham syndrome
• Pseudomarfanism
• Short stature mental retardation eye defects

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This leads to transport of vesicles or endosomes by the microfilaments and microtubules from the cytosol to the luminal membrane of the epithelial cells of the tubule. This is assisted by relaxation of external anal sphincter, decreased anorectal angle and relaxation of puborectalis muscle. Course this tract descends down ipsilaterally in the medial funic ulus of the spinal cord. The tight junctions between Sertoli cells from the blood-testis barrier that provides protection to developing sperms from harmful blood born toxins. All the four cutaneous sensory modalities can be elicited from the areas that contain only naked nerve endings. Defects of Protein Digestion Hartnup Disease this is a hereditary disorder in which absorption of amino acids in the intestinal and renal epithelial cells is defective. Transport of glucose, proteins and urea from the tubular fluid are other examples of facilitated diffusion. What is a triple heart sound, What is a gallop rhythm, What is the cause of a murmur, What are the points should be noted for a murmur. This causes shift of fluid from interstitial tissue space (extravascular compartment) into the intravascular compartment through the capillary membrane. Tubular reabsorption of electrolytes, glucose and water is also increased by thyroid hormones. More number of breasts can develop in the milk line starting from axilla to the groin. Reticular activating system has tonic excitatory drive on medullary respiratory neurons. The superior hypophyseal artery terminates in rich capillary network in the median eminence, from where long hypophyseal portal vessel arises and descends down the pituitary stalk to end in capillaries in the anterior lobe. The loss of supraspinal, more precisely the supra-segmental influences on the spinal cord in the acute phase causes shock, which is evident from the following observations: 1. Normally, turnover of about 10% of the total bone mass occurs in a year in adults. Pressure Gradients the pressure gradients across glomerular capillary wall are different from the pressure gradients along the capilla ries of other vascular beds. The hydroxyproline and chondroitin together form the extracellular matrix of cartilage. Fast response action potentials are meant for immediate initiation of muscle contraction, hence seen in cardiac muscles. Second Phase In the second phase, the acid protease enzyme secreted by osteoclasts destroys the collagen, the organic matrix. Important Mechanoreceptors Pacinian Corpuscles these are mechanoreceptors located in the skin and deep tissues. The flexion response of the ipsilateral limb results in withdrawal of the body parts from the source of noxious stimulus and the extension of the opposite limb maintains balance during the act. Contraction of muscularis mucosa in small intestine produces local movements that facilitate the process of digestion and absorption. Effects of Diseases In many nonthyroidal conditions such as chronic febrile illness, trauma, burns, liver and kidney failure, myocar dial infarction, selenium deficiency, advanced stage of cancers and other cachectic states, activity of deiodi nases is suppressed. Hence, diseases affecting hypotha lamic nuclei result in many pathological syndromes. Usually, it is not associated with any characteristic abnormalities and therefore remains undetected. Phrenic nerve activity becomes silent during expiration except in the early part of it when some burst activity occurs. Mitosis the primitive germ cells (spermatogonia) that are present in the basal lamina of seminiferous tubules undergo mitotic divisions to from primary spermatocytes. In joints: Inflammation of synovial membrane, expo sure of synovial membrane to hypertonic saline and stretching or tearing of ligaments around the joint. Therefore, by the time tubular fluid reaches the medullary part of collecting duct, its urea concen tration is very high. Positive Pressure Method this is usually used in operation theaters during surgery.

