NEET MDS Lessons
Physiology
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.
Exchange of gases:
- External respiration:
- exchange of O2 & CO2 between external environment & the cells of the body
- efficient because alveoli and capillaries have very thin walls & are very abundant (your lungs have about 300 million alveoli with a total surface area of about 75 square meters)
- Internal respiration - intracellular use of O2 to make ATP
- occurs by simple diffusion along partial pressure gradients
The nephron of the kidney is involved in the regulation of water and soluble substances in blood.
A Nephron
A nephron is the basic structural and functional unit of the kidneys that regulates water and soluble substances in the blood by filtering the blood, reabsorbing what is needed, and excreting the rest as urine.
Its function is vital for homeostasis of blood volume, blood pressure, and plasma osmolarity.
It is regulated by the neuroendocrine system by hormones such as antidiuretic hormone, aldosterone, and parathyroid hormone.
The Glomerulus
The glomerulus is a capillary tuft that receives its blood supply from an afferent arteriole of the renal circulation. Here, fluid and solutes are filtered out of the blood and into the space made by Bowman's capsule.
A group of specialized cells known as juxtaglomerular apparatus (JGA) are located around the afferent arteriole where it enters the renal corpuscle. The JGA secretes an enzyme called renin, due to a variety of stimuli, and it is involved in the process of blood volume homeostasis.
The Bowman's capsule surrounds the glomerulus. It is composed of visceral (simple squamous epithelial cells; inner) and parietal (simple squamous epithelial cells; outer) layers.
Red blood cells and large proteins, such as serum albumins, cannot pass through the glomerulus under normal circumstances. However, in some injuries they may be able to pass through and can cause blood and protein content to enter the urine, which is a sign of problems in the kidney.
Proximal Convoluted Tubule
The proximal tubule is the first site of water reabsorption into the bloodstream, and the site where the majority of water and salt reabsorption takes place. Water reabsorption in the proximal convoluted tubule occurs due to both passive diffusion across the basolateral membrane, and active transport from Na+/K+/ATPase pumps that actively transports sodium across the basolateral membrane.
Water and glucose follow sodium through the basolateral membrane via an osmotic gradient, in a process called co-transport. Approximately 2/3rds of water in the nephron and 100% of the glucose in the nephron are reabsorbed by cotransport in the proximal convoluted tubule.
Fluid leaving this tubule generally is unchanged due to the equivalent water and ion reabsorption, with an osmolarity (ion concentration) of 300 mOSm/L, which is the same osmolarity as normal plasma.
The Loop of Henle
The loop of Henle is a U-shaped tube that consists of a descending limb and ascending limb. It transfers fluid from the proximal to the distal tubule. The descending limb is highly permeable to water but completely impermeable to ions, causing a large amount of water to be reabsorbed, which increases fluid osmolarity to about 1200 mOSm/L. In contrast, the ascending limb of Henle's loop is impermeable to water but highly permeable to ions, which causes a large drop in the osmolarity of fluid passing through the loop, from 1200 mOSM/L to 100 mOSm/L.
Distal Convoluted Tubule and Collecting Duct
The distal convoluted tubule and collecting duct is the final site of reabsorption in the nephron. Unlike the other components of the nephron, its permeability to water is variable depending on a hormone stimulus to enable the complex regulation of blood osmolarity, volume, pressure, and pH.
Normally, it is impermeable to water and permeable to ions, driving the osmolarity of fluid even lower. However, anti-diuretic hormone (secreted from the pituitary gland as a part of homeostasis) will act on the distal convoluted tubule to increase the permeability of the tubule to water to increase water reabsorption. This example results in increased blood volume and increased blood pressure. Many other hormones will induce other important changes in the distal convoluted tubule that fulfill the other homeostatic functions of the kidney.
