PHYSIOLOGY OSPE QUESTIONS

SECOND YEAR

Facilitator: MC-3926

EXPERIMENT 1
1. Quadrants/Regions of Abdomen:

• Quadrants: Right Upper, Left Upper, Right Lower, Left Lower

• Regions: Right Hypochondrium, Epigastrium, Left Hypochondrium, Right Lumbar, Umbilical, Left
Lumbar, Right Iliac, Hypogastrium, Left Iliac

2. Basic Procedures for GIT Examination:

• Inspection

• Palpation
• Percussion

• Auscultation

3. Differentiating Spleen vs. Left Kidney on Palpation:

• Spleen: Moves with respiration, not bimanually palpable, has a sharp notch.

• Left Kidney: Does not move with respiration, bimanually palpable, no notch.

4. Identifying Upper Border of Liver:

• Percuss from the chest down; change from resonance to dullness indicates liver’s upper border.

5. Common Causes of Hepatomegaly:

• Liver diseases (hepatitis, cirrhosis)

• Congestive heart failure

• Malignancies

• Hematologic disorders

6. Common Causes of Splenomegaly:

• Infections (malaria, mononucleosis)

• Hematologic conditions (anemia, leukemia)

• Liver diseases

• Congestive heart failure

6. Normal Shape of Abdomen:

• Flat or slightly rounded

7. Importance of Engorged Abdominal Veins:

• Indicates portal hypertension or obstruction (e.g., cirrhosis).

8. Importance of Abdominal Scars and Umbilicus Position:

• Scars suggest previous surgeries or trauma.

• Umbilicus position changes with conditions like ascites or obesity.

EXPERIMENT 2
1. Presence of Glucose in Urine:

• Indicates possible diabetes mellitus or renal threshold exceeded due to high blood glucose.

2. Substances Affecting Urine Osmolarity:

• Electrolytes (sodium, potassium)

• Urea
• Glucose

• Proteins
3. Significance of Ketone Bodies and Bilirubin in Urine:

• Ketone Bodies: Suggests ketosis, often due to uncontrolled diabetes or starvation.

• Bilirubin: Indicates liver dysfunction or biliary obstruction.

4. Significance of RBCs and WBCs in Urine:

• RBCs: Suggests bleeding in the urinary tract (infection, stones, trauma).

• WBCs: Indicates infection or inflammation in the urinary tract.

EXPERIMENT 3
1. Specific Gravity Definition and Influencing Factors:
• Definition: Ratio of urine density compared to pure water, reflecting urine concentration.

• Factors Increasing Specific Gravity: Dehydration, glucose, proteins, excessive ADH.

• Factors Decreasing Specific Gravity: Overhydration, diuretics, diabetes insipidus.

2. Relation of Osmolarity to Specific Gravity:

• Higher osmolarity generally increases specific gravity, as both indicate solute concentration in urine.

3. Specific Gravity in Dehydration:

• Specific gravity increases due to concentrated urine with less water and more solutes.
EXPERIMENT 5
1. Proprioception:

o Awareness of body position and movement.

o Receptors: Muscle spindles, Golgi tendon organs, joint receptors.

2. Receptors for Sensations:

o Pain: Nociceptors
o Cold: Krause end bulbs

o Hot: Ruffini endings

o Touch: Meissner's corpuscles, Merkel cells

3. Pacinian Corpuscles:

o Receptors for deep pressure and vibration, located in subcutaneous tissue.

4. Stereognosis:

o Ability to recognize objects by touch without visual input.

5. Definitions:

o Analgesia: Absence of pain sensation.

o Anesthesia: Absence of all sensations.

o Hyperalgesia: Increased pain sensitivity.

o Hyperesthesia: Increased sensitivity to touch.

6. Tracts for Touch and Pain Sensations:

o Touch: Dorsal column-medial lemniscal pathway

o Pain: Spinothalamic tract

7. Tactile Localization and Two-Point Discrimination:

o Tactile Localization: Ability to identify where the skin is touched.

o Two-Point Discrimination: Ability to distinguish two close points on the skin as separate.

8. Brodmann's Area Numbers:

o Primary Sensory Area: Area 1, 2, and 3

o Secondary Sensory Area: Area 5 and 7

9. Thalamic Nucleus for Conscious Sensations:

o Ventral posterior nucleus

10. Fine vs. Crude Touch:

o Fine Touch: Precise and detailed, involves texture and shape.

o Crude Touch: General, non-specific touch sensation.

 11. Tuning Fork for Vibration Sense:

o Yes, higher frequency tuning forks (above 256 Hz) can be used to test vibration sense.

12. Conditions with Loss of Vibration Sense:

o Diabetes mellitus, Vitamin B12 deficiency, tabes dorsalis

EXPERIMENT 6
1. Muscle Tone: Continuous, passive partial contraction of muscles, maintaining posture and readiness
for action.
2. Spasticity vs. Rigidity (Hypertonia):

o Spasticity: Velocity-dependent resistance to stretch, common in upper motor neuron lesions

(e.g., stroke).
o Rigidity: Uniform resistance to stretch, independent of velocity, seen in extrapyramidal
disorders (e.g., Parkinson’s disease).
3. Definitions:

o Hemiparesis: Weakness on one side of the body.

o Hemiplegia: Paralysis on one side of the body.

o Paraplegia: Paralysis of both lower limbs.

o Quadriplegia: Paralysis of all four limbs.

