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Physiology - NEETMDS- courses
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Physiology

The small intestine

Digestion within the small intestine produces a mixture of disaccharides, peptides, fatty acids, and monoglycerides. The final digestion and absorption of these substances occurs in the villi, which line the inner surface of the small intestine.

This scanning electron micrograph (courtesy of Keith R. Porter) shows the villi carpeting the inner surface of the small intestine.


The crypts at the base of the villi contain stem cells that continuously divide by mitosis producing

  • more stem cells
  • cells that migrate up the surface of the villus while differentiating into
    1. columnar epithelial cells (the majority). They are responsible for digestion and absorption.
    2. goblet cells, which secrete mucus;
    3. endocrine cells, which secrete a variety of hormones;
  • Paneth cells, which secrete antimicrobial peptides that sterilize the contents of the intestine.

All of these cells replace older cells that continuously die by apoptosis.

The villi increase the surface area of the small intestine to many times what it would be if it were simply a tube with smooth walls. In addition, the apical (exposed) surface of the epithelial cells of each villus is covered with microvilli (also known as a "brush border"). Thanks largely to these, the total surface area of the intestine is almost 200 square meters, about the size of the singles area of a tennis court and some 100 times the surface area of the exterior of the body.

Incorporated in the plasma membrane of the microvilli are a number of enzymes that complete digestion:

  • aminopeptidases attack the amino terminal (N-terminal) of peptides producing amino acids.
  • disaccharidasesThese enzymes convert disaccharides into their monosaccharide subunits.
    • maltase hydrolyzes maltose into glucose.
    • sucrase hydrolyzes sucrose (common table sugar) into glucose and fructose.
    • lactase hydrolyzes lactose (milk sugar) into glucose and galactose.

Fructose simply diffuses into the villi, but both glucose and galactose are absorbed by active transport.

  • fatty acids and monoglycerides. These become resynthesized into fats as they enter the cells of the villus. The resulting small droplets of fat are then discharged by exocytosis into the lymph vessels, called lacteals, draining the villi.

PHYSIOLOGY OF THE BRAIN

  • The Cerebrum (Telencephalon) Lobes of the cerebral cortex

     

    1. Frontal Lobe
      1. Precentral gyrus, Primary Motor Cortex, point to point motor neurons, pyramidal cells: control motor neurons of the brain and spinal cord. See Motor homunculus
      2. Secondary Motor Cortex repetitive patterns
      3. Broca's Motor Speech area
      4. Anterior - abstract thought, planning, decision making, Personality
    2. Parietal Lobe
      1. Post central gyrus, Sensory cortex, See Sensory homunculus, size proportional to sensory receptor density.
      2. Sensory Association area, memory of sensations
    3. Occipital Lobe
      1. Visual cortex, sight (conscious perception of vision)
      2. Visual Association area, correlates visual images with previous images, (memory of vision, )
    4. Temporal Lobe
      1. Auditory Cortex, sound
      2. Auditory Association area, memory of sounds
    5. Common Integratory Center - angular gyrus, Parietal, Temporal & Occipital lobes
      1. One side becomes dominent, integrats sensory (somesthetic, auditory, visual) information
    6. The Basal nuclei (ganglia)
      1. Grey matter (cell bodies) within the White matter of cerebrum, control voluntary movements
    7. Cauadate nucles - chorea (rapi, uncontrolled movements), Parkinsons: (dopamine neurons of substantia nigra to caudate nucles) jerky movements, spasticity, tremor, blank facial expression
    8. The limbic system - ring around the brain stem, emotions(w/hypothalamus), processing of olfactory information

 

  • The Diencephalon

     

    1. The Thalamus - Sensory relay center to cortex (primitive brain!)
    2. The Hypothalamus
      1. core temperature control"thermostat", shivering and nonshivering thermogenesis
      2. hunger & satiety centers, wakefulness, sleep, sexual arousal,
      3. emotions (w/limbic-anger, fear, pain, pleasure), osmoregulation, (ADH secretion),
      4. Secretion of ADH, Oxytocin, Releasing Hormones for Anterior pitutary
      5. Linkage of nervous and endocrine systems

 

  • The Mesencephalon or Midbrain -

     

    1. red nucleus, motor coordination (cerebellum/Motor cortex),
    2. substantia nigra
  • The Metencephalon
    1. The Cerebellum -
      1. Performs automatic adjustments in complex motor activities
      2. Input from Proprioceptors (joint, tendon, muscles), position of body in Space
        1. Motor cortex, intended movements (changes in position of body in Space)
      3. Damping (breaking motor function), Balance, predicting, inhibitory function of Purkinji cells (GABA), speed, force, direction of movement
    2. The Pons - Respiratory control centers (apneustic, pneumotaxic)
      1. Nuclei of cranial nerves V, VI, VII, VIII

 

  • Myelencephalon

     