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The receptors present in many parts of the body pro vide inputs to the vomiting center, in the brainstem. Excitement Cardiac output increases in emotional excitements due to sympathetic stimulation. Basic Histology, by V Subhadra Devi, 1st edition, 2016; Jaypee Brothers Medical Publishers (P) Ltd. Via its influence on sympathetic output, hypothalamus controls secretions of adrenal medulla (hypothalamosympatho-adrenal-axis). Fick investigated the application of physical principles to physiology and devised methods for cardiac output measurement and blood flow to many organs. The abnormal sperms may have bifurcated tail, bifid head, spirally coiled tail, or absence of head. Proprioception and vibration sense are severely affected in lesion of the sensory cortex Causes 1. Spindle Responses the primary endings on the nuclear bag fibers and nuclear chain fibers are stimulated in response to stretch, but the patterns of responses are different. Therefore, nature has provided a safety factor in the form of decremental conduction to check the transmission of rapid impulses to ventricular muscles. Promotes alveolar stability: In lungs, alveoli of dif ferent diameters are connected in parallel to each other. Diameter of blood vessels depends primarily on the vasomotor tone, which is the sympathetic vasoconstrictor tone. This indicates that both lung and chest need positive transmural distending pressures. Reabsorption of Solutes Epithelium of collecting duct contains two types of cells: principal cells and intercalated cells. Such type of regulation of cardiac output by change in ventricular muscle length at various ventricular volumes is known as heterometric autoregulation of the heart. The troponin is the calcium binding protein present in the skeletal muscle involved in muscle contraction. The impulse then spreads rapidly in cardiac muscle to the different parts of the heart (mechanisms of propagation and conduction of cardiac impulse are described in the next chapter). Importance of Enterohepatic Circulation the primary function of enterohepatic circulation of bile acids and salts is to maintain the total bile acid pool of the body. This delay is shortened by sympathetic stimulation and lengthened by parasympathetic stimulation to the heart. Therefore, once it is activated in the pancreas, it digests the pancreatic tissue (Clinical Box 40. They contain numerous granules that are present in the vesicles that store catecholamines. Explain the physiological basis of various factors affecting O2-hemoglobin dissociation curve. Regulation of Intestinal Circulation Neural Regulation the neural control of intestinal and mesenteric circulation is mainly achieved by the sympathetic system. Dynamic airway compression increases airways resis tance, which effectively limits the forced expiratory flow (Clinical Box 104. The ventricular volume decreases, but ventricular pressure continues to rise, which reaches a peak at point D (the rapid ejection phase ends) and then decreases till point E (the end of slow ejection phase). For example, on the back the two points must be separated 65 mm or more to be distinguished as separate points, whereas on the finger tips this distance is reduced to as low as 3 mm. Note that the cortex contains ovarian follicle in different stages of development. The fibers of these tracts are placed in the lateral funiculus in the spinal cord and fibers terminate on the motor neurons that are placed laterally in the ventral horn of the spinal cord, i. More quantity of Na+ and Cl- enters the macula densa cells via 1Na+-1K+-2Cl- cotransporter located in their apical membrane. Chromophobe Cells the chromophobic cells are usually less active and there fore, have few secretory granules. The gastric juice secreted in the cephalic phase occurs before food reaches the stomach. The decreased production of interleukin-1 by cortisol suppresses the febrile responses to inflammation.

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During this period, an individual fails to cope with stress and may succumb to stressful situations. Therefore, the average oxygen tension (PaO2) in systemic arterial blood is about 95 mm Hg and Hb is 98% saturated. In males, orgasm occurs with ejaculation, following which the penis becomes flaccid. Clinical Importance In the early stage, airway diseases mainly affect small air ways. It pumps blood continuously throughout life due to many special properties inherent to its muscle. Stages of Deglutition Swallowing is divided into three stages (phases): oral phase, pharyngeal phase, and esophageal phase. To cut foodstuff into smaller particles and mix the food with gastric juice, the process in which food is converted into chyme. For a basic or reflexive movement to be executed, the motor signal generated in the spinal cord is conveyed to the appropriate muscles via motor neurons. Speaking or coughing during eating allows food to enter into trachea and may cause choking in severe cases. Therefore, Na+ is reabsorbed from the tubular fluid along its concentration gradient into the tubular cells. Tone of vascular smooth muscle is influenced pro foundly by the state of sympathetic discharge and Chapter 96: Regulation of Blood Pressure 823 the concentration of various circulating neurohu moral factors. Adrenocortical Insufficiency Hypofunction of adrenal gland may be primary or secondary variety. The Laplace law states that the pressure in a spherical structure is equal to twice the wall tension divided by the radius, 2T i. Significance of Hering-Breuer Reflex this is a protective reflex that protects lung from overinflation while marinating normal alveolar ventilation. The combination of these two poles that have equal and opposite charges is called a dipole. Substantia nigra is the center for coordination of impulses essential for skilled movements. The orientation of the valves allows unidirectional flow of blood through the heart and the movement of the valve leaflets opens or closes the valves. Diastolic pressure falls due to decreased peripheral resistance, which occurs due to the effect of proges terone on blood vessels. With all their wishes and blessings, finally this book has been made available to them. After descending down through contralateral brain stem, fibers occupy the lateral column of the spinal cord. It is also a system of integration that coordinates functions of various internal organ systems of the body. Irritable Bowel Syndrome this condition has been known by several synonyms such as mucous colitis, spastic colon, irritable colon, and colonic neurosis. So, this part of colon does not show peristaltic activity, Raynaud Disease It is a vasospastic disease due to hyperactivity of vaso constrictor sympathetic fibres affecting digital arteries of fingers. However, many factors arriving from variety of stimuli play simultaneously to achieve an integrated response of hormone secretion. Therefore, those who are desirous of a child, should have regular sexual act in the periovulatory period (day of ovulation, and two days before and after the ovulation). Inspite of osmotic gradient across the tubular epithelium, water reabsorption is poor. Causalgia Causalgia is a burning pain that usually develops following a traumatic peripheral nerve injury. When arteries become stiff as occurs in advanced age, systolic pressure increases.