4. Tests of Coordination:

o Finger-to-Nose Test: Assesses accuracy and smoothness of movement.

o Heel-to-Shin Test: Tests lower limb coordination by running heel down the shin.

5. Muscle Terms:

o Hypertrophy: Increase in muscle size due to fiber enlargement.

o Hyperplasia: Increase in number of muscle fibers.

o Atrophy: Decrease in muscle size due to loss of muscle tissue.

6. Rigidity:

o Increased resistance to passive movement, as seen in Parkinson’s disease.

7. Grading Muscle Power:

o Scale from 0 to 5:

▪ 0: No contraction

▪ 1: Flicker of movement

▪ 2: Movement without gravity

▪ 3: Movement against gravity

 ▪ 4: Movement against some resistance

▪ 5: Normal strength

8. Normal Grade: Grade 5 (full strength).

9. Major Descending Motor Tract: Corticospinal (pyramidal) tract.

10. Extrapyramidal Tracts:

o Rubrospinal, reticulospinal, vestibulospinal, and tectospinal tracts.

11. Primary Motor Area of the Cortex: Brodmann's area 4.

12. Paralysis and Paresis:

o Paralysis: Complete loss of muscle function.

o Paresis: Partial loss of muscle strength.

13. Winged Scapula:

o Occurs due to serratus anterior weakness, often from long thoracic nerve injury.
14. 'Saturday Night' Paralysis:

o Radial nerve palsy from prolonged arm compression, leading to wrist drop.

15. Chorea:

o Rapid, involuntary movements, seen in Huntington’s disease.

16. Athetosis:

o Slow, writhing movements, as seen in cerebral palsy.

17. Hemiballismus:
o Sudden, flinging movements of a limb, often due to subthalamic nucleus lesions.
18. Parkinsonism:

o Syndrome with bradykinesia, rigidity, resting tremor, and postural instability.

19. Tremor:

o Involuntary rhythmic oscillation.

o Types:

▪ Resting tremor (e.g., Parkinson's disease)

▪ Action tremor (e.g., essential tremor)

20. Abnormal Gaits:

o Spastic Gait: Cerebral palsy.

o Ataxic Gait: Cerebellar disorders.

o Festinating Gait: Parkinson's disease.

o Waddling Gait: Muscular dystrophy.

 21. Aspects of Motor Function Assessed:

o Muscle bulk, tone, power, coordination, reflexes, and gait.

22. Measuring Muscle Bulk:

o Measure circumference at specific landmarks.

o Landmarks: Mid-arm, mid-thigh, mid-calf, wrist.

23. Estimating Strength of Hand Intrinsic Muscles:

o Test abduction, adduction, and opposition of fingers.

24. Assessing Trunk Muscle Strength:

o Observe posture, flexion, and extension movements.

25. Assessing Knee and Thigh Muscle Strength:

o Test flexion and extension against resistance in seated or lying positions.

EXPERIMENT 7
1. Clinical Significance of Superficial Reflexes:
o Indicates integrity of spinal segments and corticospinal tract; absent reflexes can suggest
upper motor neuron (UMN) lesions or segmental spinal cord damage.

2. Reflex Arc and Components:

o Reflex Arc: Neural pathway involved in a reflex action.

o Components: Receptor, sensory neuron, integration center, motor neuron, effector.

3. Physiological Conditions with Positive Babinski’s Sign:

o Newborns and infants up to 1–2 years, due to immature corticospinal tract.

4. Reason for Positive Babinski’s Sign in Corticospinal Lesions:

o Loss of inhibition from the corticospinal tract on spinal reflexes, causing the extensor
response.

EXPERIMENT 8
1. Reflex Arc:

o A neural pathway involved in a reflex action, enabling a quick, involuntary response to a

stimulus.

o Components:

▪ Receptor: Detects the stimulus.

▪ Sensory Neuron: Carries the impulse to the spinal cord.

▪ Integration Center: Processes the impulse (in spinal cord or brainstem).

 ▪ Motor Neuron: Carries the response impulse from the spinal cord.

▪ Effector: Muscle or gland that executes the response.

2. Significance and Physiological Basis of Reinforcement:

o Significance: Enhances reflex response, useful in detecting faint reflexes during examination.
o Physiological Basis: Increases excitability of spinal motor neurons by engaging other
muscles, lowering threshold for the reflex response.

3. Clinical Significance of Stretch Reflex:

o Assesses integrity of the spinal cord and peripheral nerves; alterations may indicate
neurological disorders like UMN or LMN lesions.
4. Physiological Causes of Hyper-reflexia:

o Loss of inhibitory control from the upper motor neurons, leading to exaggerated reflexes,
commonly seen in UMN lesions.
5. Abnormalities of Tendon Reflexes:
o Hyper-reflexia: Exaggerated reflexes, usually from UMN lesions.

o Hypo-reflexia: Reduced reflexes, often due to LMN lesions.

o Areflexia: Absence of reflexes, seen in peripheral nerve damage.

