Additional Information
Book Details
Abstract
Enhanced learning in the form of animations for functioning of organ systems
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Cover | Cover | ||
Title page | iii | ||
Copyright page | iv | ||
Dedication | v | ||
Foreword | vii | ||
Preface | ix | ||
Acknowledgements | xi | ||
Reviewers | xiii | ||
Contents | xv | ||
Section I - General physiology | 1 | ||
1 - General Principles in Physiology | 3 | ||
Knowledge goals | 3 | ||
Distribution of body fluids | 3 | ||
Body compartments | 3 | ||
Ions in ECF and ICF | 3 | ||
Measurement of body fluids | 4 | ||
Nonionic diffusion | 4 | ||
Homeostasis | 5 | ||
Feedback regulation in body | 6 | ||
Negative feedback regulation | 6 | ||
Positive feedback regulation/vicious cycle | 6 | ||
2 - Cellular Physiology | 9 | ||
Knowledge goals | 9 | ||
The cell and its organelles | 9 | ||
Functions of cell | 9 | ||
Cell membrane | 9 | ||
Singer and Nicolson Model of Cell Membrane (1972) or Fluid Mosaic Model of Cell Membrane | 10 | ||
Cytoplasm | 10 | ||
Transport across cell membrane | 13 | ||
Passive transport | 13 | ||
Diffusion | 13 | ||
Simple Diffusion | 13 | ||
Facilitated Diffusion | 13 | ||
Osmosis | 14 | ||
Active transport | 15 | ||
Primary Active Transport | 15 | ||
Na+-K+ ATPase Pump | 16 | ||
Calcium Pump | 17 | ||
Potassium Pump (H+-K+ Pump) | 17 | ||
Secondary Active Transport | 17 | ||
Sodium Cotransport of Glucose | 17 | ||
Endocytosis and exocytosis | 17 | ||
Endocytosis | 18 | ||
Forms of Endocytosis | 18 | ||
Exocytosis (Reverse of Endocytosis) | 18 | ||
Oxidative phosphorylation | 18 | ||
Uncouplers | 19 | ||
Diseases associated with mitochondria | 19 | ||
Molecular motors | 19 | ||
Cell adhesion molecules | 19 | ||
Intercellular connections | 20 | ||
Cell signalling mechanisms | 21 | ||
Intercellular communication | 21 | ||
Chemical messengers | 22 | ||
Cell signalling pathway | 22 | ||
G-proteins | 22 | ||
Types of G-protein | 23 | ||
Stimulators of Transcription | 25 | ||
Summary of cell signalling pathways | 26 | ||
3 - Genetics | 29 | ||
Knowledge goals | 29 | ||
Deoxyribonucleic acid | 29 | ||
Watson and Crick model of DNA (B-DNA) | 29 | ||
DNA replication | 30 | ||
Cell cycle and cell division | 30 | ||
Mitosis | 30 | ||
Meiosis | 30 | ||
Chromosomal anomalies | 30 | ||
Numerical anomalies | 31 | ||
Down Syndrome (Mongolism) | 31 | ||
Structural anomalies | 31 | ||
Hermaphroditism | 31 | ||
Causes | 31 | ||
Karyotype | 33 | ||
Gene mutations | 33 | ||
Ribonucleic acid | 33 | ||
Types of RNA | 33 | ||
Transcription | 34 | ||
Translation | 34 | ||
Ubiquitination | 35 | ||
Chaperones | 35 | ||
Cloning | 35 | ||
Gene therapy | 35 | ||
Gene expression | 35 | ||
Central dogma of genetic information | 35 | ||
Gene amplification | 35 | ||
Bone marrow transplantation (stem cell transplantation) | 36 | ||
Gene targeting or replacement strategy | 36 | ||
Heat shock proteins or stress proteins | 36 | ||
4 - Topics of Special Interest | 37 | ||
Knowledge goals | 37 | ||
Aquaporins | 37 | ||
Patch clamp technique | 38 | ||
Calcium binding proteins | 38 | ||
Apoptosis | 38 | ||
Mechanism of apoptosis | 39 | ||
Free radicals and anti-oxidants | 39 | ||
Generation of free radicals | 39 | ||
Eicosanoids | 40 | ||
Prostaglandins | 40 | ||
Leukotrienes | 41 | ||
Introduction | 1 | ||
Section II - Blood | 43 | ||
5 - Red Blood Cells and Haemoglobin | 45 | ||
Knowledge goals | 45 | ||
Red blood cells (RBCs) | 45 | ||
RBC membrane | 45 | ||
Composition of red cells | 45 | ||
Normal count | 46 | ||
Variations in size, shape and number of red cells | 46 | ||
Packed cell volume and erythrocyte sedimentation rate | 46 | ||
Red cell indices | 47 | ||
Osmotic fragility | 48 | ||
Haemopoiesis or haematopoiesis | 48 | ||
Erythropoiesis | 48 | ||
Sites of erythropoiesis | 48 | ||
Red and yellow bone marrow | 49 | ||
Stages of erythropoiesis | 50 | ||
Erythropoietin (EPO) | 52 | ||
Source of EPO | 52 | ||
Stimulus for EPO synthesis | 52 | ||
Release of EPO | 53 | ||
Factors affecting EPO secretion | 53 | ||
Role of EPO in body | 53 | ||
Reticulocytes | 53 | ||
Haemoglobin | 54 | ||
Normal values of Hb | 54 | ||
Structure of haemoglobin | 54 | ||
Synthesis of haemoglobin | 54 | ||
Fate of haemoglobin | 55 | ||
Functions of haemoglobin | 55 | ||
Types of haemoglobin | 56 | ||
Variants of haemoglobin | 56 | ||
Haemoglobinopathies | 57 | ||
Sickle cell anaemia | 57 | ||
Forms | 57 | ||
Pathophysiology | 57 | ||
Clinical Features | 57 | ||
Diagnosis | 58 | ||
Treatment | 58 | ||
Thalassemia | 58 | ||
Jaundice | 59 | ||
Bilirubin Metabolism | 59 | ||
Clinical Features | 60 | ||
Types of Jaundice | 60 | ||
Complications | 60 | ||
Management | 60 | ||
6 - Anaemias | 63 | ||
Knowledge goals | 63 | ||
Classification of anaemia | 63 | ||
Whitby’s classification | 63 | ||
Wintrobe’s classification | 63 | ||
Iron deficiency anaemia | 63 | ||
