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They also serve as part of nonspecific defense system of the body by removing dust, bacteria, and harmful gases from the respiratory tract. Late Tertiary Stage Between 5th to 7th days of follicular phase, only one follicle grows sufficiently to become the dominant follicle. Thus, heart rate is the function of the rate at which the pacemaker generates the impulse. If cortisol is given in infections, the toxic features of infection dramatically disappear due to its anti-inflammatory actions. Intention tremor: Due to dysmetria, the corrective measures are immediately initiated, but this time hand overshoots in the opposite direction. 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. One such change was from natural cycle to superovulation protocol and the other one was replacement of laparoscopy by vaginal sonography for ovum retrieval. When the caliber of the outflow tube decreases the peripheral resistance increases. She was a great support to Starling as a sounding board, secretary, and manager of his affairs as well as mother of their four children. At the onset of parturition, the amniotic sac ruptures, and the amniotic fluid flows through the vagina. During diastole, the aortic wall immediately recoils back to its previous position. The preganglionic neurons leave spinal cord via white rami communicantes to the paravertebral sympathetic ganglion where they contact cell bodies of postgangli onic neuron, the axons of which terminate on effector organ. The exercise intolerance occurs due to decreased perfusion of skeletal muscles and decreased oxygen supply to meet the need of the body. The hydroxyproline and chondroitin together form the extracellular matrix of cartilage. Apply the knowledge of sex determination and differentiation in understanding the physiology of reproductive system. In fact, for excreting urine with osmolality of 1400 mosm/kg of H2O, kidney excretes about 0. The connection between hypothalamus and pituitary is called hypothalamopituitary axis. Mechanism of Water and Electrolyte Secretin Water and electrolyte concentration of bile in the bile canaliculi is same with that of plasma. The soma of the neuron integrates these potentials and the algebraic sum of these depolarizing and hyperpolarizing potentials finally produce the change in resultant potential. It becomes possible because the pathways are specific and discreet from the sense organ to the cortex. Therefore, stretch reflex is a monosynaptic reflex (a single synapse between the afferent and efferent limbs). Therefore, when the agonist muscle contracts, simultaneously the antagonist muscle relaxes. The adipose tissue via secretion of leptin also plays some role in the determination of the time of onset of puberty (see below). The primordial follicle consists of a primary oocyte at the center surrounded by a layer of spindle cells (flattened pregranulosa cells) that form granulosa cells later. The plasma level of melatonin, which is secreted from pineal gland, in children is about 250 pg/ml, which is much higher than the level in adults, i. The range of regulation of blood pressure by chemore ceptor reflex is 40 to 70 mm Hg. Mechanism of water reabsorption in kidney, Types and mechanisms of diuresis, Aquaporins, may asked as Short Questions in exam. Pharyngeal Phase the major objective of pharyngeal phase is to push food bolus into the esophagus without its entry into respira tory passage.

