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Physiology - NEETMDS- courses
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Physiology

A heart rate that is persistently greater than 100bpm is termed tachycardia. A heart rate that is persistantly lower than 60 pulse per min  is termed bradycardia. Let's examine some factors that could cause a change in heart rate:

  • Increased heart rate can be caused by:
    • Increased output of the cardioacceleratory center. In other words, greater activity of sympathetic nerves running to the heart and a greater release of norepinephrine on the heart.
    • Decreased output of the cardioinhibitory center. In other words, less vagus nerve activity and a decrease in the release of acetylcholine on the heart.
    • Increased release of the hormone epinephrine by the adrenal glands.
    • Nicotine.
    • Caffeine.
    • Hyperthyroidism - i.e., an overactive thyroid gland. This would lead to an increased amount of the hormone thyroxine in the blood.
  • Decreased heart rate can be caused by:
    • Decreased activity of the cardioacceleratory center.
    • Increased activity of the cardioinhibitory center.
    • Many others.

The pituitary gland is pea-sized structure located at the base of the brain. In humans, it consists of two lobes:

  • the Anterior Lobe and
  • the Posterior Lobe

The Anterior Lobe

The anterior lobe contains six types of secretory cells All of them secrete their hormone in response to hormones reaching them from the hypothalamus of the brain.

Thyroid Stimulating Hormone (TSH)

TSH (also known as thyrotropin) is a glycoprotein The secretion of TSH is

  • stimulated by the arrival of thyrotropin releasing hormone (TRH) from the hypothalamus.
  • inhibited by the arrival of somatostatin from the hypothalamus.

 TSH stimulates the thyroid gland to secrete its hormone thyroxine (T4).

Some develop antibodies against their own TSH receptors making more T4 causing hyperthyroidism. The condition is called thyrotoxicosis or Graves' disease.

Hormone deficiencies

A deficiency of TSH causes hypothyroidism: inadequate levels of T4 (and thus of T3 )..

Follicle-Stimulating Hormone (FSH)

FSH is a heterodimeric glycoprotein Synthesis and release of FSH is triggered by the arrival from the hypothalamus of gonadotropin-releasing hormone (GnRH).

FSH in females :In sexually-mature females, FSH (assisted by LH) acts on the follicle to stimulate it to release estrogens.

FSH in males :In mature males, FSH acts on spermatogonia stimulating (with the aid of testosterone) the production of sperm.

Luteinizing Hormone (LH)

LH is synthesized within the same pituitary cells as FSH and under the same stimulus (GnRH). It is also a heterodimeric glycoprotein

LH in females

In sexually-mature females, LH

  • stimulates the follicle to secrete estrogen in the first half of the menstrual cycle
  • a surge of LH triggers the completion of meiosis I of the egg and its release (ovulation) in the middle of the cycle
  • stimulates the now-empty follicle to develop into the corpus luteum, which secretes progesterone during the latter half of the menstrual cycle.

LH in males

LH acts on the interstitial cells (also known as Leydig cells) of the testes stimulating them to synthesize and secrete the male sex hormone, testosterone.

LH in males is also known as interstitial cell stimulating hormone (ICSH).

Prolactin (PRL)

Prolactin is a protein of 198 amino acids. During pregnancy it helps in the preparation of the breasts for future milk production. After birth, prolactin promotes the synthesis of milk.

Prolactin secretion is

  • stimulated by TRH
  • repressed by estrogens and dopamine.

Growth Hormone (GH)

  • Human growth hormone (also called somatotropin) is a protein
  • The GH-secreting cells are stimulated to synthesize and release GH by the intermittent arrival of growth hormone releasing hormone (GHRH) from the hypothalamus. GH promotes body growth

In Child

  • hyposecretion of GH produces dwarfism
  • hypersecretion leads to gigantism

In adults, a hypersecretion of GH leads to acromegaly.

ACTH — the adrenocorticotropic hormone

ACTH acts on the cells of the adrenal cortex, stimulating them to produce

  • glucocorticoids, like cortisol
  • mineralocorticoids, like aldosterone
  • androgens (male sex hormones, like testosterone

Hypersecretion of ACTH cause of Cushing's disease.

The thyroid gland is a double-lobed structure located in the neck. Embedded in its rear surface are the four parathyroid glands.

The Thyroid Gland

The thyroid gland synthesizes and secretes:

  • thyroxine (T4) and
  • calcitonin

T4 and T3

Thyroxine (T4 ) is a derivative of the amino acid tyrosine with four atoms of iodine. In the liver, one atom of iodine is removed from T4 converting it into triiodothyronine (T3). T3 is the active hormone. It has many effects on the body. Among the most prominent of these are:

  • an increase in metabolic rate
  • an increase in the rate and strength of the heart beat.

The thyroid cells responsible for the synthesis of T4 take up circulating iodine from the blood. This action, as well as the synthesis of the hormones, is stimulated by the binding of TSH to transmembrane receptors at the cell surface.

Diseases of the thyroid

1. hypothyroid diseases; caused by inadequate production of T3

  • cretinism: hypothyroidism in infancy and childhood leads to stunted growth and intelligence. Can be corrected by giving thyroxine if started early enough.
  • myxedema: hypothyroidism in adults leads to lowered metabolic rate and vigor. Corrected by giving thyroxine.
  • goiter: enlargement of the thyroid gland. Can be caused by:
    • inadequate iodine in the diet with resulting low levels of T4 and T3;
    • an autoimmune attack against components of the thyroid gland (called Hashimoto's thyroiditis).