Aetiology | 63 | ||
Clinical features | 63 | ||
Diagnosis | 64 | ||
Treatment | 64 | ||
Response to treatment | 65 | ||
Megaloblastic anaemia | 65 | ||
Causes | 65 | ||
Clinical features | 65 | ||
Diagnosis | 65 | ||
Treatment | 66 | ||
Folic acid deficiency anaemia | 67 | ||
Features | 67 | ||
Section III - Cardiovascular system | 117 | ||
13 - Cardiac Muscle and Properties | 121 | ||
Knowledge goals | 121 | ||
Cardiac muscle | 121 | ||
Properties of cardiac muscle | 121 | ||
Innervation of heart | 122 | ||
Length tension relationship in cardiac muscle | 122 | ||
Force-velocity relationship in cardiac muscle | 122 | ||
Conduction of impulse in cardiac tissue | 123 | ||
Pacemaker potential and cardiac muscle action potential | 124 | ||
Pacemaker potential | 124 | ||
Effect of autonomic nervous system on PMP | 125 | ||
Cardiac muscle action potential | 126 | ||
14 - Cardiac Cycle | 129 | ||
Knowledge goals | 129 | ||
Cardiac cycle | 129 | ||
Jugular venous pressure, carotid arterial pulse, heart sounds | 132 | ||
Jugular venous pressure (JVP) | 132 | ||
Heart sounds | 132 | ||
Carotid artery pulse | 133 | ||
Correlation between ECG, carotid pulse and heart sounds | 133 | ||
Arterial pulse | 134 | ||
15 - Cardiac Output | 137 | ||
Knowledge goals | 137 | ||
Cardiac output | 137 | ||
Factors affecting cardiac output | 137 | ||
Stroke Volume | 137 | ||
Intrinsic Regulation (Heterometric Regulation) of cardiac output | 138 | ||
Preload and Afterload in Cardiac Tissue | 138 | ||
Venous Return | 138 | ||
Extrinsic Regulation (Homometric Regulation) of cardiac output—Regulated by ANS | 139 | ||
Role of Myocardial Contractility | 139 | ||
Factors Affecting Heart Rate | 140 | ||
Methods of measurement of cardiac output | 140 | ||
16 - Electrocardiogram (ECG) | 143 | ||
Knowledge goals | 143 | ||
Abnormalities and significance of ECG waves, segments and intervals | 143 | ||
Uses of ECG | 144 | ||
Leads for ECG recording | 144 | ||
Physiological basis of ECG | 146 | ||
Cardiac vector concept | 149 | ||
Vector cardiography | 150 | ||
ECG changes in myocardial infarction | 151 | ||
Physiological basis of ECG in MI | 151 | ||
Ecg changes in hyperkalaemia and hypokalaemia | 152 | ||
ECG changes in HYPERCALCAEMIA and hypocalcaemia | 152 | ||
Long QT syndrome (LQTS) | 154 | ||
His bundle electrogram (HBE) | 154 | ||
Cardiac arrhythmias | 155 | ||
Atrial arrythmias | 156 | ||
Ventricular arrhythmias | 157 | ||
Sinus arrhythmia | 157 | ||
Heart block | 158 | ||
Bundle branch block | 158 | ||
Wolff–Parkinson–White (WPW) syndrome or accelerated AV conduction | 159 | ||
17 - Regulation of Blood Pressure and Blood Flow | 161 | ||
Knowledge goals | 161 | ||
Blood pressure (BP) | 161 | ||
Classification of baroreceptors | 162 | ||
Atrial baroreceptors | 165 | ||
Bainbridge reflex | 165 | ||
Ventricular baroreceptors | 166 | ||
Bezold–Jarisch reflex | 166 | ||
Pulmonary baroreceptors | 166 | ||
Functions of angiotensin II | 168 | ||
Functions of angiotensin III | 168 | ||
Mayer waves and Traube—Hering waves | 168 | ||
Regulation of blood flow | 169 | ||
Neural regulation | 169 | ||
Humoral regulation | 170 | ||
Autoregulation of blood flow | 172 | ||
18 - Circulatory Shock and Heart Failure | 173 | ||
Knowledge goals | 173 | ||
Circulatory shock | 173 | ||
Stages of shock | 173 | ||
Compensatory Mechanisms in Shock | 174 | ||
Heart failure | 176 | ||
Types of heart failure | 176 | ||
Acute and Chronic Heart Failure | 176 | ||
Left-Sided Heart Failure and Right Sided Heart Failure | 176 | ||
Forward Failure and Backward Failure | 176 | ||
High and Low Output Failure | 177 | ||
Systolic and Diastolic Failure | 178 | ||
Compensatory and Decompensatory Heart Failure | 178 | ||
19 - Haemodynamics | 181 | ||
Knowledge goals | 181 | ||
Measurement of blood flow | 181 | ||
Blood vessels | 181 | ||
Microcirculation | 182 | ||
Functions of microcirculation | 182 | ||
Concept of laminar and turbulent blood flow | 182 | ||
Shear stress | 183 | ||
Poiseuille–Hagen formula | 183 | ||
Factors on which resistance depends | 184 | ||
Factors affecting viscosity | 184 | ||
Critical closing pressure | 184 | ||
Law of laplace | 185 | ||
Physiological significance | 185 | ||
Concept of average velocity | 186 | ||
Windkessel effect | 186 | ||
Starling forces at capillary level | 186 | ||
20 - Regional Circulation | 189 | ||
Knowledge goals | 189 | ||
Peculiarities of coronary circulation | 189 | ||
Factors affecting coronary blood flow | 189 | ||
Methods of measurement of coronary blood flow | 191 | ||
Applied aspect: diseases of coronary circulation (coronary artery diseases) | 191 | ||
Foetal circulation | 192 | ||
Cerebral circulation | 192 | ||
Anatomy | 192 | ||
Regulation of cerebral blood flow | 192 | ||
Measurement of cerebral blood flow | 193 | ||
Cutaneous circulation | 193 | ||
21 - Topics of Special Interest | 195 | ||
