NEET MDS Lessons
Physiology
Functions of the nervous system:
1) Integration of body processes
2) Control of voluntary effectors (skeletal muscles), and mediation of voluntary reflexes.
3) Control of involuntary effectors ( smooth muscle, cardiac muscle, glands) and mediation of autonomic reflexes (heart rate, blood pressure, glandular secretion, etc.)
4) Response to stimuli
5) Responsible for conscious thought and perception, emotions, personality, the mind.
-
Partial Pressures of O2 and CO2 in the body (normal, resting conditions):
- Alveoli
- PO2 = 100 mm Hg
- PCO2 = 40 mm Hg
- Alveolar capillaries
- Entering the alveolar capillaries
- PO2 = 40 mm Hg (relatively low because this blood has just returned from the systemic circulation & has lost much of its oxygen)
- PCO2 = 45 mm Hg (relatively high because the blood returning from the systemic circulation has picked up carbon dioxide)
- Entering the alveolar capillaries
-
While in the alveolar capillaries, the diffusion of gasses occurs: oxygen diffuses from the alveoli into the blood & carbon dioxide from the blood into the alveoli.
- Leaving the alveolar capillaries
- PO2 = 100 mm Hg
- PCO2 = 40 mm Hg
- Blood leaving the alveolar capillaries returns to the left atrium & is pumped by the left ventricle into the systemic circulation. This blood travels through arteries & arterioles and into the systemic, or body, capillaries. As blood travels through arteries & arterioles, no gas exchange occurs.
-
- Entering the systemic capillaries
- PO2 = 100 mm Hg
- PCO2 = 40 mm Hg
- Body cells (resting conditions)
- PO2 = 40 mm Hg
- PCO2 = 45 mm Hg
- Entering the systemic capillaries
- Because of the differences in partial pressures of oxygen & carbon dioxide in the systemic capillaries & the body cells, oxygen diffuses from the blood & into the cells, while carbon dioxide diffuses from the cells into the blood.
-
- Leaving the systemic capillaries
- PO2 = 40 mm Hg
- PCO2 = 45 mm Hg
- Leaving the systemic capillaries
- Blood leaving the systemic capillaries returns to the heart (right atrium) via venules & veins (and no gas exchange occurs while blood is in venules & veins). This blood is then pumped to the lungs (and the alveolar capillaries) by the right ventricle.
A small fraction of cardiac muscle fibers have myogenicity and autorhythmicity.
Myogenicity is the property of spontaneous impulse generation. The slow sodium channels are leaky and cause the polarity to spontaneously rise to threshold for action potential generation. The fastest of these cells, those in the SA node, set the pace for the heartbeat.
Autorhythmicity - the natural rhythm of spontaneous depolarization. Those with the fastest autorhythmicity act as the 1. heart's pacemaker.
Contractility - like skeletal muscle, most cardiac muscle cells respond to stimuli by contracting. The autorhythmic cells have very little contractility however. Contractility in the other cells can be varied by the effect of neurotransmitters.
Inotropic effects - factors which affect the force or energy of muscular contractions. Digoxin, epinephrine, norepinephrine, and dopamine have positive inotropic effects. Betal blockers and calcium channel blockers have negative inotropic effects
Sequence of events in cardiac conduction: The electrical events in the cardiac cycle.
1) SA node depolarizes and the impulse spreads across the atrial myocardium and through the internodal fibers to the AV node. The atrial myocardium depolarizes resulting in atrial contraction, a physical event.
2) AV node picks up the impulse and transfers it to the AV Bundle (Bundle of His). This produces the major portion of the delay seen in the cardiac cycle. It takes approximately .03 sec from SA node depolarization to the impulse reaching the AV node, and .13 seconds for the impulse to get through the AV node and reach the Bundle of His. Also during this period the atria repolarize.
3) From the AV node the impulse travels through the bundle branches and through the Purkinje fibers to the ventricular myocardium, causing ventricular depolarization and ventricular contraction, a physical event.
4) Ventricular repolarization occurs.
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
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
Proteinuria—Protein content in urine, often due to leaky or damaged glomeruli.
Oliguria—An abnormally small amount of urine, often due to shock or kidney damage.
Polyuria—An abnormally large amount of urine, often caused by diabetes.
Dysuria—Painful or uncomfortable urination, often from urinary tract infections.
Hematuria—Red blood cells in urine, from infection or injury.
Glycosuria—Glucose in urine, due to excess plasma glucose in diabetes, beyond the amount able to be reabsorbed in the proximal convoluted tubule.
The Sliding Filament mechanism of muscle contraction.
When a muscle contracts the light I bands disappear and the dark A bands move closer together. This is due to the sliding of the actin and myosin myofilaments against one another. The Z-lines pull together and the sarcomere shortens
The thick myosin bands are not single myosin proteins but are made of multiple myosin molecules. Each myosin molecule is composed of two parts: the globular "head" and the elongated "tail". They are arranged to form the thick bands.
It is the myosin heads which form crossbridges that attach to binding sites on the actin molecules and then swivel to bring the Z-lines together
Likewise the thin bands are not single actin molecules. Actin is composed of globular proteins (G actin units) arranged to form a double coil (double alpha helix) which produces the thin filament. Each thin myofilament is wrapped by a tropomyosin protein, which in turn is connected to the troponin complex.
The tropomyosin-troponin combination blocks the active sites on the actin molecules preventing crossbridge formation. The troponin complex consists of three components: TnT, the part which attaches to tropomyosin, TnI, an inhibitory portion which attaches to actin, and TnC which binds calcium ions. When excess calcium ions are released they bind to the TnC causing the troponin-tropomyosin complex to move, releasing the blockage on the active sites. As soon as this happens the myosin heads bind to these active sites.