2. hyperthyroid diseases; caused by excessive secretion of thyroid hormones

Graves´ disease. Autoantibodies against the TSH receptor bind to the receptor mimicking the effect of TSH binding. Result: excessive production of thyroid hormones. Graves´ disease is an example of an autoimmune disease.

Osteoporosis. High levels of thyroid hormones suppress the production of TSH through the negative-feedback mechanism mentioned above. The resulting low level of TSH causes an increase in the numbers of bone-reabsorbing osteoclasts resulting in osteoporosis.

Calcitonin

Calcitonin is a polypeptide of 32 amino acids. The thyroid cells in which it is synthesized have receptors that bind calcium ions (Ca2+) circulating in the blood. These cells monitor the level of circulating Ca2+. A rise in its level stimulates the cells to release calcitonin.

  • bone cells respond by removing Ca2+ from the blood and storing it in the bone
  • kidney cells respond by increasing the excretion of Ca2+

Both types of cells have surface receptors for calcitonin.

Because it promotes the transfer of Ca2+ to bones, calcitonin has been examined as a possible treatment for osteoporosis

There are three types of muscle tissue, all of which share some common properties:

  • Excitability or responsiveness - muscle tissue can be stimulated by electrical, physical, or chemical means.
  • contractility - the response of muscle tissue to stimulation is contraction, or shortening.
  • elasticity or recoil - muscles have elastic elements (later we will call these their series elastic elements) which cause them to recoil to their original size.
  • stretchability or extensibility - muscles can also stretch and extend to a longer-than-resting length.

 

The three types of muscle: skeletal, cardiac, and visceral (smooth) muscle.

Skeletal muscle

It is found attached to the bones for movement.

cells are long multi-nucleated cylinders.

 The cells may be many inches long but vary in diameter, averaging between 100 and 150 microns.

 All the cells innervated by branches from the same neuron will contract at the same time and are referred to as a motor unit.

 Skeletal muscle is voluntary because the neurons which innervate it come from the somatic or voluntary branch of the nervous system.

That means you have willful control over your skeletal muscles.

 Skeletal muscles have distinct stripes or striations which identify them and are related to the organization of protein myofilaments inside the cell.

 

Cardiac muscle

This muscle found in the heart.

 It is composed of much shorter cells than skeletal muscle which branch to connect to one another.

 These connections are by means of gap junctions called intercalated disks which allow an electrochemical impulse to pass to all the connected cells.

 This causes the cells to form a functional network called a syncytium in which the cells work as a unit. Many cardiac muscle cells are myogenic which means that the impulse arises from the muscle, not from the nervous system. This causes the heart muscle and the heart itself to beat with its own natural rhythm.

But the autonomic nervous system controls the rate of the heart and allows it to respond to stress and other demands. As such the heart is said to be involuntary.

 

Visceral muscle is found in the body's internal organs and blood vessels.

 It is usually called smooth muscle because it has no striations and is therefore smooth in appearance. It is found as layers in the mucous membranes of the respiratory and digestive systems.

It is found as distinct bands in the walls of blood vessels and as sphincter muscles.

Single unit smooth muscle is also connected into a syncytium similar to cardiac muscle and is also partly myogenic. As such it causes continual rhythmic contractions in the stomach and intestine. There and in blood vessels smooth muscle also forms multiunit muscle which is stimulated by the autonomic nervous system. So smooth muscle is involuntary as well

Hypoxia

  • Hypoxia is tissue oxygen deficiency
  • Brain is the most sensitive tissue to hypoxia: complete lack of oxygen can cause unconsciousness in 15 sec and irreversible damage within 2 min.
  • Oxygen delivery and use can be interrupted at several sites

 

Type of
Hypoxia

O2 Uptake
in Lungs

Hemoglobin

Circulation

 Tissue O2 Utilization

 Hypoxic

 Low

Normal

Normal

Normal

 Anemic

 Normal

 Low

Normal

Normal

 Ischemic

 Normal

Normal

 Low

Normal

 Histotoxic

 Normal

Normal

Normal

 Low

  • Causes:
    • Hypoxic: high altitude, pulmonary edema, hypoventilation, emphysema, collapsed lung
    • Anemic: iron deficiency, hemoglobin mutations, carbon monoxide poisoning
    • Ischemic: shock, heart failure, embolism
    • Histotoxic: cyanide poisoning (inhibits mitochondria)

 

  • Carbon monoxide (CO) poisoning:
    • CO binds to the same heme Fe atoms that O2 binds to
    • CO displaces oxygen from hemoglobin because it has a 200X greater affinity for hemoglobin.
    • Treatment for CO poisoning: move victim to fresh air. Breathing pure O2 can give faster removal of CO

 

  • Cyanide poisoning:
    • Cyanide inhibits the cytochrome oxidase enzyme of mitochondria
    • Two step treatment for cyanide poisoning:
      • 1) Give nitrites
        • Nitrites convert some hemoglobin to methemoglobin. Methemoglobin pulls cyanide away from mitochondria.
      • 2) Give thiosulfate.
        • Thiosulfate converts the cyanide to less poisonous thiocyanate.

The defecation reflex:

As a result of the mass movements, pressure is exerted on the rectum and on the internal anal sphincter, which is smooth muscle, resulting in its involuntary relaxation. Afferent impulses are sent to the brain indicating the need to defecate. The external sphincter is voluntary muscle and is controlled by the voluntary nervous system. This sphincter is relaxed along with contraction of the rectal and abdominal muscles in the defecation reflex

Hyperventilation

  1. Treatments :Rebreath air, hold breath (Increase CO2)
    Give oxygen for Hypoxemia

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