Knowledge goals | 195 | ||
Goldblatt hypertension | 195 | ||
Murmurs | 195 | ||
Types of murmurs | 195 | ||
Hypertension | 195 | ||
Atherosclerosis | 196 | ||
Introduction | 117 | ||
Section IV - Pulmonary physiology | 199 | ||
22 - Functional Organisation of Pulmonary System | 201 | ||
Knowledge goals | 201 | ||
Branching of pulmonary tree | 201 | ||
Cells present in alveolus | 201 | ||
Respiratory membrane | 202 | ||
Factors affecting diffusion of gases across respiratory membrane | 202 | ||
Non respiratory functions of lungs | 203 | ||
23 - The Mechanics of Respiration | 207 | ||
Knowledge goals | 207 | ||
Mechanics of respiration | 207 | ||
Pressure and volume changes during respiration | 209 | ||
Factors affecting intrapleural pressure along with applied aspect | 209 | ||
Intrapleural pressure can be measured by | 209 | ||
Various lung volumes and capacities | 210 | ||
Spirometry | 210 | ||
Lung volumes and capacities | 210 | ||
Static Lung Volumes and Capacities | 210 | ||
Dynamic Lung Volume and Capacities | 211 | ||
Functional Residual Capacity (FRC) | 211 | ||
Vital Capacity (VC) | 212 | ||
Factors Affecting VC | 213 | ||
Importance of VC | 213 | ||
Alveolar surface tension and surfactants | 214 | ||
Functions of surfactant | 215 | ||
Compliance | 216 | ||
Curves are not straight— they are curved | 217 | ||
Shift of compliance curve | 217 | ||
Factors affecting compliance | 219 | ||
Ventilation perfusion ratio (V/P Ratio) | 220 | ||
24 - Alveolar Ventilation | 223 | ||
Knowledge goals | 223 | ||
Composition and partial pressure of air | 223 | ||
Dead space | 223 | ||
Calculation of anatomical dead space (Fowler’s method or single breath nitrogen method) | 223 | ||
Single Breath Nitrogen Curve | 225 | ||
Calculation of physiological dead space (Bohr’s equation method) | 225 | ||
Alveolar ventilation | 226 | ||
How does gravity affect alveolar ventilation? | 226 | ||
25 - Regulation of Respiration | 227 | ||
Knowledge goals | 227 | ||
Regulation of respiration | 227 | ||
Neural regulation of respiration | 227 | ||
Automatic control | 227 | ||
How the Effect of Respiratory Centres is Shown Experimentally | 229 | ||
Voluntary control | 230 | ||
Chemical regulation of respiration | 230 | ||
Peripheral chemoreceptors—Carotid body and aortic body | 231 | ||
Medullary chemoreceptors or central chemoreceptors | 232 | ||
Chemical changes affecting ventilator responses | 234 | ||
Effect of prolonged hyperventilation | 235 | ||
Complications | 236 | ||
Non chemical regulation of respiration | 236 | ||
Genesis of respiration | 238 | ||
26 - Gas Transport | 241 | ||
Knowledge goals | 241 | ||
Oxygen transport | 241 | ||
O2–Hb dissociation curve | 241 | ||
T–R configuration of Hb | 242 | ||
Factors affecting O2–Hb dissociation curve | 242 | ||
Bohr effect | 243 | ||
Double Bohr effect | 243 | ||
Oxygen–myoglobin curve | 244 | ||
CO2 transport in blood | 245 | ||
Dissolved in plasma | 245 | ||
As bicarbonate ion in RBCs | 245 | ||
As carbaminohaemoglobin | 246 | ||
Haldane effect | 246 | ||
CO2 dissociation curve | 246 | ||
27 - Respiratory Adjustments at High Atmospheric Pressure | 249 | ||
Knowledge goals | 249 | ||
Dysbarism | 249 | ||
Self-contained underwater breathing apparatus (SCUBA) | 249 | ||
28 - High Altitude Physiology | 251 | ||
Knowledge goals | 251 | ||
Physiological changes taking place in body at high altitude | 251 | ||
Hypoxia | 253 | ||
Types of hypoxia | 253 | ||
Signs of hypoxia | 253 | ||
Oxygen therapy | 254 | ||
Effective In | 255 | ||
Uses of Hyperbaric Oxygen Therapy | 255 | ||
Oxygen Toxicity | 255 | ||
Side Effects of Hyperbaric Oxygen Therapy | 255 | ||
29 - Exercise Physiology | 257 | ||
Knowledge goals | 257 | ||
Grading of exercise | 257 | ||
Adjustments in exercise | 257 | ||
Blood pressure changes during exercises | 257 | ||
Reasons | 258 | ||
Respiratory changes during exercise | 258 | ||
At tissue level | 259 | ||
Other changes during exercise | 259 | ||
VO2 max, oxygen deficit and oxygen debt | 259 | ||
VO2 max | 259 | ||
Oxygen deficit and oxygen debt | 259 | ||
30 - Pulmonary Circulation | 261 | ||
Knowledge goals | 261 | ||
Pulmonary circulation | 261 | ||
Features of pulmonary circulation | 261 | ||
Factors affecting pulmonary blood flow | 261 | ||
Zones of lungs | 261 | ||
Regulation of pulmonary blood flow | 262 | ||
Clinical aspect | 262 | ||
31 - Abnormalities Associated with Respiration | 265 | ||
Knowledge goals | 265 | ||
Asphyxia | 265 | ||
Causes | 265 | ||
Effects and sequelae | 265 | ||
Drowning | 265 | ||
Freshwater drowning | 265 | ||
Sea water drowning | 265 | ||
Management | 265 | ||
Periodic breathing | 265 | ||
Kussmaul breathing | 267 | ||
Sleep apnea syndrome | 267 | ||
COPD—Chronic obstructive pulmonary disease | 268 | ||
Bronchial asthma | 268 | ||
Emphysema | 268 | ||
How Cigarette Smoke Affects Lungs | 268 | ||
Pathogenesis | 268 | ||