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Therefore, menstrual cycle is sometimes loosely divided into four phases: bleeding phase, follicular phase, ovulatory phase, and luteal phase. Hypertension causes the development of cerebral vascular microaneurysm (Charcot-Bouchard aneurysm). Thus, the middle region not only controls inspiration, but also increases the caliber of the upper respiratory tract during inspiration. The activated T cells kill organisms, secrete interleukins and activate type 1 helper-T cells that mediate immunological responses. Because it decreases the negative charge in the lumen, it also decreases K+ secretion into the tubular fluid. Thy roid hormones induce formation of enzymes essential for neurotransmitter synthesis. This leads to increased excretion of fecal stercobilinogen and urinary urobilinogen (Table 41. However, physiologically, superficial and midcortical nephrons are considered as cortical nephrons due to their similarity in histological morphologies and functions. However, the rate of oxygen consumption of heart is highest of all organs of the body, which is 9. Pyloric sphincter remains partially closed and does not allow easy entry of gastric contents into the duodenum. Estrogen peak occurs about two days before ovulation and then decreases rapidly in next two days. Contraction of muscle pumps blood toward the heart through the opened venous valves. Note the expulsion of the fetus by uterine contraction, of fetus facilitated by increased abdominal pressure. Ca++ influx increases cytoplasmic Ca++ that facilitates Ca++-mediated exocytosis of insulin granules. Thus, loop diuretics cause natriuresis and kaliuresis and increase osmolality of tubular fluid that lead to increase water excretion. The cell bodies of motor neurons are located in the ventral horns of the spinal gray matter (anterior horn cells) and brainstem nuclei. V2 Bipolar Chest Leads these leads are used before the discovery of unipolar chest leads. Postganglionic sympathetic neurons supplying sweat glands and blood vessels of skeletal muscles, 4. Basal ganglia are involved in initiation, smoothening and coordination of the movement. Also, contraction of bladder muscle is poor in response to the act of micturition (evacuation). The pulse pressure is also less in capillaries, which is about 5 mm Hg at the arteriolar end and almost zero at the venular end. Thus, the direct effect of vitamin D on bone is to mobilize calcium, which is contrary to its overall effect of promoting mineralization. This episodic burst of prolactin signals the breasts for maintenance of milk production. Therefore, basal ganglia mainly influence extrapyramidal functions, and, consequently, they are classified as important extrapyramidal structures. The phenomenon of summation is seen in neuronal Sensitization Sensitization occurs when a transmission is accompanied by a painful or unpleasant sensation. Both these disorders primarily affect the bowel but may have systemic involvement in the form of polyarthritis, uveitis, ankylosing spondylitis, skin lesions, and hepatic involvement. Therefore, ovariectomy after eighth week of pregnancy does not result in abortion. Therefore, the membrane potential of the infarcted area is higher than the membrane potential of the normal surrounding area during the later part of repolarization. Internal Genitalia: Vagina, uterus, ovary, fallopian tube grow in size and functions (as described above). Describe the synthesis, metabolism and regulation of posterior pituitary hormones. There is another lipase secreted from pancreas called as bile salt activated lipase, which also assists in lipid digestion. Thyroid hormones stimulate erythropoiesis by increasing the synthesis of erythropoietin.