6. Pathophysiological Basis of Clonus:

o Repeated, rhythmic muscle contractions due to a lack of inhibitory signals, often from a
UMN lesion affecting the stretch reflex pathway.

EXPERIMENT 9
1. Organs Responsible for Equilibrium:

o Vestibular apparatus, eyes, and proprioceptors in muscles and joints.

2. Vestibular Apparatus:

o Semicircular canals, utricle, and saccule.

3. Three Types of Cerebellum (Phylogenetically):

o Archicerebellum (vestibulocerebellum), paleocerebellum (spinocerebellum), and

neocerebellum (cerebrocerebellum).

4. Nuclei of the Cerebellum:

o Dentate, emboliform, globose, and fastigial nuclei.

5. Dysdiadochokinesia:

o Inability to perform rapid, alternating movements smoothly.

6. Intention Tremors and Resting Tremors:

o Intention Tremors: Tremors during voluntary movement, seen in cerebellar lesions.
 o Resting Tremors: Tremors at rest, commonly seen in Parkinson’s disease.

7. Tetany:

o Involuntary muscle spasms due to low calcium levels, often from hypocalcemia.

8. Romberg’s Sign:
o Loss of balance upon closing the eyes, indicating proprioceptive or vestibular dysfunction.

9. Ascending Spinocerebellar Tracts:

o Dorsal (posterior) and ventral (anterior) spinocerebellar tracts.

10. Dysmetria:

o Inability to control movement range, leading to overshooting or undershooting targets.

11. Nystagmus:

o Involuntary, rhythmic eye movements, often due to vestibular or cerebellar dysfunction.

12. Tinnitus:
o Perception of ringing or buzzing in the ears without an external sound source.

13. Receptor in Semicircular Canals and Otolith Organs:

o Semicircular Canals: Crista ampullaris.

o Otolith Organs: Macula.

14. Cerebellum Connections to Brain Organs:

o Connected via superior, middle, and inferior cerebellar peduncles.

15. Cerebellar Nucleus for Coordination:

o Dentate nucleus; connected to the cortex via the dentatothalamic tract.
16. Abnormal Gaits:

o Ataxic Gait: Cerebellar disorder.

o Scissors Gait: Cerebral palsy.

o Festinating Gait: Parkinson’s disease.

o Waddling Gait: Muscular dystrophy.

EXPERIMENT 10

1. Anosmia, Hyposmia, Parosmia:

o Anosmia: Complete loss of smell; caused by head trauma, nasal obstruction, or COVID-19.

o Hyposmia: Reduced sense of smell; due to aging, nasal congestion, or neurodegenerative

diseases.

o Parosmia: Distorted smell perception; often after viral infections or head trauma.
2. Pathway of Olfaction:

o Olfactory receptors → Olfactory nerve (CN I) → Olfactory bulb → Olfactory tract →

Primary olfactory cortex (temporal lobe).

3. Extraocular Muscles and Nerve Supply:

o Lateral rectus: Abducens nerve (CN VI)

o Superior oblique: Trochlear nerve (CN IV)

o Superior rectus, inferior rectus, medial rectus, inferior oblique: Oculomotor nerve (CN III)
4. Eye Movements and Extraocular Muscles:

o Elevation: Superior rectus, inferior oblique

o Depression: Inferior rectus, superior oblique

o Abduction: Lateral rectus

o Adduction: Medial rectus

o Intorsion: Superior oblique, superior rectus

o Extorsion: Inferior oblique, inferior rectus

5. Diplopia (Double Vision):

o Causes: Extraocular muscle weakness, cranial nerve palsies, or thyroid eye disease.

6. Squint (Strabismus):

o Misalignment of the eyes; can result from muscle or nerve impairment.

7. Ptosis:

o Drooping of the upper eyelid, caused by dysfunction of the oculomotor nerve or levator
palpebrae muscle.

8. Divisions of Trigeminal Nerve and Facial Areas:

o Ophthalmic (V1): Forehead and upper eyelid.

o Maxillary (V2): Cheek and upper lip.

o Mandibular (V3): Lower lip, jaw, and anterior tongue.

9. Sensations Perceived by Trigeminal Nerve:

o Touch, pain, temperature, and proprioception on the face.

10. Symptoms of Trigeminal Nerve Lesion:

o Loss of facial sensation, weakened jaw movements, and absent corneal reflex.

11. Bell's Palsy:

o Unilateral facial nerve paralysis, causing drooping of the face, usually from viral
inflammation.

12. UMN vs. LMN Lesions of Facial Nerve:

 o UMN Lesion: Paralysis of lower face only, with forehead sparing.

o LMN Lesion: Paralysis of the entire side of the face, including the forehead.

13. Cranial Nerves for Taste Sensation:

o Facial nerve (CN VII), Glossopharyngeal nerve (CN IX), Vagus nerve (CN X)
14. Cranial Nerve in Palate Reflex:

o Glossopharyngeal nerve (CN IX).

15. Muscles Controlled by Accessory Nerve:

o Sternocleidomastoid and trapezius muscles.

16. Muscles Supplied by Hypoglossal Nerve:

o Intrinsic and extrinsic muscles of the tongue (except palatoglossus).