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Therefore, a significant venoconstriction occurs even at mild sympathetic stimulation that increases venous return adequately. Autoregulatory mechanisms for blood flow are well devel oped in many organs like kidney, heart, liver, brain and skeletal muscle. The lymphatics are mainly located near the terminal bronchioles, which is favorable for them to drain excess fluid from peribronchial space. The development of brain is also linked to the phenotypic sex (Application Box 65. Oxygen saturation of the fetal arterial blood is much lower than that of the adult. Cutaneous vasoconstriction with concurrent sweat gland activation causes cold, clammy skin of a frightened individual. In response to appropriate stimulation, the granules are released by exocytosis into the lumen of acinus. The difference in inflation and deflation limbs of the curve produces a hysteresis, which is much similar 896 Section 10: Respiratory System to the pattern obtained in pressurevolume curve of static lungs, but the difference is that dynamic compliance of lung is less than its static compliance. Presence of excess acetyl-CoA also facilitates conversion of aceto acetylCoA to acetoacetate in the liver. Relationship between electrical and mechanical responses: Slow waves that are not accompanied by action potentials do not elicit contraction, whereas, slow waves that are accompanied by action potentials evoke contraction. Types of Capillaries There are three types of capillaries: continuous, fenestrated, and sinusoidal capillaries. Note that the renal corpuscle is located in superficial layers of cortex in cortical nephron and close to corticomedullary junction in juxtamedullary nephron. Therefore, deficiency of A, D, E, and K are seen in pancreatic deficiency or biliary obstruction that prevents flow of bile into the intestine. B Other Abnormal Breathings Kussmaul Breathing the pattern of respiration seen in diabetic ketoacidosis is called Kussmaul breathing (described by Kussmaul). Hyperventilation that occurs due to chemoreceptor stimulation is not baroreceptormediated. This causes filling and distension of the rectum that initiates relaxation of internal anal sphincter and constriction of external anal sphincter. Rise in serum gastrin levels by more than 50% of basal value is diagnostic of ZollingerEllison syndrome (gastrinoma). Transairway pressure is important in keeping the airways open during forced expiration. Give the normal values and significance of systolic and diastolic pressure, mean pressure and pulse pressure. Co-transmitters the chemicals that are secreted along with the neurotransmitters are called co-transmitters. The patients with adrenal insufficiency develop changes in personality, and remain irritable and apprehensive. Metabolism of epinephrine forms metanephrine and norepinephrine forms normetanephrine. In backward heart failure, the pressure and volume in the atrium and venous compartment behind the failed ventricle are more, therefore, edema occurs. Features of cerebellar disorder depend on the part of cerebellum affected and whether the cortex or the deep cerebellar nuclei are involved in the disease process. Vasodilators Vasodilators like hydralazine decrease blood pressure by directly causing relaxation of vascular smooth muscle.

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Responses Responses consist of movement of body parts (motor activities), change in visceral functions (autonomic responses) or even the change in behavior of the individual. Therefore, muscle spindle and its reflex connection with the motor neurons constitute a feedback device that controls muscle length. Therefore, the rate of excretion of these organic compounds, especially hydroxyproline indicates the rate of bone resorption. Note that the cortex contains ovarian follicle in different stages of development. As excitability of nerves and muscles depends on this electrical potential, precise control of K+ level in plasma is very essential, in which kidneys play an important role. Capillary permeability depends on the integrity of the capillary endothelial membrane. As maximum pressure is recorded during systole, the pressure is called systolic pressure. This is why fat is emptied slower than the carbohydrate and protein (Applica tion Box 48. Quadriceps muscle, though contract adequately, relax immediately and, therefore, limb drops soon. Other acquired causes are ischemia resulting in acute tubular necrosis, metabolic disorders such as hypercalcemia and hypokalemia, and infiltrative diseases like neurosarcoidosis and amyloidosis. The metabolic factors that cause coronary vasodilation are hypoxia, increased local concentration of carbon diox ide, increased hydrogen and potassium ion concentration, accumulation of lactate, adenosine, and adenine nucleo tide, and increased release of prostaglandins locally. Therefore, stimulation of striatum activates globus pallidus internus through this indirect pathway. Duration and Phases of Menstrual Cycle Duration of Menstrual Cycle the length of menstrual cycle usually averages at about 28 days. Changes in dendritic spines have been observed to provide the physiological basis in motivation, learning and long-term memory. On the normal side, the balance between outward recoiling of chest wall and inward recoiling of lungs (as indicated by equally thick opposite arrows) maintain negative Pip and the normal shape of chest. Change in oncotic and hydrostatic pressures between peritubular capillaries and lateral intercellular space: this mechanism is more effective for Na+. Therefore, in the tubules, cells of different stages are seen at any particular time. Increased atrial contraction, as occurs in exercise Factors that decrease preload: 1. However, the autoregulation of blood flow in the heart is not so well developed like that in brain. The blood vessels form a close system of tubes (the vascular system) that transport blood from the heart to the tissues and return blood from the tissues to the heart. Parasympathetic stimulation increases secretion whereas sympathetic stimulation decreases secretion. In fact, the spermatogonia undergo many mitotic divisions to produce two types of spermatogonia: spermatogonia A and spermatogonia B. Hemoglobin that binds with oxygen is called oxyhemoglobin (HbO2) and the hemoglobin that does not bind with O2 is called deoxyhemoglobin (deoxy-Hb) or reduced-hemoglobin. Hiccup For hiccup reflex, inspiratory muscles including diaphragm contract spasmodically, causing an instantaneous inspiration. Inspiratory Capacity this is the maximum volume of air that can be inspired after tidal expiration. Hypokalemia can cause cardiac complications such as arrhythmias, and muscular dysfunctions. In the upper brainstem, spinothalamic tract and medial lemniscus become confluent. The main difference is that the fetal lungs are functionally inactive and fetus derives oxy gen and nutrients from the placenta. In 28 days regular cycles, normally ovulation occurs between 12th and 16th day (usually on 14th day).