Effects and Sequelae | 268 | ||
Chronic bronchitis | 269 | ||
Bronchiectasis | 269 | ||
Cystic fibrosis | 269 | ||
32 - Topics of Special Interest | 271 | ||
Knowledge goals | 271 | ||
Foetal lung | 271 | ||
Placenta consists of two parts | 271 | ||
Carbon monoxide poisoning | 271 | ||
Diffusion capacity of lung | 272 | ||
Artificial respiration | 273 | ||
Iron lung (Drinker’s method or negative pressure ventilation) | 273 | ||
Continuous positive airway pressure (CPAP) | 274 | ||
Introduction | 199 | ||
Physiological shunt | 200 | ||
Section V - Renal physiology | 275 | ||
33 - Nephron and Renal Circulation | 277 | ||
Knowledge goals | 277 | ||
Structure of nephron | 277 | ||
Juxtaglomerular apparatus (JGA) | 278 | ||
Functions of JGA | 279 | ||
Peculiarities of renal circulation | 279 | ||
Peculiar points about renal circulation | 280 | ||
Renal autoregulation | 280 | ||
Myogenic mechanism | 280 | ||
Tubuloglomerular and glomerulo tubular feedback mechanism | 281 | ||
34 - Mechanism of Urine Formation | 283 | ||
Knowledge goals | 283 | ||
Glomerular filtration rate (GFR) | 283 | ||
Factors affecting GFR | 283 | ||
Conditions affecting GFR | 286 | ||
Measurement of GFR | 286 | ||
Tubular transport | 287 | ||
In loop of Henle | 287 | ||
Transport of Na+ and other solutes like glucose, , , amino acids | 288 | ||
In Early PCT | 288 | ||
In Late PCT | 288 | ||
In Loop of Henle | 288 | ||
In Early DCT | 290 | ||
Late DCT and Collecting Duct | 290 | ||
Renal transport of K | 290 | ||
In PCT | 290 | ||
In loop of Henle | 291 | ||
In early DCT | 291 | ||
In late DCT and collecting duct | 291 | ||
Factors affecting urinary K+ excretion | 291 | ||
Renal handling of glucose | 291 | ||
In early PCT | 291 | ||
In late PCT | 291 | ||
Glucose titration curve | 292 | ||
Renal handling of urea | 293 | ||
Urea recycling | 293 | ||
35 - Physiology of Micturition | 295 | ||
Knowledge goals | 295 | ||
Micturition reflex | 295 | ||
Nerve supply of urinary bladder | 295 | ||
Cystometrogram | 296 | ||
Components of cystometrogram | 297 | ||
Diuretics | 297 | ||
Classification of diuretic drugs | 297 | ||
Mnemonics | 297 | ||
Water diuresis and osmotic diuresis | 299 | ||
Diabetes insipidus | 300 | ||
SIADH—Syndrome of inappropriate secretion of ADH | 300 | ||
36 - Renal Function Tests | 303 | ||
Knowledge goals | 303 | ||
Renal function tests | 303 | ||
37 - Haemodialysis and Peritoneal Dialysis | 307 | ||
Knowledge goals | 307 | ||
Haemodialysis (artificial kidney) | 307 | ||
Peritoneal dialysis | 307 | ||
38 - Counter Current Mechanism in Kidney | 311 | ||
Knowledge goals | 311 | ||
Counter current mechanism in kidney (or hyperosmolality of medullary interstitium) | 311 | ||
Concentration dilution of urine (or factors affecting counter current mechanism) | 313 | ||
39 - Acidification of Urine | 317 | ||
Knowledge goals | 317 | ||
Acidification of urine | 317 | ||
Acidification of urine in renal tubules | 317 | ||
Fate of H+ Secreted by Tubular Cells | 318 | ||
40 - Acid Base Balance | 319 | ||
Knowledge goals | 319 | ||
Henderson Hasselbalch equation | 319 | ||
Acid base disturbances | 320 | ||
Anion gap | 322 | ||
Buffer system | 322 | ||
41 - Topics of Special Interest | 327 | ||
Knowledge goals | 327 | ||
Nephrotic syndrome and nephritic syndrome | 327 | ||
Acute renal failure and chronic renal failure | 327 | ||
TAMM–horsfall proteins | 327 | ||
Introduction | 275 | ||
Section VI - Gastrointestinal tract | 329 | ||
42 - Organisation of GIT | 331 | ||
Knowledge goals | 331 | ||
Histology of gut (from inside to outside) | 331 | ||
Innervation of gut | 331 | ||
Plexus present in intrinsic nervous system | 332 | ||
Immunology of gut | 333 | ||
43 - Salivary Secretion and Oesophagus | 335 | ||
Knowledge goals | 335 | ||
Salivary secretion | 335 | ||
Saliva | 335 | ||
Functions of Saliva | 335 | ||
Oesophagus | 335 | ||
Oesophageal sphincters | 336 | ||
Deglutition (swallowing) | 336 | ||
Phases of deglutition | 336 | ||
Disorders of deglutition | 337 | ||
Achalasia cardia | 337 | ||
Gastroesophageal reflex disease (GERD) | 337 | ||
44 - Gut Peptides | 339 | ||
Knowledge goals | 339 | ||
Gut peptides | 339 | ||
Gastrin | 339 | ||
Actions of Gastrin | 339 | ||
CCK—Cholecystokinin-pancreozymin | 339 | ||
Actions of CCK | 339 | ||
Secretin (1st hormone) | 340 | ||
Bayliss and Starling | 340 | ||
Stimuli for Secretin Release | 340 | ||
Section VII - Nerve muscle physiology | 389 | ||
52 - Classification of Nerve Fibres | 391 | ||
Knowledge goals | 391 | ||
Classification of nerve fibres | 391 | ||
Different types of neurons | 391 | ||
Transport system in neuron | 393 | ||
Sheaths around nerve | 393 | ||
53 - Properties of Nerve | 395 | ||
Knowledge goals | 395 | ||
Excitation | 395 | ||
Resting membrane potential (RMP) | 395 | ||
Technique to record RMP | 395 | ||
Genesis of RMP | 395 | ||
Nernst equation | 396 | ||