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Digestion of carbohydrate begins in the mouth by the action of salivary amylase which catalyses the hydrolysis of a-1, 4 linkage (but not a-1, 6 linkage) to form a-dextrins. Thus, stress predis poses to hypertension, ischemic heart disease and other cardiovascular diseases. Administration of oxygen through cannula is useful in conditions in which hypoxic drive is essential to drive ventilation, as oxygen content of inspired air never reaches 100% by this method. Thyroid hormones enter the brain in adults and found in gray matter of various parts of the brain. As a result, inner temperature of the furnace circulates in the furnace without much loss to the environment. Ltype is the dominant one in the heart muscle and Ttype is present in smaller amount. The rapid and synchronous excitation of the ventricles ensures almost simultaneous contraction of all ven tricular muscles, which is essential for effective ven tricular ejection of blood. However, the hydrophobic character of the amino acids at the Cterminal of B chain is important for bio logical activity of insulin. Especially, acting on the suprachiasmatic area of hypothalamus, it produces sexual behaviors. Distribution of Receptors Touch receptors are abundantly present in hands especially in fingertips, and lips, and are less in number in the proximal part of the limbs and trunk of the body. Thus, vasomotor center is stimulated that increases sympathetic discharge and causes vasoconstriction, tachycardia, increased cardiac output, and increase in blood pressure. For example, to enhance gastrointestinal secretions, when parasympathetic stimulation increases volume and enzyme content, simultaneous sympathetic activation contributes to increased mucus content of the secretory product. It helps in storage of androgen in seminiferous tubule and facilitates transport of testosterone from testis to epididymis. Thus, the quantity of oxyhemoglobin formation is a function of partial pressure of oxygen in the blood. The part of the axon distal to axotomy degenerates, which is called Wallerian degeneration (for details, refer Chapter 24). Hering-Breuer Reflex this reflex was described by Hering and Breuer in 1868, who found that lung inflation decreases tidal volume and increases respiratory frequency. Say the altitude at which significant hypoxia occurs, and the maximum height up to which adaptation occurs. Defecation reflex relaxes the anal sphincters and expels feces from rectum to outside through anal canal. The sensory fibers have different diameter and conduction velocity depending on the receptors they innervate and the sensation carried by them. Superficial Pain vs Deep Pain the pain elicited in the superficial structures like skin and subcutaneous tissues is the superficial pain, which is usually the fast pain. Sympathetic Innervation the cardiac sympathetic fibers originate in the intermediolateral grey column of the spinal cord starting from lower two cervical segments to the upper five thoracic segments. In the pharyngeal phase, epiglottis covers the glottis to prevent aspiration of food (prevents food to enter trachea) and soft palate is elevated to prevent food to enter nasal passage. Salivary secretion exclusively occurs in the cephalic phase (sight, smell and thought of food, presence of food Sialolithiasis this is the condition in which stone is formed in the ducts of salivary gland. The peak pressure generated by the right ventricular contraction is about 25 mm Hg. Mechanical and Chemical Factors Accumulation of food in the stomach increases acid secretion. When blood pressure falls, baroreceptor reflex ope rates within few seconds to correct the pressure, which is essential and life saving in acute hypotension and hemorrhage. The concentration of Na+ is less in the enterocytes, which is created by Na+K+ pump present on the basolateral membrane of the cells that pumps Na+ into the lateral intercellular space from the enterocytes in exchange for K+. There are separate genes that code the synthesis of and subunits of gonadotropins. Viscosity increases in conditions in which concentration of plasma protein is more, for example, in paraproteinemia and multiple myeloma (increase in myeloma protein). During inspiration, diaphragm descends that pushes abdominal viscera down and, therefore, abdominal wall is raised. The effect of Bainbridge reflex on heart rate is more observable if the initial heart rate is less.

