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NEET MDS Synopsis

Types of Neurons
Pharmacology

Types of Neurons (Function)

•There are 3 general types of neurons (nerve cells): 

1-Sensory (Afferent ) neuron:A neuron that detects changes in the external or internal environment and sends information about these changes to the CNS. (e.g: rods and cones, touch receptors). They usually have long dendrites and relatively short axons. 

2-Motor (Efferent) neuron:A neuron located within the CNS that controls the contraction of    a muscle or the secretion of a gland. They usually have short dendrites and long axons. 

2-Interneuron or association neurons: A neuron located entirely within the CNS in which they form the connecting link between the afferent and efferent neurons. They have short dendrites and may have either a short or long axon.

Drugs Used in Diabetes -Biguanides
Pharmacology

Biguanides

metformin

Mechanism

↓ gluconeogenesis


appears to inhibit complex 1 of respiratory chain

↑ insulin sensitivity
↑ glycolysis
↓ serum glucose levels
↓ postprandial glucose levels

Clinical use

first-line therapy in type II DM

Toxicity

no hypoglycemia
no weight gain
lactic acidosis is most serious side effect 
contraindicated in renal failure 

Structural Divisions of the nervous system
Physiology

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

Sympatholytics And Alpha Adrenergic Blockers 
Pharmacology

Sympatholytics And Alpha Adrenergic Blockers 

Types 
1.    Alpha 1-receptor blockers: prazocin,doxazocin. 
2.    Centrally acting alpha 2- agonists: methyldopa, clonidine. 
3.    Peripherally acting adrenergic antagonists: reserpine. 
4.    Imidazoline receptor agonists: rilmenidine, moxonidine. 
 
Advantages 

- Alpha1- receptor blockers and imidazoline receptor agonists improve lipid profile and insulin sensitivity. 
- Methyldopa: increases renal blood flow. Drug of choice during pregnancy. 
- Reserpine: neutral metabolic effects and cheap. 

Indications: 

- Diabetes mellitus: alpha1- receptor blockers, imidazoline receptor agonists. 
- Dyslipidemia: alpha 1- receptor blockers, imidazoline receptor agonists. 
- Prostatic hypertrophy: alpha 1- receptor blockers. 
- When there is a need for rapid reduction in blood pressure: clonidine. 

Side Effects 

- Prazocin: postural hypotension, diarrhea, occasional tachycardia, and tolerance (due to fluid retention). 
- Methyldopa: sedation, hepatotoxicity, hemolytic anemia, and tolerance. 
- Reserpine: depression, lethargy, weight loss, peptic ulcer, diarrhea, and impotence
- Clonidine: dry mouth, sedation, bradycardia, impotence, and rebound hypertension if stopped suddenly. 

Considerations 
- Prazocin, methyldopa, and reserpine should be combined with a diuretic because of fluid retention. 

Direct Arterial Vasodilators 

Types: hydralazine, diazoxide, nitroprusside, and minoxidil

Heroin
Pharmacology

Heroin (diacetyl morphine)

Heroin is synthetically derived from the natural opioid alkaloid morphine

Largely owing to its very rapid onset of action and very short half-life, heroin is a popular drug of abuse

It is most effective when used intravenously

Heroin is rapidly deacetylated to 6-monoacetyl morphine and morphine, both of which are active at the mu opioid receptor

More lipid soluble than morphine and about 2½ times more potent.  It enters the CNS more readily.

BIOLOGICAL BUFFER SYSTEMS 
Biochemistry

BIOLOGICAL BUFFER SYSTEMS 

Cells and organisms maintain a specific and constant cytosolic pH, keeping biomolecules in their optimal ionic state, usually near pH 7. In multicelled organisms, the pH of the extracellular fluids (blood, for example) is also tightly regulated. Constancy of pH is achieved primarily by biological buffers : mixtures of weak acids and their conjugate bases 

Body fluids and their principal buffers


Body fluids                     Principal buffers

Extracellular fluids        {Biocarbonate buffer Protein buffer } 

Intracellular fluids         {Phosphate buffer, Protein }

Erythrocytes                 {Hemoglobin buffer}

Properties of Amalgam
Dental Materials

Properties of Amalgam.

