NEET MDS Lessons
Physiology
-
There Are 12 Pairs of Cranial Nerves
- The 12 pairs of cranial nerves emerge mainly from the ventral surface of the brain
- Most attach to the medulla, pons or midbrain
- They leave the brain through various fissures and foramina of the skull
-
Nerve
Name
Sensory
Motor
Autonomic
ParasympatheticI
Olfactory
Smell
II
Optic
Vision
III
Oculomotor
Proprioception
4 Extrinsic eye muscles
Pupil constriction
Accomodation
FocusingIV
Trochlear
Proprioception
1 Extrinsic eye muscle (Sup.oblique)
V
Trigeminal
Somatic senses
(Face, tongue)Chewing
VI
Abducens
Proprioception
1 Extrinsic eye muscle (Lat. rectus)
VII
Facial
Taste
Proprioception
Muscles of facial expression
Salivary glands
Tear glandsVIII
Auditory
(Vestibulocochlear)Hearing, Balance
IX
Glossopharyngeal
Taste
Blood gasesSwallowing
GaggingSalivary glands
X
Vagus
Blood pressure
Blood gases
TasteSpeech
Swallowing GaggingMany visceral organs
(heart, gut, lungs)XI
Spinal acessory
Proprioception
Neck muscles:
Sternocleidomastoid
TrapeziusXII
Hypoglossal
Proprioception
Tongue muscles
Speech - Many of the functions that make us distinctly human are controlled by cranial nerves: special senses, facial expression, speech.
-
Cranial Nerves Contain Sensory, Motor and Parasympathetic Fibers
Biological Functions are Extremely Sensitive to pH
- H+ and OH- ions get special attention because they are very reactive
- Substance which donates H+ ions to solution = acid
- Substance which donates OH- ions to solution = base
- Because we deal with H ions over a very wide range of concentration, physiologists have devised a logarithmic unit, pH, to deal with it
- pH = - log [H+]
- [H+] is the H ion concentration in moles/liter
- Because of the way it is defined a high pH indicates low H ion and a low pH indicates high H ion- it takes a while to get used to the strange definition
- Also because of the way it is defined, a change of 1 pH unit means a 10X change in the concentration of H ions
- If pH changes by 2 units the H+ concentration changes by 10 X 10 = 100 times
- Human blood pH is 7.4
- Blood pH above 7.4 = alkalosis
- Blood pH below 7.4 = acidosis
- Body must get rid of ~15 moles of potential acid/day (mostly CO2)
- CO2 reacts with water to form carbonic acid (H2CO3)
- Done mostly by lungs & kidney
- In neutralization H+ and OH- react to form water
- If the pH changes charges on molecules also change, especially charges on proteins
- This changes the reactivity of proteins such as enzymes
- Large pH changes occur as food passes through the intestines.
Events in gastric function:
1) Signals from vagus nerve begin gastric secretion in cephalic phase.
2) Physical contact by food triggers release of pepsinogen and H+ in gastric phase.
3) Muscle contraction churns and liquefies chyme and builds pressure toward pyloric sphincter.
4) Gastrin is released into the blood by cells in the pylorus. Gastrin reinforces the other stimuli and acts as a positive feedback mechanism for secretion and motility.
5) The intestinal phase begins when acid chyme enters the duodenum. First more gastrin secretion causes more acid secretion and motility in the stomach.
6) Low pH inhibits gastrin secretion and causes the release of enterogastrones such as GIP into the blood, and causes the enterogastric reflex. These events stop stomach emptying and allow time for digestion in the duodenum before gastrin release again stimulates the stomach.
Neurons :
Types of neurons based on structure:
a multipolar neuron because it has many poles or processes, the dendrites and the axon. Multipolar neurons are found as motor neurons and interneurons. There are also bipolar neurons with two processes, a dendrite and an axon, and unipolar neurons, which have only one process, classified as an axon.. Unipolar neurons are found as most of the body's sensory neurons. Their dendrites are the exposed branches connected to receptors, the axon carries the action potential in to the central nervous system.
Types of neurons based on function:
- motor neurons - these carry a message to a muscle, gland, or other effector. They are said to be efferent, i.e. they carry the message away from the central nervous system.
- sensory neurons - these carry a message in to the CNS. They are afferent, i.e. going toward the brain or spinal cord.
- interneuron (ie. association neuron, connecting neuron) - these neurons connect one neuron with another. For example in many reflexes interneurons connect the sensory neurons with the motor neurons.