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Increase in calcium concentration in the presynaptic terminal increases calcium-mediated exocytosis of the vesicles. Synthesis and release: Synthesize and release following chemicals (local hormones) into systemic circulation: Histamine Kallikrein Prostaglandins iv. Understand the difference in the structure of resting and activated parietal cell. He had emphasized the role chemical factors in functional activity, especially in digestive process. Functional Morphology Capillaries form extensive branching networks that increase the surface area for rapid exchange of materials. The increased contractility represents increase in developed force and velocity of contraction. Autonomic nervous system and peripheral nerves are also involved in the disease process. Control of Efferent Discharge motor neurons do not receive input from primary sensory afferents. First Order of Neuron Neurons arriving from lower extremity and lower part of the trunk ascend up in the gracile fasciculus, whereas the neurons arriving from upper extremity and upper part of the trunk ascend in the cuneate fasciculus. Estrogen induces the synthesis of oxytocin receptors, which enhances uterine smooth muscle contraction. Toward later part, due to regression of corpus luteum, progesterone and estrogen secretions decrease. Sinusoids and Bile Canaliculi In a typical lobule, between the plates of hepatic cells, the sinusoids are present that carry blood. However, heart rate increases steadily throughout this phase due to vagal withdrawal (in the early phase) and sympathetic activation (in the later phase). Acute Postural Hypotension this is due to temporary fall of blood pressure that may result in transient fainting. Target cells are conferred with receptors that are specific in their affinity for hormones. Mixing: the aqueous part of secretions help in mixing of food with chemicals and enzymes in the secretions. Digestion and Absorption of Carbohydrates Digestion of Carbohydrate the dietary carbohydrates are mainly polysaccharides, disaccharides, and monosaccharides. Compensation for increased excessive workload on heart occurs first by concentric left ventricular hypertrophy that increases the wall thickness. Anorexia Nervosa It is a complex behavioral disorder in women which manifests as severe anorexia (loss of food intake) associated with functional abnormalities. But, if the position of the electrodes is changed or the position of the dipole is changed, magnitude of vector is decreased and, therefore, the voltage is also decreased. The efferent limb is mainly humoral, in which oxytocin from posterior pituitary released into circulation causes contraction of myoepithelial cells of alveoli to eject milk into the milk duct. Adrenogenital Syndrome Etiology this occurs due to 21b-hydroxylase deficiency, which decreases the synthesis of glucocorticoids and mineralocorticoids. The motor neurons innervate extrafusal muscle fibers, which are responsible for force generation. Though the patients are usually asymp tomatic, they complain lethargy, weakness and giddiness. What is obligatory reabsorption of water, What is facultative reabsorption of water, What is the mechanism of action of aquaporins, What is osmotic diuresis, give example, What is water diuresis, give example, List the important diuretics and give their mechanism of action. Obesity significantly increases insulin secretion and activity of insulin receptors. Therefore, normally, venous content of oxygen is high (oxyhemoglobin content is more), which makes it bright red. Einthoven Triangle Einthoven triangle is an equilateral triangle with each side representing the axis of one of the bipolar limb leads.

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Lesion of peripheral nerve results in anesthesia corresponding to the distribution of sensory fibers. The responses are initiated by vestibular stimulation, stretching of neck muscle, pressure on the side of the body or on the limbs, and stimulation of visual receptors. Name the spinal reflexes, Receptor, Stimulus, Reflex Arc, Function and importance of each spinal reflex, Details of stretch reflex, Reciprocal inhibition, Differences between stretch reflex and withdrawal reflex. Placenta is the combination of interdigitating fetal and maternal tissues that serves as the organ of exchange between mother and fetus during pregnancy. Hypothalamic Hormones Hypothalamic hormones are secreted from various nuclei of the brain. In fact, the sensitivity of the muscle spindle to stretch varies with the state of efferent discharge. Appreciate the arrangement of arterial supply and venous drainage in renal circulation. Another cause of steatorrhea is impaired reabsorp tion of bile salts in the distal ileum. It is secreted from the endothelial cells of the renal blood vessels, mesangial cells, and cells of the distal tubules. Example of periodical secretion is alteration in sex hormones or gonadotropins in different phases of menstrual cycle. The processes of oligodendrocytes wrap many times around an axon to form the myelin sheath. Though it is controlled by sympathetic and parasympathetic systems, it has its own well developed autoregulatory mechanisms. As, osmotic pressure of tissue space is nil, the osmotic pressure gradient along the capillary wall is always inward, which favors absorption of fluid from the interstitial tissue space into the capillary. It is proposed that adrenarche initiates the process of puberty in which adrenal androgen sensitizes the gonads to secrete more sex hormones and sensitizes the sex organs to the effects of sex hormones. In circulatory system, at the sites of narrowing of blood vessel the velocity of flow increases, which in turn increases the dynamic component of the pressure. However, as Chapter 96: Regulation of Blood Pressure 829 complexities exist for locations and interaction between these areas, and the nature of their output is confusing, we describe only the vasomotor center for sympathetic neurons in the medulla. Hypophysiotropic hormones are synthesized in small hypothalamic neurons (parvocellular neurons), the axon terminals of which contact the capillary net work in the median eminence and infundibulum in hypothalamus that give rise to long portal vessels in the pituitary stalk. This is called the capillary recruitment and is the primary mechanism that accounts for the fall in pulmonary vascular resistance to increased cardiac output. A nerve plexus is located between the muscle layers, called as myenteric plexus or plexus of Auerbach. Mechanomechanical Coupling Stretch of smooth muscle causes muscle contraction, which is known as mechanomechanical coupling. 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). Following parturition, estrogen and progesterone concentration in plasma falls appreciably as placenta, which was secreting large amount of these hormones is no more present. Vision Audition Memory and emotion Integration of somatic and visceral sensations, and arousal. The oxygen consumption by kidneys as a whole is much less, which is about 18 mL per min, in comparison to 52 mL per min for liver, 50 mL per min for skeletal muscles, 45 mL per min for brain and 30 mL per min for heart. The exact mechanism of this unique phenomenon of hypoxiainduced pulmonary vasoconstriction is not known. Hyperbaric Oxygen Therapy Hyperbaric O2 therapy means, administration of 100% O2 at increased pressure. This results in transudation of fluid into the abdominal cavity that causes ascites. This is why fat is emptied slower than the carbohydrate and protein (Applica tion Box 48. However, if the increase in flow is due to parasympathetic stimulation, secretion of bicarbonate from duct cells is more that increases salivary content of bicarbonate. Effects of Lesions Lesion of lateral corticospinal tract results in impairment of skilled voluntary activities like writing, painting, etc.