Action potential in nerve fibre | 397 | ||
Findings | 397 | ||
Phases and ionic basis (Hodgkin and Huxley theory) | 398 | ||
Action potential in mixed nerve | 399 | ||
Characteristic features of stimulus | 399 | ||
Technique of Recording Electrotonic Potential | 401 | ||
Conduction | 402 | ||
Summation | 404 | ||
Unfatigability | 404 | ||
Glial cells | 404 | ||
Microglia cells | 404 | ||
Functions of Microglia Cells | 404 | ||
Macroglia cells | 405 | ||
Myelinogenesis | 405 | ||
54 - Neuromuscular Junction | 407 | ||
Knowledge goals | 407 | ||
Neuromuscular junction | 407 | ||
Sequence of events | 407 | ||
Applied aspect | 407 | ||
Myasthenia gravis | 407 | ||
Lambert – eaton syndrome | 408 | ||
55 - Nerve Injury and Regeneration | 411 | ||
Knowledge goals | 411 | ||
Nerve injury and degeneration | 411 | ||
Causes | 411 | ||
Sunderland classification of nerve injuries | 411 | ||
Degenerative changes in nerve fibre | 411 | ||
Complications of nerve injury | 412 | ||
Nerve regeneration | 412 | ||
Neurotropins | 412 | ||
Nerve growth factor (NGF) | 412 | ||
Brain derived neurotrophic factor (BDNF) | 413 | ||
Other growth factors | 413 | ||
Mechanism of action of growth factors | 414 | ||
56 - Skeletal Muscle | 415 | ||
Knowledge goals | 415 | ||
Sarcomere and muscle proteins | 415 | ||
Sarcotubular system | 419 | ||
Excitation contraction coupling in skeletal muscle | 419 | ||
Sequence of events | 419 | ||
Isotonic and isometric contraction | 420 | ||
Fast muscle and slow muscle | 421 | ||
Length tension relationship in skeletal muscle | 421 | ||
Recording | 423 | ||
ForcE-Velocity relationship in skeletal muscle | 424 | ||
57 - Smooth Muscle | 425 | ||
Knowledge goals | 425 | ||
Types of smooth muscles | 425 | ||
Excitation contraction in smooth muscle | 425 | ||
Electrophysiology of smooth muscle | 425 | ||
58 - Topics of Special Interest | 429 | ||
Knowledge goals | 429 | ||
Differences between skeletal muscle, smooth muscle and cardiac muscle | 429 | ||
Ryanodine receptor | 429 | ||
Rigor mortis | 429 | ||
Electromyography | 430 | ||
Types of EMG | 432 | ||
Nerve physiology | 389 | ||
Introduction | 389 | ||
Function of neuron | 390 | ||
Section VIII - Endocrine | 433 | ||
59 - General Principles of Endocrine System | 435 | ||
Knowledge goals | 435 | ||
Control of hormonal secretion | 435 | ||
Feedback regulation | 435 | ||
Negative Feedback Regulation | 435 | ||
Positive Feedback Regulation | 436 | ||
Nervous regulation | 436 | ||
Chronotropic regulation | 436 | ||
Mechanism of action of hormones | 436 | ||
Classification of hormones | 436 | ||
Hypophysiotropic hormones | 437 | ||
60 - Pituitary Gland and Growth Hormone | 439 | ||
Knowledge goals | 439 | ||
Structure of pituitary gland (the master gland) | 439 | ||
Histology of pituitary gland | 439 | ||
Hypothalamus-pituitary axis (HPA) | 440 | ||
Hormones secreted by anterior pituitary | 440 | ||
Growth hormone (GH) | 440 | ||
Actions of GH | 441 | ||
Growth curves | 441 | ||
Hormones affecting growth | 442 | ||
Somatomedins | 442 | ||
Applied aspect associated with growth hormone | 443 | ||
Dwarfism | 443 | ||
Types of Dwarfism | 444 | ||
Gigantism | 445 | ||
Acromegaly | 445 | ||
Posterior pituitary hormones | 446 | ||
Functions of oxytocin | 446 | ||
Functions of vasopressin and associated applied aspect | 446 | ||
61 - Thyroid Gland and Thyroid Hormones | 447 | ||
Knowledge goals | 447 | ||
Structure of thyroid gland | 447 | ||
Histological features of thyroid gland | 447 | ||
Hormones of thyroid | 448 | ||
Metabolism of iodine | 448 | ||
Synthesis of thyroid hormones | 449 | ||
Actions of thyroid hormones | 450 | ||
Causes of hyperthyroidism and hypothyroidism | 451 | ||
Causes of hypothyroidism | 451 | ||
Graves’ disease (thyrotoxicosis) | 451 | ||
Thyroid storm (thyrotoxic crisis) | 452 | ||
Goitre | 452 | ||
Cretinism | 452 | ||
Myxoedema | 453 | ||
62 - Calcium Homeostasis and Calcitropic Hormones | 455 | ||
Knowledge goals | 455 | ||
Role of calcium in body | 455 | ||
Calcium homeostasis or calcium balance | 455 | ||
Absorption of calcium | 456 | ||
Role of calcitropic hormones in calcium homeostasis | 456 | ||
PTHrP | 459 | ||
Bone | 459 | ||
Cells present in bones | 459 | ||
Types of bone tissue | 459 | ||
Applied aspect associated with calcium homeostasis | 459 | ||
Rickets | 459 | ||
Osteomalacia | 460 | ||
Osteoporosis | 460 | ||
Osteopetrosis | 461 | ||
Tetany | 461 | ||
Hyperparathyroidism | 462 | ||
63 - Adrenal Cortical Hormones | 465 | ||
Knowledge goals | 465 | ||
Synthesis of adrenal cortical hormones | 465 | ||
Actions of glucocorticoids | 466 | ||
Glucocorticoids as anti-inflammatory (pharmacological actions of glucocorticoids) | 466 | ||
Other actions of glucocorticoids | 467 | ||
Regulation of secretion | 468 | ||
Aldosterone | 469 | ||
Aldosterone escape | 469 | ||
Effect of renin on aldosterone | 470 | ||
