NEET MDS Lessons
Physiology
Hemostasis - the stopping of the blood. Triggered by a ruptured vessel wall it occurs in several steps:
1) vascular spasm - most vessels will constrict strongly when their walls are damaged. This accounts for individuals not bleeding to death even when limbs are crushed. It also can help to enhance blood clotting in less severe injuries.
2) platelet plug - platelets become sticky when they contact collagen, a protein in the basement membrane of the endothelium exposed when the vessel wall is ruptured. As they stick together they can form a plug which will stem the flow of blood in minor vessels.
3) Formation of the Blood Clot:
A) release of platelet factors - as platelets stick together and to the vascular wall some are ruptured releasing chemicals such as thromboxane, PF3, ADP and other substances. These become prothrombin activators. Thromboxane also makes the platelets even stickier, and increases the vascular constriction. These reactions are self perpetuating and become a cascade which represents a positive feedback mechanism.
B) prothrombin activators : prothrombin (already in the blood) is split into smaller products including thrombin, an active protease.
C) thrombin splits soluble fibrinogen, already present in the plasma, into monomers which then polymerize to produce insoluble fibrin threads. The fibrin threads weave the platelets and other cells together to form the actual clot. This occurs within four to six minutes when the injury is severe and up to 15 minutes when it is not. After 15 minutes the clot begins to retract as the fibrin threads contract, pulling the broken edges of the injury together and smoothing the surface of the clot causing the chemical processes to cease. Eventually the clot will dissolve due to enzymes such as plasmin also present in the blood.
The extrinsic pathway: when tissues are damaged the damaged cells release substances called tissue thromboplastin which also acts as a prothrombin activator. This enhances and speeds coagulation when tissue damage is involved.
Anti-thrombin III - this factor helps to prevent clotting when no trigger is present by removing any thrombin present. Its function is magnified many times when heparin is present. Therefore heparin is used clinically as a short-term anticoagulant.
Vitamin K - stimulates the production of clotting factors including prothrombin and fibrinogen in the liver. This vitamin is normally produced by bacteria in the colon. Coumarin (or coumadin) competes with Vitamin K in the liver and is used clinically for long-term suppression of clotting.
Several factors important to clotting are known to be absent in forms of hemophilia. These factors are produced by specific genes which are mutated in the deficient forms. The factors are VIII, IX, and XI.
Calcium is necessary for blood clotting and its removal from the blood by complexing with citrate will prevent the blood from clotting during storage
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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
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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.
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Cranial Nerves Contain Sensory, Motor and Parasympathetic Fibers
Physiology - science that describes how organisms FUNCTION and survive in continually changing environments
Typical Concentration Gradients and Membrane Potentials in Excitable Cells
The Na Pump is Particularly Important in the Kidney and Brain
- All cells have Na pumps in their membranes, but some cells have more than others
- Over-all Na pump activity may account for a third of your resting energy expenditure!
- In the kidney the Na pump activity is very high because it is used to regulate body salt and water concentrations
- Kidneys use enormous amounts of energy: 0.5% of body weight, but use 7% of the oxygen supply
- Pump activity is also high in the brain because Na and K gradients are essential for nerves
- The brain is another high energy organ; it is 2% of body weight, but uses 18% of the oxygen supply
In the Resting State Potassium Controls the Membrane Potential of Most Cells
- Resting cells have more open K channels than other types
- More K+ passes through membrane than other ions- therefore K+ controls the potential
- Blood K+ must be closely controlled because small changes will produce large changes in the membrane potentials of cells
- Raising K will make the membrane potential less negative (depolarization)
- High blood K+ can cause the heart to stop beating (it goes into permanent contraction)
During an Action Potential Na Channels Open, and Na Controls the Membrane Potential
- Whichever ion has the most open channels controls the membrane potential
- Excitable cells have Na channels that open when stimulated
- When large numbers of these channels open Na controls the membrane potential
Structural Divisions of the nervous system:
1) Central Nervous System (CNS) - the brain and spinal cord.
2) Peripheral Nervous System (PNS) - the nerves, ganglia, receptors, etc
Gonadotropin-releasing hormone (GnRH)
GnRH is a peptide of 10 amino acids. Its secretion at the onset of puberty triggers sexual development.
Primary Effects
FSH and LH Relaese
Secondary Effects
Increases estrogen and progesterone (in females)
testosterone Relaese (in males)
Growth hormone-releasing hormone (GHRH)
GHRH is a mixture of two peptides, one containing 40 amino acids, the other 44. GHRH stimulates cells in the anterior lobe of the pituitary to secrete growth hormone (GH).
Corticotropin-releasing hormone (CRH)
CRH is a peptide of 41 amino acids. Its acts on cells in the anterior lobe of the pituitary to release adrenocorticotropic hormone (ACTH) CRH is also synthesized by the placenta and seems to determine the duration of pregnancy. It may also play a role in keeping the T cells of the mother from mounting an immune attack against the fetus
Somatostatin
Somatostatin is a mixture of two peptides, one of 14 amino acids, the other of 28. Somatostatin acts on the anterior lobe of the pituitary to
- inhibit the release of growth hormone (GH)
- inhibit the release of thyroid-stimulating hormone (TSH)
Somatostatin is also secreted by cells in the pancreas and in the intestine where it inhibits the secretion of a variety of other hormones.
Antidiuretic hormone (ADH) and Oxytocin
These peptides are released from the posterior lobe of the pituitary
As the contents of the stomach become thoroughly liquefied, they pass into the duodenum, the first segment of the small intestine. The duodenum is the first 10" of the small intestine
Two ducts enter the duodenum:
- one draining the gall bladder and hence the liver
- the other draining the exocrine portion of the pancreas.
From the intestinal mucosal cells, and from the liver and gallbladder. Secretions from the pancreas and bile from the gallbladder enter the duodenum through the hepatopancreatic ampulla and the sphincter of Oddi. These lie where the pancreatic duct and common bile duct join before entering the duodenum. The presence of fatty chyme in the duodenum causes release of the hormone CCK into the bloodstream. CCK is one of the enterogastrones and its main function, besides inhibiting the stomach, is to stimulate the release of enzymes by the pancreas, and the contraction of the gallbladder to release bile. It also stimulates the liver to produce bile. Consumption of excess fat results in excessive bile production by the liver, and this can lead to the formation of gallstones from precipitation of the bile salts.
The acid in the chyme stimulates the release of secretin which causes the pancreas to release bicarbonate which neutralizes the acidity