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The one set of cells that are present near the inner border of circular muscles produce regular slow waves of high amplitude like that of gastric slow waves. The blood that accumulates in atria during the ventricular systole rapidly enters into the ventricles as soon as the atrioventricular valves open. Hysteresis Loop: the difference between the inflation and deflation pressurevolume curves. Therefore, it is important to diagnose and initiate the treatment of stroke at the earliest possible. The exact cause of peculiar distribution of fat is not known, but it is associated with insulin resistance and/or increase in insulin level. For example, in the management of bronchial asthma, to ensure effective bronchodilation, inhalation of both cortisol and sulbutamol is advised. Cortical sensations (tactile localization, tactile Chapter 123: Sensory Cortex 1035. If axons are covered by myelin sheath, the nerve fibers are known as myelinated fibers and without the cover, they are unmyelinated fibers. This effect is well demon strated by a flowvolume curve that depicts the rela tionship between airflow and lung volume during a forced inspiratory and expiratory effort. Being a synthetic ana logue of gastrin, it is a potent stimulus for acid secretion. Functions of Thalamus All afferent impulses on their way to the sensory cortex terminate in the thalamus. Though glial cells generally provide support for neurons, their functions are complex and not completely understood. Sympathetic Nuclei Sympathetic fibers originate from vasomotor center in the medulla and project to the intermediolateral horn of spi nal cord via bulbospinal pathway. In systemic allergy (anaphylaxis), histamine released into circulation inhibits heart that decreases cardiac output, and causes vasodilation that decreases blood pressure. Negative Pressure Method this is achieved by alternate compression and relaxing of chest wall. Radius of Blood Vessel the radius of the blood vessel significantly affects peripheral resistance. Therefore, though iron is not actually absorbed in the stomach, gastrectomy or gastric atrophy causes iron deficiency anemia. Secretin increases secretion of pancreatic juice rich in bicarbonate (watery and alkaline pancreatic secretion). This is a spinal reflex integrated at lower lumbar and upper sacral segments of spinal cord (L5, S13). For example, if the subject is asked to copy a geometry, the figures are distorted. The exocrine pancreas constitutes about 80% of the total mass of the pancreas (12% by ducts and blood vessels, and 2% by endocrine tissues). Especially in nerves, low calcium can cause generation of spontaneous action potentials. Therefore, the infarcted tissue becomes negative relative to the normal Chapter 88: Electrocardiogram 775. In parasympathetic system (craniosacral outflow), preganglionic fibers are very long as ganglions are located close to the organs. Second Order of Neuron the cell bodies of these neurons are present in the dorsal horn of the spinal cord. The total urinary Na+ output ranges between 1 meq and 400 meq (average about 150 meq) per day, depending on the dietary salt intake of the person. Retroperistalsis is also initiated by emotional factors or due to stimulation of medullary vomiting centers. The main glucocorticoids formed are cortisol and corticosterone (Application Box 59. From spinal cord, they are carried to the different centers in the brain in various ascending pathways. At the time of ejaculation, sperms enter into the urethra in the body of prostate through the ejaculatory duct and via urethra they come out of the genital tract. Hypocapnia produces vasoconstriction and reduces cerebral blood flow by more than 30%.