Applied aspect associated with adrenocortical hormones | 470 | ||
Cushing syndrome | 470 | ||
Hyperaldosteronism | 471 | ||
Addison disease | 471 | ||
Adrenogenital syndrome | 471 | ||
64 - Pancreatic Hormones | 473 | ||
Knowledge goals | 473 | ||
Islets of Langerhans | 473 | ||
Insulin | 473 | ||
Actions of insulin | 474 | ||
Regulation of insulin secretion | 476 | ||
Effect of insulin excess and insulin deficiency | 476 | ||
Effects of insulin excess | 476 | ||
Effects of insulin deficiency | 477 | ||
Diabetes Mellitus | 477 | ||
Oral hypoglycaemic drugs | 479 | ||
Glucose transporters | 481 | ||
Forms of insulin | 481 | ||
Glucagon | 481 | ||
Synthesis | 481 | ||
Mechanism of action | 481 | ||
Insulin-Glucagon Molar Ratio | 481 | ||
Diabetogenic hormones | 482 | ||
65 - Stress Hormones | 485 | ||
Knowledge goals | 485 | ||
Stress hormones | 485 | ||
Neuroendocrinal response to stress | 486 | ||
66 - Pineal Gland and Melatonin | 489 | ||
Knowledge goals | 489 | ||
Pineal gland | 489 | ||
Melatonin | 489 | ||
Functions of melatonin | 489 | ||
67 - Topics of Special Interest | 493 | ||
Knowledge goals | 493 | ||
Differences between enzymes and hormones | 493 | ||
Metabolic syndrome | 493 | ||
Treatment | 493 | ||
Biological rhythm or circadian rhythm | 493 | ||
Kallmann syndrome | 494 | ||
Sheehan’s syndrome or Simmond’s syndrome | 494 | ||
Introduction | 433 | ||
Section IX - Nervous system | 495 | ||
68 - Synaptic Transmission and Neurotransmitters | 497 | ||
Knowledge goals | 497 | ||
Structure of chemical synapse | 497 | ||
Events taking place during chemical synaptic transmission | 497 | ||
Properties of synapse | 499 | ||
Types of inhibition in CNS | 501 | ||
Neurotransmitters | 502 | ||
Criteria of neurotransmitter | 502 | ||
Classification of neurotransmitters | 502 | ||
Receptors | 503 | ||
Glutamate | 503 | ||
Acetylcholine | 504 | ||
GABA—Gamma amino butyric acid | 504 | ||
Receptors | 504 | ||
Mechanism of Action | 504 | ||
Glycine | 505 | ||
Catecholamines | 505 | ||
Fate of Catecholamines | 505 | ||
Histamine | 506 | ||
Neuropeptides | 506 | ||
Opioid peptides | 506 | ||
69 - Motor Cortex | 509 | ||
Knowledge goals | 509 | ||
Cerebral cortex | 509 | ||
Layers of cerebral cortex | 509 | ||
Cells in cerebral cortex | 509 | ||
Lobes of cerebral cortex | 509 | ||
Motor cortex and descending tracts | 511 | ||
Motor cortex | 511 | ||
Descending tracts | 512 | ||
Corticospinal Tract (Pyramidal Tract) | 512 | ||
Extrapyramidal Tracts | 513 | ||
Upper and lower motor neurons | 515 | ||
Brown-Sequard syndrome | 516 | ||
70 - Somatosensory Transmission | 519 | ||
Knowledge goals | 519 | ||
Sensory receptors | 519 | ||
Mechanoreceptors | 519 | ||
Nociceptors | 520 | ||
Properties of sensory receptors | 521 | ||
Somatosensory cortex | 522 | ||
Somatosensory pathways or ascending tracts of spinal cord | 523 | ||
Spinothalamic tract | 523 | ||
Pain | 525 | ||
Referred pain | 527 | ||
Theories of referred pain | 527 | ||
Gate control theory of pain | 529 | ||
71 - Posture Regulating Mechanisms | 533 | ||
Knowledge goals | 533 | ||
Posture | 533 | ||
The stretch reflex/myotatic reflex | 533 | ||
Muscle Spindle: Structure | 533 | ||
Mechanism of Stretch Reflex | 535 | ||
Functions of Stretch Reflex | 535 | ||
Inverse stretch reflex /golgi tendon reflex/inverse myotatic reflex | 536 | ||
Righting reflexes | 536 | ||
Tonic neck and tonic labyrinthine reflexes | 537 | ||
Procedure for studying tonic reflexes | 537 | ||
Role of tonic reflexes | 537 | ||
Placing and hopping reactions | 537 | ||
Mechanism of standing in man | 537 | ||
Spinal animal | 538 | ||
Stage of areflexia or stage of spinal shock | 538 | ||
Stage of recovery or stage of reflex activity | 538 | ||
Decerebrate animal or bulbospinal animal | 538 | ||
Mid-brain animal or ‘mesenchephalic animal’ or ‘high decerebrate animal’ | 539 | ||
Decorticate animal | 539 | ||
Decerebellate animal | 539 | ||
Spinal shock | 540 | ||
72 - Cerebellum | 543 | ||
Knowledge goals | 543 | ||
Anatomy | 543 | ||
Circuits of cerebellum | 543 | ||
Layers of cerebellar cortex (outside to inside) | 543 | ||
Functional connections of cerebellum | 545 | ||
Cerebellar functions | 545 | ||
Cerebellar dysfunction | 547 | ||
Cerebellar function tests | 547 | ||
73 - Basal ganglia | 549 | ||
Knowledge goals | 549 | ||
Circuits of basal ganglia | 549 | ||
Major connections within basal ganglia | 549 | ||
Neural pathways through basal ganglia involved in controlling motor activities | 549 | ||
Functions of basal ganglia | 549 | ||
Diseases of basal ganglia | 550 | ||
Parkinsonism | 550 | ||
Chorea | 552 | ||
Athetosis | 552 | ||
Huntington disease | 552 | ||
Hemiballismus | 552 | ||
Wilson disease (hepatolenticular degeneration) | 552 | ||
Tardive dyskinesia | 552 | ||
74 - Hypothalamus and thalamus | 555 | ||
Knowledge goals | 555 | ||
Hypothalamus | 555 | ||