The most important physical properties of amalgam are


Coefficient of thermal expansion = 25-1 >ppm/ C (thus amalgams allow percolation during temperature changes)



Thermal conductivity-high (therefore, amalgams need insulating liner or base in deep restorations)
Flow and creep. Flow and creep are characteristics that deal with an amalgam undergoing deformation when stressed. The lower the creep value of an amalgam, the better the marginal integrity of the restoration. Alloys with high copper content usually have lower creep values than the conventional silver-tin alloys.


 Dimensional change. An amalgam can expand or contract depending upon its usage. Dimensional change can be minimized by proper usage of alloy and mercury. Dimensional change on setting, less than ± 20 (excessive expansion can produce post operative pain)


 Compression strength. Sufficient strength to resist fracture is an important requirement for any restorative material. At a 50 percent mercury content, the compression strength is approximately 52,000 psi. In comparison, the compressive strength of dentin and enamel is 30,000 psi and 100,000 psi, respectively. The strength of an amalgam is determined primarily by the composition of the alloy, the amount of residual mercury remaining after condensation, and the degree of porosity in the amalgam restoration.
Electrochemical corrosion produces penetrating corrosion of low-copper amalgams but only produces superficial corrosion of high copper amalgams, so they last longer



Because of low tensile strength, enamel support is needed at margins



Spherical high-copper alloys develop high tensile strength faster and can be polished sooner
Excessive creep is associated with silver mercury phase of low-copper amalgams and contributes to early marginal fracture
Marginal fracture correlated with creep and electrochemical corrosion in low-copper amalgams
Bulk fracture (isthmus fracture) occurs across thinnest portions of amalgam restorations because  of high stresses during traumatic occlusion and/or the accumulated effects of fatigue
Dental amalgam is very resistant to abrasion


       

Gross Features of the Tongue
Anatomy

Gross Features of the Tongue


The dorsum of the tongue is divided by a V-shaped sulcus terminalis into anterior oral (presulcal) and posterior pharyngeal (postsulcal) parts.
The apex of the V is posterior and the two limbs diverge anteriorly.
The oral part forms about 2/3 of the tongue and the pharyngeal part forms about 1/3.


 

Oral Part of the Tongue


This part is freely movable, but it is loosely attached to the floor of the mouth by the lingual frenulum.



On each side of the frenulum is a deep lingual vein, visible as a blue line.
It begins at the tip of the tongue and runs posteriorly.
All the veins on one side of the tongue unite at the posterior border of the hyoglossus muscle to form the lingual vein, which joins the facial vein or the internal jugular vein.



On the dorsum of the oral part of the tongue is a median groove.
This groove represents the site of fusion of the distal tongue buds during embryonic development.


 

The Lingual Papillae and Taste Buds


The filiform papillae (L. filum, thread) are numerous, rough, and thread-like.
They are arranged in rows parallel to the sulcus terminalis.



The fungiform papillae are small and mushroom-shaped.
They usually appear are pink or red spots.



The vallate (circumvallate) papillae are surrounded by a deep, circular trench (trough), the walls of which are studded with taste buds.



The foliate papillae are small lateral folds of lingual mucosa that are poorly formed in humans.



The vallate, foliate and most of the fungiform papillae contain taste receptors, which are located in the taste buds.


 

The Pharyngeal Part of the Tongue


This part lies posterior to the sulcus terminalis and palatoglossal arches.
Its mucous membrane has no papillae.



The underlying nodules of lymphoid tissue give this part of the tongue a cobblestone appearance.
The lymphoid nodules (lingual follicles) are collectively known as the lingual tonsil.

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