The collecting duct is similar in function to the distal convoluted tubule and generally responds the same way to the same hormone stimuli. It is, however, different in terms of histology. The osmolarity of fluid through the distal tubule and collecting duct is highly variable depending on hormone stimulus. After passage through the collecting duct, the fluid is brought into the ureter, where it leaves the kidney as urine.
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Damage to Spinal Nerves and Spinal Cord |
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Damage |
Possible cause of damage |
Symptoms associated with innervated area |
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Peripheral nerve |
Mechanical injury |
Loss of muscle tone. Loss of reflexes. Flaccid paralysis. Denervation atrophy. Loss of sensation |
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Posterior root |
Tabes dorsalis |
Paresthesia. Intermittent sharp pains. Decreased sensitivity to pain. Loss of reflexes. Loss of sensation. Positive Romberg sign. High stepping and slapping of feet. |
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Anterior Horn |
Poliomyelitis |
Loss of muscle tone. Loss of reflexes. Flaccid paralysis. Denervation atrophy |
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Lamina X (gray matter) |
Syringomyelia |
Bilateral loss of pain and temperature sense only at afflicted cord level. Sensory dissociation. No sensory impairment below afflicted level |
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Anterior horn and lateral corticospinal tract |
Amyotrophic lateral sclerosis |
Muscle weakness. Muscle atrophy. Fasciculations of hand and arm muscles. Spastic paralysis |
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Posterior and lateral funiculi |
Subacute combined degeneration |
Loss of position sense. Loss of vibratory sense. Positive Romberg sign. Muscle weakness. Spasticity. Hyperactive tendon reflexes. Positive Babinski sign. |
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Hemisection of the spinal cord |
Mechanical injury |
Brown-Sequard syndrome |
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Below cord level on injured side |
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Flaccid paralysis. Hyperactive tendon reflexes. Loss of position sense. Loss of vibratory sense. Tactile impairment |
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Below cord level on opposite side beginning one or two segments below injury |
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Loss of pain and temperature |
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Plasma: is the straw-colored liquid in which the blood cells are suspended.
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Composition of blood plasma |
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Component |
Percent |
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Water |
~92 |
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Proteins |
6–8 |
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Salts |
0.8 |
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Lipids |
0.6 |
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Glucose (blood sugar) |
0.1 |
Plasma transports materials needed by cells and materials that must be removed from cells:
- various ions (Na+, Ca2+, HCO3−, etc.
- glucose and traces of other sugars
- amino acids
- other organic acids
- cholesterol and other lipids
- hormones
- urea and other wastes
Most of these materials are in transit from a place where they are added to the blood
- exchange organs like the intestine
- depots of materials like the liver
to places where they will be removed from the blood.
- every cell
- exchange organs like the kidney, and skin.
Sensory pathways include only those routes which conduct information to the conscious cortex of the brain. However, we will use the term in its more loosely and commonly applied context to include input from all receptors, whether their signals reach the conscious level or not.
The Parathyroid Glands
The parathyroid glands are 4 tiny structures embedded in the rear surface of the thyroid gland. They secrete parathyroid hormone (PTH) a polypeptide of 84 amino acids. PTH increases the concentration of Ca2+ in the blood in three ways. PTH promotes
- release of Ca2+ from the huge reservoir in the bones. (99% of the calcium in the body is incorporated in our bones.)
- reabsorption of Ca2+ from the fluid in the tubules in the kidneys
- absorption of Ca2+ from the contents of the intestine (this action is mediated by calcitriol, the active form of vitamin D.)
PTH also regulates the level of phosphate in the blood. Secretion of PTH reduces the efficiency with which phosphate is reclaimed in the proximal tubules of the kidney causing a drop in the phosphate concentration of the blood.
Hyperparathyroidism
Elevate the level of PTH causing a rise in the level of blood Ca2+ .Calcium may be withdrawn from the bones that they become brittle and break.
Patients with this disorder have high levels of Ca2+ in their blood and excrete small amounts of Ca2+ in their urine. This causes hyperparathyroidism.