17. Paralysis of Hypoglossal Nerve:

o Tongue deviates toward the paralyzed side when protruded.

18. Cranial Nerves Relevant to Blood Pressure Control:

o Glossopharyngeal nerve (CN IX) and Vagus nerve (CN X).

19. Mixed Cranial Nerves:

o Trigeminal (CN V), Facial (CN VII), Glossopharyngeal (CN IX), Vagus (CN X)

20. Cranial Nerves for Special Senses:

o Olfactory (CN I), Optic (CN II), Vestibulocochlear (CN VIII)

EXPERIMENT 11
1. Taste and Flavor:

o Taste: The basic sensations detected by the taste buds on the tongue, including sweet, salty,
sour, bitter, and umami.
o Flavor: The overall sensory experience of food, combining taste, smell, texture, and other
sensory inputs.
2. Factors Affecting Taste Perception:

o Age, gender, genetic predisposition, cultural background, temperature of food, texture,

olfactory input, and health conditions (e.g., sinus issues, medication effects).
3. Primary Tastes and Their Locations on the Tongue:

o Sweet: Perceived primarily at the tip.

o Salty: Detected on the anterior sides.

o Sour: Best perceived on the sides toward the back.

o Bitter: Detected at the back of the tongue.

 o Umami: Distributed throughout the tongue but often noted on the sides.

4. Definitions:

o Ageusia: Complete loss of taste.

o Hypogeusia: Reduced ability to taste.

o Hypergeusia: Increased sensitivity to taste.

5. Dry Tongue and Taste Perception:

o Saliva is essential for dissolving food molecules, allowing them to interact with taste
receptors. A dry tongue limits this process, hindering taste perception.

6. Receptors for Spicy Food:

o Spicy foods are detected by TRPV1 (transient receptor potential vanilloid 1) receptors,
which are not taste receptors but pain receptors that perceive capsaicin (the active component
in chili peppers).
7. Bitter Taste and Vomiting:
o Bitter compounds are often toxic, so the body has evolved to respond to bitter tastes with
nausea or vomiting as a protective mechanism.

8. Taste Pathway:

o Taste receptors on the taste buds → Taste nerves (facial nerve (CN VII), glossopharyngeal
nerve (CN IX), and vagus nerve (CN X)) → Nucleus of the solitary tract in the brainstem →
Thalamus (ventral posterior medial nucleus) → Primary gustatory cortex (insula and frontal
operculum).

EXPERIMENT 12
1. Important Reflexes of the Eye:
o Pupillary light reflex

o Accommodation reflex

o Corneal reflex (blink reflex)

o Consensual light reflex

2. Direct vs. Consensual Light Reflex:

o Direct Light Reflex: Constriction of the pupil in response to light shining directly into that
eye.

o Consensual Light Reflex: Constriction of the pupil in the opposite eye when light is shone in
one eye.

3. Cause of Consensual Light Reflex:

o The consensual reflex occurs due to the bilateral projection of retinal ganglion cell signals to
the pretectal area in the midbrain, which sends signals to both Edinger-Westphal nuclei
(controlling pupil constriction).
 4. Neuronal Pathway of Light Reflex:

o Light → Retina → Optic nerve (CN II) → Pretectal nucleus → Edinger-Westphal nucleus
(bilateral) → Oculomotor nerve (CN III) → Ciliary ganglion → Sphincter pupillae muscle →
Pupil constriction.

5. Neuronal Pathway of Accommodation Reflex:

o Visual stimulus (near object) → Retina → Optic nerve (CN II) → Lateral geniculate nucleus
(LGN) → Visual cortex → Edinger-Westphal nucleus → Oculomotor nerve (CN III) →
Ciliary ganglion → Ciliary muscles (contraction for lens thickening) and sphincter pupillae
muscle (pupil constriction).
6. Stimulus for the Accommodation Reflex:

o The stimulus is a near object, which requires the eye to adjust focus by changing the lens
shape (thickening).
7. Argyll Robertson Pupil:

o A condition where pupils are small, irregular, and constrict to accommodation but not to
light; often associated with neurosyphilis or other central nervous system lesions.

8. Significance of the Corneal Reflex:

o The corneal reflex is crucial for protecting the eye; it involves a blink response to protect the
eye from foreign bodies or irritation, indicating the integrity of sensory (trigeminal nerve) and
motor (facial nerve) pathways.

EXPERIMENT 13
1. Visual Acuity:

o Visual acuity is the clarity or sharpness of vision, typically measured by the ability to discern
letters or symbols at a standardized distance.

2. Testing Visual Acuity:

o Visual acuity is commonly tested using a Snellen chart, where the patient reads letters from a
specific distance (usually 20 feet or 6 meters). The results are expressed as a fraction (e.g.,
20/20 or 6/6).
3. Factors Affecting Visual Acuity:

o Age, refractive errors (myopia, hypermetropia, astigmatism), eye diseases (cataracts,

glaucoma, macular degeneration), lighting conditions, and overall eye health.

