— PHYSIOLOGY RR: DR ASHISH KUMAR

Notes by:
DR.AKANSHA
SARANGAL
 Cell and general physiology

→ Unit
of life : cells 4) Water soluble hormones Neurotransmitter
,

2
# use cell
surface Receptors
5) Proteins
cell Membrane cytoplasm of Chl also act as : enzymes,
cell marker etc
Best Model →
singer → Nicholson antigen .

fluid Mosaic model

CM has
lipids and
proteins ( more) Body fluids : -
60 -70%
of body wt.is

water called
Main lipid are
phospholipid as

I TBW = Total body water

Polar head non -

polar tails 1)
pop groups lipid 2/3 43
-

chain
• •

ICF ECF
Hydrophilic hydrophobic 75% I 25%

IF
plasma
phospholipids are
arranged as Interstitial -

inside

bilayers with proteins in betweens .

fluid vessels
-

Same as IF

fluid
-

blew
but has

%⑧ §④
vessels & cells plasma proteins
fluid?
-

Tissue

$ $ $ form lymph
proteins
cell = ICF

Functions
of lipids : Integrity ,

lipid
flexibility /fluidity
soluble substances
& solubility
can
? ¥Éiasma]- ECF

cross
eg
CM . now
poler gasses , ,

Thyroid & steriod

,
Vit ADEK etc .
All
exchange btw cells & vessels

occur in IF
i

internal environment
proteins of Chl help water soluble It
form
substances cross & Act Across CM C Milieu Interior) & It is

1) Ions : Use channels & pumps maintained in constant state

2) water : use
Aquaporins called as homeostasis
)^
3) solutes : sugars ,
AAS , urea eg BP.HR ,
PH , temp etc

Transporters eg AWT estimation

of fluid chambers
-
 DYE DILUTION METHOD CELL JUNCTIONS ( btw cells)

Vol =
amount
of Dye 1) Uap Junctions : Connex on protein
concentration
helps in Fons current spread ,

Dye used electrical heat & smooth

eg :
synapses ,

1) TBW =D 20 L
heavy water) muscles ( viscera) bladder , uterus,

Deuterium oxide 91T → contract as one unit

2) ECF = Inulin
,
Sucrose

3) Plasma =
Radio labelled albumin 2) Tight Junctions : 20mbar

(-1-123) Occludes
Evan's blue
dye eg
BBB ,
Kidneys ,

Intestines etc .

TRASPORT ACROSS Che

# 3) Desmosonres : sonata adherens

Active passive cellular cements ,

Joint the
→ use ATP → no use
adjacent cells with each other .

against gradient along gradient

→ →

Cuphiu) (Downhill GIT

→
low to
high to low
→
high
CMS Ms)
g. pumps eg diffusion &
.
4 layers
✗ osmosis
via
1) Mucosa : Innermost
NMzg→
microvilli

1° 2° → indirect use : pumps Vitti & microvilli

direct use sodium

symport finger : TT area
for absorb tion

of energy :
pumps Nat K+ puny 2) Submucosa : vessels .
Nerves
, lymphatics ,

3 glands → secretion

→ sodium
glucose symcsa.it 3) Muscular's : smooth muscles
y
→ sodium AA movements
sympost
→ Sodium, Iodine "
4) serosa : attachment

absent in adventitia
esophagus :

Passive Transport
# Enteric Nervous system
simple facilitated I
-

no carrier
-

carrier used Meissner's or Auerbach

coz GLUT
eg 02 ,
eg Sulsmucous
plexus or
my enteric
diffusion plexus
-

in submucosa -
in muscular's
-

T secretion -

movements
ANS control at ( Inner ) 2) Reverse Peristalsis :
Vomiting
organs
)
sympcfight 00
flight
⑦ UIT :& see ,
d mvt .
3) Migratory motor complexes
MMC :

Parasymp ( safe & secure)

hunger pangs / broomstick /
-

Rest & Digest : ⑦ UIT

,
TT erection
housekeeping of AIT
TT secretion & 1^9 movement
prod by empty stomach & clear 91T
.

cholinergic → Tall secretions : Pani Pani

for Next meal
Duration : 90 -
100 min

Pacemaker
of 91T : Cajal cells motilin hormone
from stomach

↳ make slow waves / BER TT all movements ( MMC)

Basal electrical Rhythm food will -0 MMC & ① Desist .