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Appreciate the role of feedback control systems in improvement of motor functions. However, in basal conditions, parasympathetic or vagal tone is more than the sympathetic tone. This prevents ovulation and causes amenorrhea in lactating mothers (Clinical Box 55. The medial group of anterior horn cells innervates the axial and proximal muscles, and the lateral group of anterior horn cells innervates the distal muscles. It should be noted that at transpulmonary pressure of 20 cm of H2O, lung reaches its elastic limit; therefore, the pressure curve flattens beyond this pressure. That means, if the tissue responds, it responds optimally or it does not respond at all. Prolactin stimulates secretion of dopamine and somatostatin, those in turn inhibit prolactin secretion. The kinase autophosphorylates tyrosine residue within the receptor and tyrosine residues on intracellular protein substrates. Applied Aspects Carbohydrate Malabsorption Syndromes Carbohydrate malabsorption occurs due to deficiency of oligosaccharidases, the membrane enzymes of enterocytes. However, the process of repolarization occurs in the opposite direction to that of depolarization, i. Progesterone causes relaxation of smooth muscles and therefore produces vasodilation. This involves ultrafiltration of plasma that takes place through the glomerulocapsular filtering membrane. During fasting, by promoting lipolysis, cortisol causes rapid release of free fatty acid and glycerol from adipose tissues, which are utilized for gluconeogenesis. Usually, asphyxia develops due to mechani cal obstruction of airway as occurs in suffocation, strangu lation, drowning, foreign body impaction in the trachea or larynx, and traumatic compression of the chest. The trigger zone may be located on the cheek, nose, lip, oral mucosa, teeth, or scalp. The fist peak, which is the major peak, occurs about 48 hours before ovulation and the second peak, which the minor peak, occurs in the post-midluteal phase. The mechanism mediating prolactin pulses is initiated by stimulation of nipple receptors by suckling that sends afferent input to the hypothalamus. K+ efflux increases the membrane potential that closes the calcium channel and produces relaxation. Though absorption occurs by both active and passive processes, active transport is the primary mechanism of absorption. The mucosal surface of stomach is studded with gastric pits (faveola) into which gastric glands empty. Mucin is the major component of mucous that forms a gel to cover the mucosal epithelium. These conditions are treated by injection of sclerosing agents or by using elastic stockings. It follows the aortic component of the second sound and heard early in the diastole, i. Treatment of Hypothyroidism Thyroid hormone replacement is the mainstay of treat ment. The space between presynaptic and postsynaptic membrane is called the synaptic cleft. Other Inputs: Cerebellum receives monoaminergic inputs, and inputs from thalamus and other parts of the brain. For example, neoplastic tissues of lungs like small cell pulmonary carcinoma produce several hormones. It mainly decreases T cell population, especially type-I helper T cells by stimulating their apoptosis.

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If hypogonadism occurs after puberty, the secondary sex characteristics regress slowly as androgenic maintenance of these features is less essential. Regular Physical Exercise Regular practice of isotonic exercise is very helpful in reducing blood pressure and body weight. Factors Affecting Stroke Volume Stroke volume depends on three major factors: the preload (degree of ventricular filling or the end diastolic volume), the inotropic state (myocardial contractility), and the afterload (resistance offered to the ventricular output). The extracellular domain possesses the binding site for hormone and the intracellular domain possesses tyrosine kinase activity. Each germ cell is a spermatogonium that forms spermatocytes and spermatozoa in the process of its development, i. Thus, the precision and stability of movements are achieved by various feedback control mechanisms. The A fibers are small myelinated axons that discharge only in response to intense mechanical stimuli (but, not to thermal or chemical stimuli). Activation of these receptors leads to alteration in multiple intracellular mecha nisms and signaling pathways that change cell functions. Examples are hypokalemia inhibiting insu lin secretion, hyperkalemia or hyponatremia stimulating aldosterone secretion, etc. Normally, the volume of urine in night is half the volume of urine excreted during day time. It causes muscle hypertrophy, increases muscle protein synthesis and increases muscle mass. The considerable amount of cartilage is present in first four generations of the conducting zone. These drugs are usually used in the treatment of asth matic attacks as they alleviate bronchial constric tion. In chronic or complete stagnant hypoxia, local acidosis develops due to accumulation of the lactate that inhibits cellular metabolism. It can also occur in chronic kidney diseases and prostatic enlargement, or in sleep disturbances/disorders without functional abnormalities of urinary tract. Temporary storage of food: the primary function of stomach is the temporary storage of food. Thus, initial change observed in thyroid hormones due to change in plasma proteins is a temporary effect. So, damage of the nerve causes loss of light reflex with