4. Understanding Visual Acuity Measurements:

o 6/6: Normal visual acuity; the individual can see at 6 meters what a person with normal
vision can see at that distance.

o 6/12: The individual can see at 6 meters what a person with normal vision can see at 12
meters; indicates reduced visual acuity.
 o 6/60: The individual can only see at 6 meters what a person with normal vision can see at 60
meters; indicates significant visual impairment.

5. Myopia (Nearsightedness):

o Myopia is a refractive error where distant objects appear blurred due to light rays focusing in
front of the retina.

o Correction: It can be corrected with concave (negative) lenses that diverge light rays,
allowing them to focus on the retina.

6. Hypermetropia (Farsightedness):

o Hypermetropia is a refractive error where close objects appear blurred because light rays
focus behind the retina.

o Correction: It can be corrected with convex (positive) lenses that converge light rays,
bringing the focus forward onto the retina.

7. Presbyopia:

o Presbyopia is the age-related loss of the eye's ability to focus on near objects due to decreased
elasticity of the lens.

o Pathophysiology: As the lens becomes stiffer with age, it loses its ability to change shape
(accommodate) for near vision, leading to difficulty in reading and performing tasks that
require close-up vision.

EXPERIMENT 14
1. Clinical Significance of Testing Color Vision:

o Testing color vision is crucial for diagnosing color vision deficiencies (color blindness) that
can impact daily activities and job performance, especially in professions requiring color
discrimination (e.g., pilots, electricians, and graphic designers). It also helps in assessing the
health of the optic nerve and retina.
2. Chart Used to Test Color Blindness:

o Ishihara Test: This chart consists of a series of colored plates with numbers or shapes
embedded in colored dots.
o Principle: The principle is based on the ability to differentiate between colors; individuals
with color vision deficiencies will struggle to see the numbers or shapes clearly against the
background.

3. Red-Green Color Blindness:

o Red-green color blindness is a common form of color vision deficiency where individuals
have difficulty distinguishing between red and green hues. It can be classified as:

▪ Protanopia: Reduced sensitivity to red light.

▪ Deuteranopia: Reduced sensitivity to green light.

4. Methods for Testing Color Vision:

 o Ishihara Test: As mentioned, it uses colored plates with hidden numbers.

o Farnsworth-Munsell 100 Hue Test: Involves arranging colored caps in order of hue.

o Anomaloscope: A device that measures color discrimination by mixing red and green light to
match a yellow light.

5. Pilots Wearing Red Goggles:

o Pilots wear red goggles before evening flights to simulate and adapt their vision to night
flying conditions. This practice helps them adjust to the reduced visibility and enhances their
ability to see and interpret aviation instruments in low-light environments.

6. Red Color for Stop Lights:

o Red is used for stop lights because it is easily distinguishable from other colors and has the
longest wavelength, making it visible from a distance. The color red also has associations
with danger and caution, making it an effective choice for signaling a stop.

EXPERIMENT 15
1. Field of Vision:

o The field of vision refers to the total area that can be seen when the eyes are fixed in one
position. It encompasses all visual stimuli within the peripheral and central vision, typically
measured in degrees.

2. Physiological Blind Spot:

o The physiological blind spot is an area in the visual field where there are no photoreceptors
(rods and cones) because it corresponds to the location of the optic disc (where the optic
nerve exits the eye). Light that falls on this area cannot be perceived, creating a gap in the
visual field.
3. Non-Circular Shape of Field of Vision:

o The field of vision is not circular due to the anatomy of the eye and the position of the optic
nerve. The nasal (inner) part of the field of vision overlaps with the temporal field from the
other eye, resulting in a more oval shape rather than a perfect circle. Additionally, physical
structures such as the nose and brow limit the peripheral visual field.

4. Factors Affecting Field of Vision:

o Eye health (e.g., diseases like glaucoma or retinal detachment), age, refractive errors,
binocular vision, and the presence of obstructions (like eyelids or brow) can all impact the
field of vision.

5. Scotoma:

o A scotoma is a localized area of visual loss within the visual field, appearing as a dark or
blank spot. Common causes include retinal diseases (e.g., diabetic retinopathy, macular
degeneration), optic nerve disorders, and lesions along the visual pathway.

6. Expected Visual Field Defects:

 o a. Right Optic Nerve Lesion: Complete loss of vision in the right eye (right monocular
blindness).

o b. Optic Chiasma Lesion: Bitemporal hemianopia; loss of the outer (temporal) visual fields
of both eyes.

o c. Right Optic Tract Lesion: Left homonymous hemianopia; loss of the left visual field in
both eyes.

o d. Right Optic Radiation Lesion: Left homonymous hemianopia; similar to optic tract
lesion, but with potential for different patterns of vision loss depending on the exact location
within the radiation.
7. Importance of Maintaining Gaze During Perimetry:

o It is crucial for the subject not to change their gaze during perimetry testing because any
movement can lead to inaccuracies in measuring the visual field. Consistent fixation ensures
that the test accurately assesses the peripheral and central vision.

8. Tunnel Vision:
o Tunnel vision is a condition where a person loses peripheral vision while retaining central
vision, creating the effect of looking through a narrow tunnel. This can be caused by various
conditions, such as glaucoma, retinitis pigmentosa, or optic nerve damage.