BERT stimulus (
food ,
distension , la ?
3 ach

⑤
,
at hormones) 4) Mass movements

by colon C
for Defecation
ganglionic
Jcells)

Spike potentials absent

hirschsprung dis]
in

↳ Tait : bind calmodulin dlegacolon

<

t Frequency 1-3 times day a

④ Mick : contraction Need

good bulk of feces for proper
-

bowel movements
41T CONTRACTIONS
.

it
by dietary fibres (cellulose lignin, ,

Max BER → Duodenum Pectin, chitin ,

Inulin etc)

min BER → cecum (slow)

91T MOVEMENTS Gastro colic
Reflux
1) peristalsis :
food movements in

forward directions •
food T Gastrin T
Defecation
BER +
food → Distension 7• Tmassmovt
Release NTS ,
cot hormones etc
of colon

--
3 Phases
• Retro / back

↳ Ach
• Front / antero

↳ UP
of Digestion
; Relax
↳ 51-1-1 ↳ No
Name Stimuli Mediates Response

↳ substance P → Vasoactive &

Intes -

D cephalic smell ,
signal Tparesymp + saliva
( brain) of food 10% HCl
Tca "
.
Contract final peptide
C Thought)

forward 2)gastric Food in

vagus LMD max HU Sec
cont → I Gastrin
push stomach
4-cell Cantm)
Tgastoic
emptying
 Food ,
HU in
① HU see
S -
"
secretin
3. Intestinal Duodenum 1- ceil : cue -
pz ①gastric

L " :
Cup-1,2 emptying
vagus ,
K "
! GIP ⑦ all Hwi
distension rich see

paucretic ,

bile

99 Insulin
CULP-1 & alp)

SALIVA
f
-
max submandibular

gland 170% )
lubrication
function D
2) Taste

3) Mastication 1) Gastric
phase : gastric glands→ Main

4) swallowing a) Parietal / oxyutic cells

,
cells

5) antibacterial : IgA ,
max at
fundus -11+1<-1 ATPase

) J
zinc
Defensive Lysozyme
, ,
s i Hcl secretion
by proton pump
6) Digestive Role by enzymes & Hcoz / a- exchange :
-

AU in lumen &
a) S amylase / ptylin
. Hwi in blood CAlk.PH )
activated by d- >
ii Intrinsic
factor : Bind vit Biz in duodenum
-

optimum pH 6.7 & absorb .

in Terminal ileum .

break starch ( casts)

Defeat
cause :
nlegaloblastic anemia
-

iii)
b) 5.
lipase & peptidase Ghrelin : T UH

cell (Inactive
b) chief or
zymogen
enzyme)
at Rest PH is 6.8 acidic eg .

pepsinogen 1¥ Pepsin
on stim . (eating) + secretion
of Nat ,
( Active

Kt Heo 5 d volume 9 Hot see by

f
•
make
ph alkaline 8.0 1) Vagus -
Ach Mi Receptor
Brunner duodenum 2) Ect Entesochsomafjin like
gland in cells cells
• -

protect from acid burn ↳ secretes histamine ,

51+-1

3) ↳
alkaline
by making mucus a- cells →
gastrin Hz Receptor
9 HU
pH 10-11 : most Alk ,
9 GIT mvt .
,T Bite see

[
Facets ulcer Caag)
:
gastrincoma
> Diarrhea Lbhaaa)
"
2041 NUER
"

ELLSION Sym ( hookah)

 Digestion Cjesrous) Feat : enter duodenal
cells
by apical / luminal DMT -1

1) Proteins ?ÉAAs : absorb to

by
trypsin Leave cells to to blood
sodium AA
⑦
symp .
ao

J
3- pancreatic basal
fesropostin (① by liver hepcidin
-

chymotrypsin tail)
enzyme
& Intestinal d t Iron absorb Vite
peptides :
,
Hel

d Iron
Enter Kinase
exocrine
absorp : Tannin ,
phytates
Tsypsinogen Trypsin
RESPIRATORY SYSTEM
Duodenum

" " Pase

2) Fats > LCFA -1 bite salts
P lipase
panc.fco.ci pase Airway classification
.
"

Emuusificat Weibel
Stahnke -23
water
generations
micelles El absorbed

¢ zerogenerh)
3) Casbc
polysaccharides Pancreatic
amylase
Di <
5. Trachea

d
d ✗ -

amylase bronchi Clstgen)

& absorb Jr Terminal
mono
glucosidase
(
↳
Maltose Maltase
>
2
glucose bronchioles -
gem 16
sucrase 9Mtfructose &
sucrose > Respiratory
lactase
glutgalac
Aciny£(
lactose alveolar ↳ ↳ 17
> gem
monosaccharides are absorbed by &
SALT-1 & GLUT alveoli
sodium
glucose 142 :
glutgalac
linked
Transport 5 →
fructose

Fastest galactose
alssorp :

Max
absorp in
Jejunum (Max area)

J Then ilium ,
colon

except 1) 7. ileum : Vit 1312

,
bite salt

T bite see = cholerectic : most

bite
potent are salts and acid .

2) Duodenum : Iron
absorb .

Diet : Fest
Reductase
-1
Fez <
 Exchange / Rep zone .

pressure in
lungs Intrapul or
is .

generates 17 232
-

intra alveolar pressure ( IAP)

6 alveoli
Resp .br → same as
atmosphere as
lungs
"
conduct Dead connected to Atm
zone : no
exchange = are .