dilation of pupil due to nonfunctioning of sphincter papil lae. The blood present in the skeletal vascular bed contri butes significantly to the venous return (the skeletal muscle pump activity). The depolarization is mainly due to influx of calcium ions through the long acting calcium channels (Lcal cium channels). Learn the physiological basis of Hirschsprung, disease, irritable bowel syndrome, diarrhea, and constipation. The cell bodies of motoneurons are located in the ventral horn of the spinal cord, which are known as anterior horn cells. Other Nociceptors these include thermal nociceptors (A and C fiber termi nals that respond to very low and high temperature, i. The stone may induce inflammation and edema of gallbladder, resulting in chronic cholecystitis. Heart Rate Response to Deep Breathing the variation of heart rate with respiration is known as sinus arrhythmia. During expiration, relaxation of diaphragm brings back its dome shape and decreases thoracic cage capacity. Usually, patients die irrespective of judicious treatment to increase the circulatory status. Abdominal muscles: Muscles of abdominal wall that take part in expiration are internal oblique, external oblique, and transverse abdominis. This becomes possible due to the activation of selective estrogen receptor modulators in specific tissues. Weight Loss In diabetes, food intake is more due to stimulation of feeding center.

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Just by bending a hair (without touching skin) therefore touch sensation can be well elicited. Role of phosphorylation: Phosphorylation is an important post-translational event in the cell signaling pathway. Usu ally, a narrow zone of hyperesthesia occurs at the upper margin of anesthetic zone. High-Pressure Nervous Syndrome As dissolved N2 at deeper regions of sea produces narcotic effects, a mixture of helium and O2 is preferred for following reasons. The trophoblast cells become cytotrophoblasts (large polyhedral cells) that are surrounded by syncytiotrobhobalsts (cells with no boundaries). When the animal looks above, for example, looking for an object in the tree, during which extension of the head extends the forelimb and flexes the hindlimb. The mesangial cells contain contractile units that are present in close contact with glomerular capillaries. Norepinephrine is mostly taken up by the nerve ter minals, and the remaining amount is slowly absorbed into circulation. The hormones are: Thyrotropin releasing hormone, gonadotropin releas ing hormone, corticotropin releasing hormone, growth hormone releasing and inhibiting hormones, and prolactin Chapter 54: Hypothalamus and Hypothalamopituitary Axis Flowchart 54. This prevents collapse of these airways as they are subjected to changes in thoracic pressures. Congenital hypothyroidism Secondary Hypothyroidism When hypothyroidism develops primarily due to a defect outside the thyroid gland, the condition is called secondary hypothyroidism. This apex to base increasing negative gradient of intrapleural pressure is due to the effect of gravity. However, after menopause, in females, diastolic pressure becomes almost equal with males, and systolic pressure may even become more than in males. Firstly, they elevate the pectoral girdle that increases the crosssectional area of the thorax, and secondly, they extend the back that increases the vertical length of the thorax. Relation with respiration: During inspiration, the stroke volume of the right ventricle increases while that of the left ventricle decreases. However, the cough responses to tracheal stimulation remains intact as innervation of trachea in not interfered in such persons. The major function of estrogen is development secondary sexual characters in women including the development of breast and reproductive structures. He had also analyzed referred pain from visceral disturbance, and investigated symbolic formulation and expression in aphasia. Change in renal blood flow: Increased blood flow to kidney increases the delivery of blood to glomerulus that promotes filtration and conversely decreased flow decreases filtration. About 150 mL of this volume fills the airways from the nose and mouth down to the respiratory bronchioles and this Chapter 114: Pulmonary Function Tests 967 change is higher than normal, the tissues are more distensible and if it is less then the tissue are stiffer than normal. This forms the physiological basis of interaction of steroid hormones with other hormones. Laboratory Diagnosis of Jaundice Hemolytic Jaundice In hemolytic jaundice, excessive production of bilirubin allows liver to conjugate more than the normal quantity of bilirubin. In cortical nephron, the loop of Henle is small, does not have a thin ascending limb and does not extend into the inner medulla. The introduction of sperm into the female genital tract should ideally occur in the period of two days before and one day after ovulation. The sympathetic fibers innervate the atria, nodal tissues and conducting pathways, and pierce ventricles to extensively supply the myocardium. Midbrain contains central pattern generator for locomotion and nuclei for righting reflexes. Approximately 98% of the oxygen is transported in combination with hemoglobin and the remaining 2% in the physically dissolved form. Temporal Summation the impulse arriving in one afferent neuron may not be able to stimulate the target neuron; but, when the same afferent neuron is stimulated repeatedly in rapid succession, the target neuron is activated.