SPECIAL SOMATIC AFFERENT (SSA) PATHWAYS
Hearing
The organ of Corti with its sound-sensitive hair cells and basilar membrane are important parts of the sound transducing system for hearing. Mechanical vibrations of the basilar membrane generate membrane potentials in the hair cells which produce impulse patterns in the cochlear portion of the vestibulocochlear nerve (VIII)
Special somatic nerve fibers of cranial nerve VIII relay impulses from the sound receptors (hair cells) in the cochlear nuclei of the brainstem
These are bipolar neurons with cell bodies located in the spiral ganglia of the cochlea.
Vestibular System
The vestibulocochlear nerve serves two quite different functions.
The cochlear portion, conducts sound information to the brain,
The vestibular portion conducts proprioceptive information.
It is the central neural pathways
Special somatic afferent fibers from the hair cells of the macula utriculi and macula sacculi conduct information into the vestibular nuclei on the ipsilateral side of the pons and medulla.
These are bipolar neurons with cell bodies located in the vestibular ganglion.
Some of the fibers project directly into the ipsilateral cerebellum to terminate in the uvula, flocculus, and nodulus, but most enter the vestibular nuclei and synapse there.
Vision
The visual system receptors are the rods and cones of the retina.
Special somatic afferent fibers of the optic nerve (II) conduct visual signals into the brain
Fibers from the lateral (temporal) retina of either eye terminate in the lateral geniculate body on the same side of the brain as that eye.
SSA II fibers from the medial (nasal) retina of each eye cross over in the optic chiasm to terminate in the contralateral lateral geniculate body.
Area 17 is the primary visual area, which receives initial visual signals.
Neurons from this area project into the adjacent occipital cortex (areas 18 and 19) which is known as the secondary visual area. It is here that the visual signal is fully evaluated.
The visual reflex pathway involving the pupillary light reflex - in which the pupils constrict when a light is shined into the eyes and dilate when the light is removed.
Some SSA II fibers leave the optic tract before reaching the lateral geniculates, terminating in the superior colliculi instead.
From here, short neurons project to the EdingerWestphal nucleus (an accessory nucleus of III) in the midbrain, which serves as the origin of the preganglionic parasympathetic fibers of the oculomotor nerve (GVE III).
The GVE III fibers in turn project to the ciliary ganglia, from which arise the postganglionic fibers to the sphincter muscles of the iris, which constrict the pupils.
Transport of Carbon Dioxide
A. Dissolved in Blood Plasma (7-10%)
B. Bound to Hemoglobin (20-30%)
1. carbaminohemoglobin - Carb Dioxide binds to an amino acid on the polypeptide chains
2. Haldane Effect - the less oxygenated blood is, the more Carb Diox it can carry
a. tissues - as Oxygen is unloaded, affinity for Carb Dioxide increases
b. lungs - as Oxygen is loaded, affinity for Carb Dioxide decreases, allowing it to be released
C. Bicarbonate Ion Form in Plasma (60-70%)
1. Carbon Dioxide combines with water to form Bicarbonate
CO2 + H2O <==> H2CO3 <==> H+ + HCO3-
2. carbonic anhydrase - enzyme in RBCs that catalyzes this reaction in both directions
a. tissues - catalyzes formation of Bicarbonate
b. lungs - catalyzes formation of Carb Dioxide
3. Bohr Effect - formation of Bicarbonate (through Carbonic Acid) leads to LOWER pH (H+ increase), and more unloading of Oxygen to tissues
a. since hemoglobin "buffers" to H+, the actual pH of blood does not change much
4. Chloride Shift - chloride ions move in opposite direction of the entering/leaving Bicarbonate, to prevent osmotic problems with RBCs
D. Carbon Dioxide Effects on Blood pH
1. carbonic acid-bicarbonate buffer system
low pH → HCO3- binds to H+
high pH → H2CO3 releases H+
2. low shallow breaths → HIGH Carb Dioxide → LOW pH (higher H+)
3. rapid deep breaths → LOW Carb Dioxide → HIGH pH (lower H+)
Asthma = Reversible Bronchioconstruction 4%-5% of population
Extrinsic / Atopic = Allergic, inherited (familia), chromosome 11
IgE, Chemical Mediators of inflammation
a. Intrinsic = Negative for Allergy, Normal IgE, Negative Allergic Tests
Nucleotide Imbalance cAMP/cGMP: cAMP = Inhibits mediator release, cGMP = Facilitates mediator release
b. Intolerance to Asprin (Triad Asthma)
c. Nasal Polyps & Asthma
d. Treatment cause, Symptoms in Acute Asthma
1. Bronchial dilators
2. steroids edema from Inflamation
3. Bronchiohygene to prevent Secondary Infection, (Remove Excess Mucus)
4. Education