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9Cell & General physiologyGeneral PhysiologyMeasurement of body fluid volumesVolumei. Total Body Waterii. ECFiii. Plasma Volumeiv. Blood Volumev. Interstitial Fluidvi. ICFIndicatorsDeuterium, Tritium, AntipyrineInulin, sucrose, mannitol, sodium thiosulphateAIIMS’19Evans blue, 125-I Albumin53-Cr labelled RBCsECF - plasmaTotal body water - ECF- Most commonly used indicator for TBW- Deuterium (2-H2O)- Gold standard substance for ECF- Inulin- Most dominant cation in ICF- Potassium MagnesiumReference : Guyton and Hall Textbook of Physiology, 13th edition, pg 309

12Sodium Potassium ATPase Pumpi. Is an electrogenic pumpii. It is a heterodimer,has 2 subunits, alpha andbetaiii. Uses energy to move 3sodium ions from inside tooutside and 2 potassiumions from outside to insideiv. Coupling ratio 3 : 2Alpha subunit21- Has intracellular and extracellularbinding sitesEXTRACELLULAR1 Na Binding siteBINDING SITE52 K Binding site34INTRACELLULARBINDING SITENEET’173 ATP Binding site4 Phosphate Binding site5 Ouabain Binding siteBeta subunit- Is a glycoprotein, which has 3 extracellular glycosylation sitesATPase binding siteReference : Complete Review of Integrated System- Physiology, 2nd edition, pg 8

20Nerve injuryNEET’15Wallerian/ distal/anterograde degenerationi. Occurs distal to the site of injuryii. Usually begins within 24-36 hrs afterinjuryiii. Axonal degeneration is the earliest tooccur followed by degeneration of myelinsheathiv. Macrophages & Schwann cell clearthe debris following degeneration.Retrograde/ proximaldegenerationi. Changes in proximal cell body ofinjured nerve happens within 48 hrs ofinjury and continue up to 15 20 daysii. Rough endoplasmic reticulum/ Nisslbodies undergo degeneration anddissolution (Chromatolysis)iii. Nucleus is usually pushed towardsthe peripheryiv. Golgi apparatus and mitochondriafragment and disintegrate.- Nerve regeneration occurs at the rateof 1 3 mm/ day- Indication of nerve regeneration isPositive Tinel Sign (production oftingling sensation)Reference : Complete Review of Integrated System- Physiology, 2nd edition, pg 50

28Blood brain barrier- BBB is formed by tight junctionsbetween capillary endothelial cells andastrocyte foot processes- Substances that crosses BBB easily are:i. Water (using carrier protein AQP-4)ii. Glucose (using GLUT 1 55K andGLUT 1 45K)iii. O2iv. CO2v. Steroid hormonesP-glycoprotein(a) If any drug crosses BBB, they are immediately pumped out of brain by P-glycoprotein(b) Also known as Multi-drug resistance protein 1 (MDR1)(c) Member of family of ATP binding cassettes that transport proteins and lipids acrosscell membranesReference : Ganong’s Review of Physiology, 24th edition, pg 605CIRCUMVENTRICULAR ORGANS- Areas includes:(1) Posterior pituitary(neurohypophysis, NH) andadjacent ventral part of themedian eminence of thehypothalamus(2) Area postrema (AP)(3) Organum vasculosum ofthe lamina terminalis(OVLT, supraoptic crest)- PI, pineal; SCO, subcommissural organ(4) Subfornical organ (SFO).Reference : Ganong’s Review of Physiology, 24th edition, pg 606

37Rods & cones1. Outer segment- stores photopigments in the form ofmembraneous disks2. Inner segment- rich in mitochondria- synthesises photopigments3. Synaptic Terminal- stores gluatamte, neurotransmitterfor signalingReference : Ganong’s Review of Physiology, 24th edition, pg 182Visual pathways- A lesion that interrupts oneoptic nerve causes blindness inthat eye (A).- A lesion in one optic tractcauses blindness in half of thevisual field (C) and is calledhomonymous (same side of bothvisual fields) hemianopia(half- blindness).- Lesions affecting the opticchiasm destroy fibers fromboth nasal hemiretinas andproduce a heteronymous(opposite sides of the visualfields) hemianopia (B).- Occipital lesions may sparethe fibers from the macula (D)because of the separation inthe brain of these fibers fromthe others subserving vision.Reference : Ganong’s Review of Physiology, 24th edition, pg 189

44Ventricular volumei. At the end of systole, 50 mL of blood remains which is called end-systolic volumeii. At. The end of diastole, ventricle is filled up to 130 mL which is called end-diastolic volumeHeart soundsi. 1st Heart sound- heard during closure of mitral and tricuspid valves at iso-volumetric contraction- Peak of R waveii. 2nd Heart sound- heard during closure of aortic and pulmonary valves at iso-volumetric relaxation- End of T waveiii. 3rd Heart sound- heard during rapid filling phaseAIIMS’17iv. 4th Heart sound- heard during atrial systole - End of P waveCardiac cycle eventsDurationi. Atrial systoleO.1 sii. Atrial diastole0.7 siii. Ventricular systole0.27 siv. Ventricular diastoleO.53 sTotal 0.8 sTotal 0.8 sJugular venous pressurea waveformi. Due to right atrial contraction (atrial systole)ii. It peaks just before the 1st heart soundc waveformi. Due to bulging of tricuspid valve into right atriumduring iso-volumetric contraction NEET’18 NEET’20ii. Occurs during the 1st heart soundx descenti. Denotes fall in right atrial pressure during atrialrelaxationii. Ends just before the 2nd heart soundy descentv waveformi. Due to rapid emptying of right atrium oncei. Due to right atrial filling (atrial diastole)tricuspid valve opensii. V wave peaks just after the 2nd heart soundii. Correlates with the 3rd heart sound

55Respiratory PhysiologyRespiratory distress syndromei. Also known as Hyaline membrane diseaseii. Caused due to deficiency of pulmonarysurfactants (Type II pneumocytes), NEET’20mainly dipalmitoylphosphatidylcholine.iii. Seen in(a) Premature infants(b) Maternal diabetes(c) Delivery by Cesarean sectioniv. Characteristicspersistence of arterial O2 tension 50 mmHgand central cyanosisv. Microscopically- necrotic eosinophilichyaline membrane lining the alveoli withalternating atelectasis and dilation of alveoli.Reference : ute-respiratory-distress-syndrome-ardsLung volumes and capacitiesAIIMS’17Lung capacitiesInspiration capacity TV IRVFunctional residual capacity ERV RVVital capacity TV IRV ERVTotal lung capacity VC RV

64Neural regulation of respirationNormal patternSlow & deepSlow & Rhythm generationprebotzinger complex,medullaInitiation of inspirationInitiates inspiration, by driving phrenicdischarge and diaphragm contractionMaintenance of inspirationApenustic center- -DrgTermination of inspirationStretchvagal afferentsPneumotaxic centerExpirationi. Passive process (no neurons fired)ii. Brought by elastic recoil of lungsQ: Pacemaker generating rhythm for breathing isAnswer- Prebotzinger complexramp signals Inspiration Tidalvolume- 500 mLAIIMS’19

Reference : Ganong’s Review of Physiology, 24th edition, pg 606 Blood brain barrier - BBB is formed by tight junctions between capillary endothelial cells and astrocyte foot processes - Substances that crosses BBB easily are: i. Water (using carrier protein AQP-4) ii. Glucose (using GLUT

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