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As the total pressure does not change, the alteration in any component of pressure occurs at the cost of the other. About 150 mg of calcium is secreted into the intestine, which makes a total of about 850 mg excreted daily in the stool. Role of Hypothalamus and Cortex Hypothalamus and cortex provide the highest levels of autonomic control. Changes in different pressures in the thoracic cavity that result in breathing are: 1. True Precocious Puberty Early development of secondary sexual characteristics, may be associated with premature development of gonads is known as true precocious puberty. Quadriplegia Quadriplegia or tetraplegia indicates paralysis of all four extremities. Each pathway has a typical pattern of termination Chapter 122: Thalamus Table 122. This activates renninangiotensin-aldosterone axis, therefore, edema (due to water retention) may be seen. Define movement, Name the types of movements, What are the characteristics of automatic and volitional movements, What are the Feedback control system for movement, and how are they organized, What are the different levels of organization of movement. Thus, the paleospinothalamic pathway mediates arou sal, affective aspects and autonomic responses of pain. Bladder, uterus, fallopian tube, testes, vas deferens, seminal vesicle, and prostate. Therefore, diseases of liver and kidney alter hormonal status of the body by impair ing removal of hormones from the body. Voltage gated Ca++ channels open (depicted by + sign) and calcium influx increases intracellular Ca++ concentration. Also, the concentration remains elevated when the degradation of the hormone is less, in addition to increased production. Spinal motor neurons are continuously influenced by the impulses arriving from various supraspinal centers via descending fibers. The space between presynaptic and postsynaptic membrane is called the synaptic cleft. Tissue Pressure Theory When perfusion pressure increases blood flow increases, which in turn increases capillary permeability due to increased hydrostatic pressure. To deliver normal quantity of oxygen to the tissues, many compensatory mechanisms are activated. Some of the Fe++ in the enterocytes is oxidized to the ferric form, which bind with apoferritin to form ferritin. Intestinal Modifications Villi In small intestine, from the luminal surface, finger like projections extend into the lumen. Peristaltic waves in ureters originate by a pacemaker tissue located close to the calyces at a frequency of about one per minute. Fibers for submandibular and sublingual glands are present in the 7th cranial nerve that originate from superior salivary nucleus and terminate in submandibular ganglion from where postganglionic fibers come out and supply the glands. The pain typically radiates to the ulnar border of the left hand, but it can also radiate to the back or even to the neck or abdomen. Cell bodies of excitatory motor neurons are present in the myenteric plexus and the axons project aborally to innervate muscle fibers. During this process the flattened pregranulosa cells (spindle cells) become cuboidal granulosa cells that further proliferate to form a continuous cell layer surrounding the oocyte. There are two types of sympathetic systems for blood vessels: Sympathetic vasoconstrictor system and sympathetic vaso dilator system. Sympathetic stimulation increases heart rate, conduction velocity, myocardial contractility and cardiac output. Some spermatozoa can survive in a viable state within the slightly alkaline medium of the cervical mucus for up to 48 hours. It may be due to improper recovery from pancreatitis or persistence of low grade acute pancreatitis. Inhibitory thalamic reticular neurons are proposed to be the part of this neuronal network that causes induction of sleep. The descent from inguinal region to scrotum depends on testosterone and other factors. Note that the muscle of upper part of the esophagus is striated and of lower part is smooth.