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Its role in modulation of pain is discussed in "Physiology of Pain" in Sensory System. In the inner medulla, urea moves from the tubular fluid into the interstitium passively. The mucous and bicarbonate ions secreted by them protect the stomach epithelium from acidic gastric secretion. Note, normally a balance is maintained between the amount of iodide presented to extracellular fluid from intestine and the amount excreted from the body (in urine and stool). Bile acids are conjugated with taurine or glycine to form taurocholic acid or glycocholic acid. Therefore, interruption of corticoreticular pathway facil itates reticulospinal activity. The early part of this phase is due to the closure of potassium channels (decreased potassium conduct ance). Usually, there is no significant overlapping of the dermatomes of the adjacent ganglia. Ovulation that occurs during mating in some animals like rabbit is also an example of neurohumoral reflex. Juxtamedullary Nephrons the renal corpuscle of juxtamedullary nephrons is located in the juxtamedullary region of the cortex, i. The surface tension at the airliquid interface in the lung alveoli is a major factor that influences lung compliance. Spinal Interneurons Interneurons in the spinal cord are placed in between the dorsal and ventral horns. Micelles are cylindrical aggregates of lipids like fatty acids, monoglycerides, and cholesterol with their hydrophobic ends at the center. Drugs: Phenothiazine derivatives, reserpine, ganglion blocking agents and estrogen-progesterone preparations (pill contraceptives) are common drugs that prevent menstrual cycles. This produces small "q" wave (septal q wave) in V6 and small "r" wave (septal r wave) in lead V1. In the later stage as intensity of exer cise increases, sympathetic tone increases that increases heart rate and contractility. A spinal reflex is defined as a stereotyped motor response to a specific stimulus like stretch of the muscle. Muscles of Inspiration Muscles of inspiration cause expansion of chest and increase the elastic recoil of chest wall. Tissue suffers from hypoxia due to decreased oxygen content inspite of normal oxygen saturation. The frequency of action potential spike, which determines the strength of muscle contraction, depends on excitability of the smooth muscles. Synapses are the neuro-neuronal junctions through which information from one neuron passes to the other. Regulation of Testicular Functions the major function of testes is to secrete testicular hormones, especially testosterone that controls gametogenesis, sexual development and anabolic effects. Significance: this represents ventricular depolarization and ventricular repolarization. This reflex accounts for tachycardia produced fol lowing saline infusion or blood transfusion. They discharge in response to increased airway transmural pressure, and sense the changes in lung volume. Regulation of NaCl and water reabsorption is primarily the function of various hormones acting on kidneys. Slowly Adapting Receptors the slowly adapting receptors are located within the smooth muscle of conducting airways. Pyruvate and lactate are also oxidized by insulin as it stimulates pyruvate dehydrogenase activity. Acid output Chapter 39: Gastric Secretion 357 histalog is injected subcutaneously and similar protocol as in histamine test is followed. After the binding of the neurotransmitter with receptors, the ion channels in the postsynaptic membrane open up and movement of ions occurs. Composition of Bile Bile is a greenish yellow fluid formed in the liver and stored in gallbladder.