Connections of hypothalamus | 555 | ||
Functions of hypothalamus | 555 | ||
Theories of Food Intake | 555 | ||
Role in Sex Regulation | 556 | ||
Rage and sham rage | 558 | ||
Thalamus | 558 | ||
Thalamic nuclei | 558 | ||
Connections of thalamic nuclei | 558 | ||
Functions of thalamus | 559 | ||
Thalamic pain syndrome | 560 | ||
75 - Electrical Activity of Brain: EEG, RAS, Sleep | 561 | ||
Knowledge goals | 561 | ||
Electroencephalogram (EEG) | 561 | ||
Physiological basis of EEG | 561 | ||
Technique of EEG recording | 561 | ||
Waves of EEG | 561 | ||
Alpha waves | 561 | ||
Reticular activating system (RAS) | 563 | ||
Functions of RAS | 564 | ||
Sleep | 564 | ||
Genesis of sleep | 565 | ||
Role of melatonin | 566 | ||
Sleep disorders | 567 | ||
Parasomnias | 567 | ||
76 - Higher Functions of CNS | 569 | ||
Knowledge goals | 569 | ||
Memory | 569 | ||
Neurological basis of memory | 570 | ||
Role of hippocampus and amygdala | 570 | ||
Synaptic plasticity and memory | 570 | ||
Post-tetanic potentiation | 570 | ||
Long-term potentiation and long-term depression | 571 | ||
Types of LTP | 571 | ||
Learning | 572 | ||
Associative learning | 572 | ||
Non associative learning | 572 | ||
Senile dementia and Alzheimer disease | 573 | ||
Speech | 574 | ||
Categorical and representational hemisphere | 575 | ||
Physiology of emotions | 576 | ||
Arnold theory of emotions | 576 | ||
Neural mechanisms of genesis of emotions | 576 | ||
77 - CSF Flow | 579 | ||
Knowledge goals | 579 | ||
CSF formation and circulation | 579 | ||
Functions of CSF | 579 | ||
Collection of CSF | 580 | ||
Applied aspect | 580 | ||
Hydrocephalus | 580 | ||
Countrecoup injury | 580 | ||
78 - Blood–Brain Barrier | 581 | ||
Knowledge goals | 581 | ||
Blood–brain barrier (BBB) | 581 | ||
Circumventricular organs | 582 | ||
Circumventricular organs and physioclinical significance | 582 | ||
79 - Autonomic Nervous System | 583 | ||
Knowledge goals | 583 | ||
Autonomic nervous system | 583 | ||
Sympathetic division of ANS | 583 | ||
Neurotransmitters in ANS | 584 | ||
Acetylcholine (ACh) | 584 | ||
Mechanism of Action | 584 | ||
Norepinephrine (NE) | 585 | ||
Mechanism of Action | 585 | ||
Non-adrenergic non-cholinergic neurotransmitters | 585 | ||
Integrated role of parasympathetic and sympathetic divisions of ANS | 588 | ||
Antagonistic effect | 588 | ||
Synergistic effect | 588 | ||
Complementary effect | 588 | ||
Concept of catabolic and anabolic nervous system | 588 | ||
Organophosphorus poisoning | 589 | ||
Autonomic function tests | 589 | ||
80 - Topics of Special Interest | 591 | ||
Knowledge goals | 591 | ||
Rigidity and spasticity | 591 | ||
Cerebral palsy | 591 | ||
Addiction | 591 | ||
Depression | 592 | ||
Raynaud phenomenon | 592 | ||
Introduction | 495 | ||
Section X - Special senses | 593 | ||
81 - Vision | 595 | ||
Knowledge goals | 595 | ||
Anatomy of human eye | 595 | ||
Flow of aqueous humour | 596 | ||
Dioptric power of eye | 597 | ||
Refractive indices | 597 | ||
Schematic eye and Listing’s reduced eye | 597 | ||
Errors of refraction | 597 | ||
Myopia and hypermetropia | 597 | ||
Astigmatism | 597 | ||
Presbyopia | 598 | ||
Accommodation and pupillary light reflexes | 598 | ||
Accommodation | 598 | ||
Pupillary light reflexes | 599 | ||
Retina | 599 | ||
Photoreceptors | 600 | ||
Structurally | 601 | ||
Rhodopsin and phototransduction | 602 | ||
Rhodopsin (or visual purple) | 602 | ||
Phototransduction | 602 | ||
Dark adaptation | 603 | ||
Visual pathway and lesions | 604 | ||
Visual pathway | 604 | ||
Effect of lesions | 604 | ||
Processing of visual information | 605 | ||
Primary visual cortex (V1) | 607 | ||
Cells and columns in primary visual cortex | 607 | ||
Colour vision | 608 | ||
Importance of colour vision determination | 609 | ||
Tests to check colour vision | 609 | ||
Eye movements | 609 | ||
Field of vision and binocular vision | 609 | ||
Field of vision | 609 | ||
Extent of Normal Field of Vision | 609 | ||
Charting of Central Field of Vision | 610 | ||
Binocular vision | 611 | ||
82 - Hearing | 613 | ||
Knowledge goals | 613 | ||
Ear and sound transmission | 613 | ||
External ear | 613 | ||
Middle ear | 613 | ||
Internal ear (labyrinth) | 614 | ||
Components of Bony Labyrinth | 614 | ||
Components of Membranous Labyrinth | 614 | ||
Sound transmission | 617 | ||
Tip link theory | 617 | ||
Von Bekesy travelling wave theory/place theory | 618 | ||
Tympanic reflex or attenuation reflex | 618 | ||
Impedance matching | 619 | ||
Qualities of sound waves | 619 | ||
Deafness | 620 | ||
Causes of deafness | 620 | ||
Hearing tests | 620 | ||
Vestibular disorders | 621 | ||
Vestibular pathway | 621 | ||
Auditory cortex | 622 | ||
Auditory pathway | 622 | ||
Role of vestibular apparatus in maintaining equilibrium | 622 | ||
Response to rotational acceleration: functioning of semicircular canals | 622 | ||
Response towards linear acceleration | 623 | ||