EXPERIMENT 16
1. Layers of the Eyeball:
o Fibrous Layer: Comprises the sclera (white part of the eye) and cornea.

o Vascular Layer (Uvea): Includes the choroid, ciliary body, and iris.

o Inner Layer (Retina): Contains the sensory layer (photoreceptors) and the retinal pigment
epithelium.

2. Examined Part of the Eye with an Ophthalmoscope:

o The fundus of the eye, which includes the optic disc, macula, and blood vessels, can be
examined with an ophthalmoscope.
3. Emmetropia:

o Emmetropia refers to the normal refractive condition of the eye where light rays focus
precisely on the retina, resulting in clear vision without the need for corrective lenses.

4. Myopia:

o Myopia, or nearsightedness, is a refractive error where distant objects appear blurry because
light rays focus in front of the retina due to an elongated eyeball or excessive curvature of the
cornea.

5. Hypermetropia:
 o Hypermetropia, or farsightedness, is a refractive error where close objects appear blurry
because light rays focus behind the retina, often due to a shortened eyeball or insufficient
curvature of the cornea.

6. Optic Disc:

o The optic disc is the point where the optic nerve exits the eye, lacking photoreceptors,
creating a physiological blind spot.

o Clinical Significance: It is important for diagnosing conditions such as glaucoma,

papilledema, and optic neuritis by assessing its appearance, shape, and any changes in the
surrounding retina.
7. Major Function of the Retina:

o The retina's primary function is to convert light into neural signals through photoreceptors
(rods and cones) and transmit these signals to the brain via the optic nerve for visual
perception.

8. Macula:
o The macula is a small, specialized area of the retina responsible for sharp central vision and
color perception. It contains a high concentration of cones, which are essential for detailed
vision.

9. Normal Fundus Appearance:

o A normal fundus appears as a pinkish color with a well-defined optic disc, healthy retinal
blood vessels, and a fovea (located in the macula) that is a lighter yellowish spot. There
should be no signs of hemorrhage or abnormal pigmentation.

10. Significance of Distant Direct Ophthalmoscopy:

o Distant direct ophthalmoscopy allows for the assessment of the fundus without requiring the
patient to be in close proximity, reducing the risk of discomfort and making it easier to
examine patients with limited mobility or those who are uncooperative. It enhances the
examiner's ability to see the fundus more clearly and can be performed in various clinical
settings.

EXPERIMENT 17
1. Ossicular Conduction, Air Conduction, and Bone Conduction:

o Ossicular Conduction: The transmission of sound through the ossicles (malleus, incus,
stapes) of the middle ear to the inner ear.

o Air Conduction: Sound transmission through air, which involves the outer ear, tympanic
membrane, and the ossicular chain, ultimately leading to the cochlea.

o Bone Conduction: The transmission of sound vibrations directly through the bones of the
skull to the cochlea, bypassing the outer and middle ear.

2. Why Air Conduction is Better Than Bone Conduction:

 o Air conduction is generally better than bone conduction because it allows for the
amplification and filtering of sound through the outer ear and the resonance of the ear canal,
providing clearer and more efficient sound transmission compared to the direct vibration of
bone conduction.
3. Conductive Deafness and Perceptive Deafness:

o Conductive Deafness: Hearing loss due to problems in the outer or middle ear that impede
sound transmission, such as earwax buildup, fluid, or damage to the ossicles.
o Perceptive Deafness (or Sensorineural Deafness): Hearing loss resulting from damage to the
inner ear (cochlea) or the auditory nerve, affecting the perception of sound. This type of
deafness often involves issues with hair cells or neural pathways.

4. Tuning Fork Frequency for Hearing Tests:

o Tuning forks of specific frequencies (commonly 256 Hz and 512 Hz) are used for hearing
tests because these frequencies are optimal for assessing human hearing sensitivity and
differentiating between types of hearing loss (conductive vs. sensorineural).

5. Rinne's False Negative and Reduced Positive:

o Rinne's False Negative: Occurs when a patient falsely perceives that bone conduction is
better than air conduction in the presence of conductive hearing loss, despite air conduction
being normal or better.

o Reduced Positive: Refers to a situation in which the air conduction is perceived as being
only slightly better than bone conduction, indicating possible early conductive hearing loss or
a mixed hearing loss.

6. Masking Effect of Environmental Noise:

o The masking effect of environmental noise occurs when background sounds interfere with the
ability to hear a test sound during audiometric testing. This can lead to inaccurate hearing
assessments, as the patient's true hearing ability may be obscured by the noise.

7. Weber Test Lateralization with Negative Rinne's Test:

o If Rinne's test is negative on the right side (indicating conductive hearing loss in the right
ear), the Weber test will lateralize to the right side. This is because sound will be perceived as
louder in the ear with conductive hearing loss, as the background noise will not be as
effectively heard.

EXPERIMENT 19
1. Reflex Pathway for Decrease of Heart Rate by Pressing the Carotid Sinus:

o When the carotid sinus is pressed, it detects increased blood pressure, activating
baroreceptors. This triggers:
 ▪ Afferent Pathway: Signals are sent via the glossopharyngeal nerve (CN IX) to the
nucleus of the solitary tract (NST) in the medulla oblongata.