    1. The Medulla
      1. Visceral motor centers (vasomotor, cardioinhibtory, respiratory)
      2. Reticular Formation RAS system, alert cortex to incoming signals, maintenance of consciousness, arousal from sleep
      3. All Afferent & Efferent fibers pass through, crossing over of motor tracts
    2. Corpus Callosum: Permits communication between cerebralhemispheres
  • Generalized Brain Avtivity
    1. Brain Activity and the Electroencephalogram(EEG)
      1. alpha waves: resting adults whose eyes are closed
      2. beta waves: adults concentrating on a specific task;
      3. theta waves: adults under stress;
      4. delta waves: during deep sleep and in clinical disorders
    2. Brain Seizures
      1. Grand Mal: generalized seizures, involvs gross motor activity, affects the individual for a matter or hours
      2. Petit mal: brief incidents, affect consciousness but may have no obvious motor abnormalities
    3. Chemical Effects on the Brain
      1. Sedatives: reduce CNS activity
      2. Analgesics: relieve pain by affecting pain pathways or peripheral sensations
      3. Psychotropics: alter mood and emotional states
      4. Anticonvulsants: control seizures
      5. Stimulants: facilitate CNS activity
    4. Memory and learning
      1. Short-term, or primary, memories last a short time, immediately accessible (phone number)
      2. Secondary memories fade with time (your address at age 5)
      3. Tertiary memories last a lifetime (your name)
      4. Memories are stored within specific regions of the cerebral cortex.
      5. Learning, a more complex process involving the integration of memories and their use to direct or modify behaviors
      6. Neural basis for memory and learning has yet to be determined.
  • Fibers in CNS
    1. Association fibers: link portions of the cerebrum;
    2. Commissural fibers: link the two hemispheres;
    3. Projection fibers: link the cerebrum to the brain stem

The Body Regulates pH in Several Ways

  • Buffers are weak acid mixtures (such as bicarbonate/CO2) which minimize pH change
    • Buffer is always a mixture of 2 compounds
      • One compound takes up H ions if there are too many (H acceptor)
      • The second compound releases H ions if there are not enough (H donor)
    • The strength of a buffer is given by the buffer capacity
      • Buffer capacity is proportional to the buffer concentration and to a parameter known as the pK
    • Mouth bacteria produce acids which attack teeth, producing caries (cavities). People with low buffer capacities in their saliva have more caries than those with high buffer capacities.
  • CO2 gas (a potential acid) is eliminated by the lungs
  • Other acids and bases are eliminated by the kidneys

1. Automatic control (sensory) of respiration is in - brainstem (midbrain) 

2. Behavioral/voluntary control is in - the cortex

3. Alveolar ventilation -the amount of atmospheric air that actually reaches the alveolar per breath and that can participate in the exchange of gasses between alveoli and blood

4. Only way to increase gas exchange in alveolar capillaries - perfusion-limited gas exchange 

5. Pulmonary ventiliation not effected by - concentration of bicarbonate ions

6. Central chemoreceptors - medulla -  CO2, O2 and H+ concentrations

7. Peripheral chemoreceptors - carotid and aortic bodies- PO2, PCO2 and pH 

8. Major stimulus for respiratory centers - arterial PCO2 

9. Rhythmic breathing depends on 
1. continuous (tonic) inspiratory drive from DRG (dorsal respiratory group)
2. intermittent (phasic) expiratory input from cerebrum, thalamus, cranial nerves and ascending spinal cord sensory tracts

10. Primary site for gas exchange - type I epithelial cells for alveoli

 

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.

Neural Substrates of Breathing

A.    Medulla Respiratory Centers

Inspiratory Center (Dorsal Resp Group - rhythmic breathing) → phrenic nerve→ intercostal nerves→ diaphragm + external intercostals

Expiratory Center (Ventral Resp Group - forced expiration) → phrenic nerve → intercostal nerves → internal intercostals + abdominals (expiration)

1.    eupnea - normal resting breath rate (12/minute)
2.    drug overdose - causes suppression of Inspiratory Center

B.    Pons Respiratory Centers

1.    pneumotaxic center - slightly inhibits medulla, causes shorter, shallower, quicker breaths
2.    apneustic center - stimulates the medulla, causes longer, deeper, slower breaths

C.    Control of Breathing Rate & Depth

1.    breathing rate - stimulation/inhibition of medulla
2.    breathing depth - activation of inspiration muscles
3.    Hering-Breuer Reflex - stretch of visceral pleura that lungs have expanded (vagal nerve)

D.    Hypothalamic Control - emotion + pain to the medulla

E.    Cortex Controls (Voluntary Breathing) - can override medulla as during singing and talking

Structure of a nerve:

A peripheral nerve is arranged much like a muscle in terms of its connective tissue. It has an outer covering which forms a sheath around the nerve, called the epineurium. Often a nerve will run together with an artery and vein and their connective coverings will merge. Nerve fibers, which are axons, organize into bundles known as fascicles with each fascicle surrounded by the perineurium. Between individual nerve fibers is an inner layer of endoneurium.

 

 The myelin sheath in peripheral nerves consists of Schwann cells wrapped in many layers around the axon fibers. Not all fibers in a nerve will be myelinated, but most of the voluntary fibers are. The Schwann cells are portrayed as arranged along the axon like sausages on a string. Gaps between the Schwann cells are called nodes of Ranvier. These nodes permit an impulse to travel faster because it doesn't need to depolarize each area of a membrane, just the nodes. This type of conduction is called saltatory conduction and means that impulses will travel faster in myelinated fibers than in unmyelinated ones.

The myelin sheath does several things:

1) It provides insulation to help prevent short circuiting between fibers.

2) The myelin sheath provides for faster conduction.

3) The myelin sheath provides for the possibility of repair of peripheral nerve fibers. Schwann cells help to maintain the micro-environments of the axons and their tunnel (the neurilemma tunnel) permits re-connection with an effector or receptor  CNS fibers, not having the same type of myelination accumulate scar tissue after damage, which prevents regeneration.

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