Role of otolith organs in maintaining equilibrium | 623 | ||
83 - Taste and Smell | 627 | ||
Knowledge goals | 627 | ||
Taste | 627 | ||
Taste bud | 627 | ||
Taste pathway | 627 | ||
Receptors for taste sensation | 627 | ||
Smell | 627 | ||
Functions | 629 | ||
84 - Topics of Special Interest | 631 | ||
Knowledge goals | 631 | ||
Electro-oculogram (EOG) | 631 | ||
Electroretinogram (ERG) | 631 | ||
Visual evoked potential (VEP) | 632 | ||
Vitamin A deficiency (VAD) | 632 | ||
Hearing aids | 632 | ||
Brain stem auditory evoked potential (baep) or brain stem evoked response audiometry (bera) | 632 | ||
Applications | 632 | ||
Introduction | 593 | ||
Section XI - Reproductive physiology | 635 | ||
85 - Embryology of Reproductive System | 637 | ||
Knowledge goals | 637 | ||
Differentiation of external genitalia from primordial (indifferent) structure | 637 | ||
Sex differentiation | 637 | ||
86 - Puberty: Changes, Regulation and Disorders | 639 | ||
Knowledge goals | 639 | ||
Puberty | 639 | ||
Sudden physical growth | 639 | ||
Development of secondary sexual characters | 639 | ||
Hormonal changes during puberty | 639 | ||
Regulation of onset of puberty | 640 | ||
Disorders of puberty | 641 | ||
Causes | 641 | ||
Clinical features | 641 | ||
Treatment | 641 | ||
87 - Male Reproductive System | 643 | ||
Knowledge goals | 643 | ||
Structure of human testes | 643 | ||
Sertoli cells | 643 | ||
Functions | 643 | ||
Structure of sperm | 644 | ||
Spermatogenesis | 644 | ||
Semen | 645 | ||
Sperm capacitation | 646 | ||
Endocrine function of testes | 646 | ||
Androgens | 646 | ||
Synthesis | 647 | ||
Actions and Effects of Androgens | 647 | ||
Other Actions of Androgens | 647 | ||
Regulation of Testicular Function | 648 | ||
Abnormalities of male reproductive system | 648 | ||
Cryptorchidism | 648 | ||
Male hypogonadism | 648 | ||
Causes | 648 | ||
Features | 648 | ||
Male menopause | 649 | ||
Prostate cancer | 649 | ||
Clinical Features | 649 | ||
Diagnosis | 649 | ||
Treatment | 649 | ||
88 - Female Reproductive System | 651 | ||
Knowledge goals | 651 | ||
Ovarian hormones | 651 | ||
Oestrogen | 651 | ||
Synthesis | 651 | ||
Effects of Oestrogen | 652 | ||
Mechanism of Action | 652 | ||
Oestrogen and Endocrine Regulation | 652 | ||
Progesterone | 653 | ||
Synthesis and Degradation | 653 | ||
Functions | 653 | ||
Other ovarian hormones | 653 | ||
Menstrual cycle and hormonal regulation of female sexual cycle | 654 | ||
Ovarian cycle | 654 | ||
Uterine cycle (endometrial cycle) | 655 | ||
Cyclical changes occurring in uterine cervix | 656 | ||
Cyclical changes occurring in female breasts | 656 | ||
Reflex ovulation | 657 | ||
Oestrous cycle | 657 | ||
Menstrual abnormalities | 657 | ||
Determinants of ovulation | 657 | ||
Anovulatory cycle | 660 | ||
Menopause (or climateric) | 660 | ||
89 - Pregnancy | 661 | ||
Knowledge goals | 661 | ||
Fertilisation and implantation | 661 | ||
Fertilisation | 661 | ||
Maternal physiological changes during pregnancy | 662 | ||
Pregnancy tests | 662 | ||
Fetoplacental unit | 664 | ||
Placental progesterone | 664 | ||
Placental oestrogen synthesis | 665 | ||
Human chorionic gonadotropin (hCG) | 665 | ||
Significance of hCG | 665 | ||
Human chorionic somatomammotropin (hCS) or chorionic growth hormone-prolactin (CGP) or human placental lactogen (HPL) | 665 | ||
Other placental hormones | 665 | ||
Medical Termination of Pregnancy (MTP) ACT | 665 | ||
90 - Parturition and Lactation | 667 | ||
Knowledge goals | 667 | ||
Parturition | 667 | ||
Role of oxytocin during parturition | 667 | ||
Ferguson reflex | 668 | ||
Section XII - miscellaneous topics | 679 | ||
93 - Ageing | 681 | ||
Age-related changes in different organ systems | 681 | ||
Theories of ageing | 683 | ||
Genetic theories of ageing | 683 | ||
Damage repair theory of ageing concept | 683 | ||
How to stay young/delay ageing? | 684 | ||
Knowledge goals | 681 | ||
94 - Body Temperature and Regulation | 685 | ||
Knowledge goals | 685 | ||
Body temperature | 685 | ||
Factors affecting body temperature | 685 | ||
Physiological Variations | 685 | ||
Pathological Variations | 686 | ||
Heat producing mechanisms | 686 | ||
Heat loss mechanisms | 687 | ||
95 - Physiological Changes in Newborn After Birth | 691 | ||
Knowledge goals | 691 | ||
Cardiovascular changes | 691 | ||
Respiratory changes | 691 | ||
CNS changes | 691 | ||
Haematological and immunological changes | 691 | ||
Renal changes | 692 | ||
Temperature regulatory changes | 692 | ||
GIT changes | 692 | ||
Foetal circulation | 692 | ||
Changes after birth | 693 | ||
96 - Topics of Special Interest | 695 | ||
Knowledge goals | 695 | ||
Yoga and pranayama | 695 | ||
Benefits of yoga | 695 | ||
Yoga nidra | 695 | ||
Benefits of yoga nidra | 695 | ||
Steps of yoga nidra practice | 695 | ||
Cognition | 696 | ||
Introduction | 679 | ||
Index | 697 |