▪ Central Processing: The medulla integrates this information and activates the
parasympathetic nervous system.

▪ Efferent Pathway: The vagus nerve (CN X) is stimulated, resulting in increased

parasympathetic output, leading to a decrease in heart rate.

2. Function of Sino-Aortic Reflexes:

o Sino-aortic reflexes involve baroreceptors located in the carotid sinus and aortic arch,
regulating blood pressure by adjusting heart rate and vascular resistance. They help maintain
stable blood pressure in response to changes in posture, physical activity, and blood volume,
ensuring adequate blood flow to vital organs.

3. Practical Significance of Carotid Sinus:

o The carotid sinus plays a crucial role in blood pressure regulation and cardiovascular
homeostasis. Its ability to sense changes in arterial pressure helps protect against conditions
like hypotension and hypertension. Clinically, it is significant in diagnosing and managing
disorders such as carotid artery disease and syncope.

4. Why Carotid Sinus Reflex is Not Effective in Long-Term Regulation of Blood Pressure:

o The carotid sinus reflex primarily provides short-term adjustments to blood pressure. It does
not adapt well to chronic changes because:

▪ Baroreceptors can become desensitized with sustained high blood pressure, leading to
a reduced response over time.

▪ Long-term blood pressure regulation relies on other mechanisms, such as hormonal

regulation (e.g., renin-angiotensin-aldosterone system) and renal function, rather than
solely on the carotid sinus reflex.

EXPERIMENT 20
1. Core Body Temperature:

o Core Body Temperature: The temperature of the body's internal environment, typically
maintained around 37°C (98.6°F).

o Oral Temperature: Measured under the tongue; normal range is approximately 36.1°C to
37.2°C (97°F to 99°F).

o Rectal Temperature: Considered more accurate for core temperature; normal range is about
37.0°C to 38.1°C (98.6°F to 100.5°F), usually 0.5°C to 1.0°C (0.9°F to 1.8°F) higher than
oral temperature.

2. Normal Response of the Body on Exposure to Severe Cold:

o The body initiates several responses to severe cold, including:

▪ Vasoconstriction: Blood vessels constrict to reduce heat loss.

 ▪ Shivering: Muscle contractions generate heat to raise body temperature.

▪ Increased Metabolic Rate: Enhanced metabolism increases heat production.

▪ Behavioral Responses: Seeking warmth and wearing additional clothing.

3. Fever:
o Definition: Fever is an increase in body temperature above the normal range, typically
considered above 38°C (100.4°F).

o Common Causes: Infections (viral, bacterial), inflammatory conditions, autoimmune

disorders, malignancies, heat exhaustion, and certain medications.

4. Mechanism of Development of Pathophysiology of Fever:

o Fever develops through a process initiated by pyrogens (substances that induce fever), which
can be endogenous (produced by the body, e.g., cytokines) or exogenous (originating outside,
e.g., bacterial toxins).

o These pyrogens act on the hypothalamus, particularly the preoptic area, to increase the set
point for body temperature. The body then responds by generating heat through increased
metabolism, shivering, and vasoconstriction, resulting in elevated body temperature.

5. Difference Between Remittent and Intermittent Fever:

o Remittent Fever: Characterized by elevated body temperature that fluctuates but does not
return to normal. The temperature remains above normal throughout the day but varies by
several degrees.

o Intermittent Fever: Characterized by periods of fever followed by normal temperature. The

temperature returns to normal at least once within 24 hours, often seen in conditions like
malaria or certain bacterial infections.

6. Heat Stroke:
o Heat stroke is a severe heat-related illness resulting from prolonged exposure to high
temperatures, leading to the body’s inability to regulate its temperature.

o It is characterized by a core body temperature exceeding 40°C (104°F), altered mental status,
confusion, or loss of consciousness, and may involve symptoms such as hot, dry skin (due to
the cessation of sweating), rapid heartbeat, and potential organ failure. It requires immediate
medical attention.

EXPERIMENT 21
1. Vital Signs:

o Definition: Vital signs are measurable physiological parameters that reflect the body’s basic
functions and are essential for assessing health status. They provide critical information about
the body's physiological state.

o Importance:

▪ Monitoring Health: Vital signs help monitor the health of patients and can indicate
potential medical emergencies.
 ▪ Assessment of Treatment: They are used to evaluate the effectiveness of treatments
and interventions.

▪ Early Detection: Changes in vital signs can be early indicators of deterioration or

improvement in a patient’s condition, guiding timely medical interventions.

2. Commonly Observed Vital Signs:

o Body Temperature: Measures the body’s ability to generate and dissipate heat.

o Pulse Rate: Indicates heart rate and rhythm, reflecting cardiovascular health.

o Respiratory Rate: Measures the number of breaths taken per minute, indicating respiratory
function.

o Blood Pressure: Measures the force of blood against the walls of the arteries, indicating
cardiovascular health and circulation.

o Oxygen Saturation: Assesses the level of oxygen in the blood, indicating respiratory and
circulatory efficiency.

3. Critical Nature of Vital Signs:

o Vital signs are critical because:

▪ Indicators of Life: They provide immediate insight into life-threatening conditions,

such as shock, respiratory failure, or cardiac arrest.

▪ Guiding Clinical Decisions: Healthcare providers use vital sign measurements to

make informed clinical decisions, prioritize care, and determine the need for further
diagnostic testing.

▪ Tracking Trends: Monitoring trends in vital signs over time can help in recognizing
patterns in a patient’s health status, facilitating timely interventions and improving
patient outcomes.

EXPERIMENT 22
1. Body Mass Index (BMI):

o Definition: BMI is a numerical value calculated from an individual's weight and height,
defined as weight in kilograms divided by the square of height in meters (kg/m²).

o Significance: It provides a simple and effective method to categorize individuals into weight
categories (underweight, normal weight, overweight, and obesity) and is used as a general
indicator of body fat and related health risks.

2. Why BMI is Used to Assess the Severity of Obesity:

o BMI is a widely accepted tool for assessing obesity severity because:

▪ It provides a standardized measure that correlates with body fatness and the associated
health risks.

▪ It allows for easy classification into categories (e.g., Class I, II, III obesity) based on
ranges, aiding in public health monitoring and individual health assessments.
 ▪ It helps guide treatment decisions and interventions based on the degree of obesity.

3. How Excess Adipose Tissue Makes a Person More Vulnerable to Certain Diseases:

o Excess adipose tissue can lead to various health issues due to:

▪ Metabolic Dysregulation: Increased fat tissue can disrupt normal metabolic

processes, leading to insulin resistance and type 2 diabetes.

▪ Inflammation: Adipose tissue, especially visceral fat, secretes pro-inflammatory

cytokines, contributing to chronic inflammation linked to cardiovascular diseases.

▪ Mechanical Strain: Increased body weight can impose mechanical stress on joints,
leading to osteoarthritis.

▪ Hormonal Changes: Excess fat can alter hormone levels, increasing the risk of
certain cancers and reproductive issues.

4. How BMI Can Be Used to Classify Children in Different Categories of Weight:

o For children and adolescents, BMI is interpreted using age- and sex-specific percentiles,
considering growth and development. The classification includes:

▪ Underweight: BMI below the 5th percentile.

▪ Normal Weight: BMI between the 5th and 85th percentiles.

▪ Overweight: BMI between the 85th and 95th percentiles.

▪ Obesity: BMI at or above the 95th percentile.

o This method allows for the assessment of weight status relative to peers, ensuring appropriate
health guidance tailored to developmental needs.

EXPERIMENT 23
1. Basic Principle for the Pregnancy Test:

o Pregnancy tests detect the presence of human chorionic gonadotropin (hCG) in the urine or
blood. hCG is a hormone produced by the placenta shortly after a fertilized egg attaches to
the uterine lining. Most tests employ antibodies that specifically bind to hCG, leading to a
detectable change, often indicated by a color change or a visible line.
2. Source of Secretion of hCG During the Initial Days of Pregnancy:

o The source of hCG secretion in the early days of pregnancy is primarily the developing
placenta, specifically from the trophoblast cells that surround the embryo. After implantation,
these cells begin to produce hCG, which helps maintain the corpus luteum and supports early
pregnancy.

3. How Early is the Pregnancy Test Advised to the Mother:

o Pregnancy tests are generally advised to be taken after a missed period, typically about 14
days after conception or approximately 1-2 weeks after a missed menstrual cycle for the most
 reliable results. Some sensitive tests can detect hCG even a few days before a missed period,
but accuracy improves when done after the expected menstrual date.

4. hCG Profile During Pregnancy:

o The hCG profile during pregnancy typically shows:

▪ A rapid increase in hCG levels in the first trimester, usually doubling every 48-72
hours.

▪ Peak levels around 8 to 11 weeks of gestation.

▪ A gradual decline or plateau in the second trimester as the placenta takes over
hormone production.

5. Possible Conditions Leading to False Positive or False Negative Pregnancy Test:

o False Positive:

▪ Recent pregnancy loss or miscarriage.

▪ Certain medications (e.g., fertility drugs containing hCG).
▪ Some tumors (e.g., trophoblastic disease, germ cell tumors) that produce hCG.

o False Negative:

▪ Testing too early before sufficient hCG is produced.

▪ Dilute urine (testing with concentrated urine may yield better results).

▪ Ectopic pregnancy where hCG levels may be lower than expected.

6. Probable Condition Causing a Positive Pregnancy Test in Male:

o A positive pregnancy test in males can be caused by the presence of testicular tumors,
particularly those of the germ cell type, which can secrete hCG.
7. Physiological Causes of Amenorrhea:

o Physiological causes of amenorrhea include:

▪ Pregnancy.

▪ Breastfeeding (lactational amenorrhea).

▪ Menopause (natural cessation of menstruation).

▪ Hormonal changes during puberty.

8. Merits and Demerits of Immunological Tests for Pregnancy Detection:

o Merits:
▪ High sensitivity and specificity for hCG detection.

▪ Quick and easy to perform with results available within minutes (for urine tests).

▪ Non-invasive for urine tests, making them convenient for at-home use.

o Demerits:
▪ Possible false positives and negatives due to various conditions.

▪ Reliance on proper technique and timing for accurate results.

▪ Blood tests, while more accurate, require medical intervention and are more costly.