Trachea to) to space by airways ,

open cavity
Term .
bronchiole ( lo) Atm •
LAP at Rest
, ,
Max smooth muscle →
760 mmHg or

Broncho constrict
"
←↳ B. Dilation -1 At
ommtlg
parasymp ④ sym ⑧ Insp : -1
mmHg / 759
mmHg
:
pull
-

•
-

-
histamine Ctrl AP ) air inside

Exp : 1
mmHg / 761 mmHg pushed out
•
:

Boyle's Law CTIAP)

pressure v01 PLEURAL CAVITY SURROUND

£ .

LUNGS
Respiratory Movements •
2
layers
[ parietal
> visceral

•
Insp : active process : use muscles • closed cavity - non zero
pressure
✓↳ • Intra thoracic Pressure CITP)

Diaphragm External IC -2
mmHg at rest C-3cm
" ">
75% 25% This -
ve Itp expand lungs &
Expand & TT
size of thorax prevent collapse
d pressure pull air = Inside In
pneumothorax ,
ITP becomes

lungs zero or
lung collapse
+ ve :

11th
•
Expi 1) .
normal expiration : passive air enters
-2
no muscles →
compress lungs → ITP : non -
ve

-2
T pressure : push air out

-2
→ pneumo -

Forceful exp coughing shouting

•
: thorax
eg ,

-2
active use muscles to compress thorax Invert
recoil
high pressure
abdominal & Internal

Intercostals
 ITP at Rest → -2
mmHg Surface tension inward
force due to

ITP Insp normal

→ -6
mmHg
( tulip)
fluid & air inside alveoli

Exp → mmHg ( return to d ST

'

ITP normal -2
fluid u

÷@¥E
Wi

normal) #
forceful Insp ( very -
ve) = -
20
mmHg push air out pull fluid
forceful Exp -120 to 30
mmHg ④ ④ collapse Inside
-
=

alveoli pul edema

-

-1
(Atelectasis)
to
compliance
& Difficult breathing : RDS

UST
by surfactant :
prevent RDS

& Clara
Diaphragm : Down Type -1T
pnenmocytes cells

Contain 70%
phospholips : Main DPPC
•

&
Dipalmitoyl phosphatidylcholine
COMPLIANCE surfactant protein CSP ) -
A, B : main

normal
lungs are elastic :
good Recoil & C D
,

surf
"
compliance .

product at 18 -
20 weeks I. U
life
all lung Parenchymal disease cause but see & Action at 28 wks

trcowp .
due to
fibrosis Iuflammat ,
"

age of viability
£
Infiltration etc .
Called RLD

tied Max
as all movements ,
volumes are
surf by .
34 -35 wks

eg : asbestosis , silicosis, pneumoconiosis

( Wal )
by steroids , progesterone Estrogen ,

TB , sarcoidosis etc
↳ cortisol

preterm labour steroids

→ The
only disease with
high compliance give
:

is EMPHYSEMA : loss
of elastase
2 for lung Maturity .

poor recoil but T compliance

> normal →
healthy lung Pulmonary Function Test

•
comp high →
emphysema ① by SPIROMETRY
> how → Rus normal & Expi V01 Tidel
Inspi .
=

Volume
If Airways narrow OLD
②
=

comp =

4¥
=D is
change Max
forceful inspi .
= IRV :
Insp Reserve

normal hung =
2201cm -1120 h -73 -3.5L V01 .
 max
forceful exp after normal exp Spiro fail to
give
RV & FRC

2
1.3L
FRC estm .

IRV
1) helium Dilution
n : Exp
Tv
2) breath
- - - - - - - -

E- pij Single Nz washout

Fowler method Dead also

:
space
=

Max EXP
3)
plethysmography in OLD

③ Rv ! Residual Vol : 1.2L

④ vital Cvc)
air
left in
lungs even
after max
capacity
forceful exp Since it won't come out It is max
insp & expire
-

prevent ✗↳ not
given
collapse by spirometer c- IRV -1

ii. ERV

Capacity : sum
of 2 or more v01 .
normal

RV : not
0-1 3.2L

1C → TV + normal out
IRV : 3.5 -4L
Coming Q
4.8L

F-C→ TV + ERV normal : 1.8 -

2L

RLD : dd VC due to
poor compliance
FRC =
Functional Residual all Vol .
less f due to air

OLD : normal / a Vc trapping

capacity ve

↳ T time but normal V01

It is air
left in lungs at Rest .

ou
after norm expiratory .
/
TVC FVC : Timed or
forced VC

to It is Vc & Time taken

? 2
ERV won't come out and
stay SL 3sec

RV Divide
*
in
lungs with Tvc as FEV ,
,
FEVZ Ftvs ,

¥11228 1st
= ERV -1 RV : 2.5L ( normal ) forced expiratory volume in see

1st
-

past of vc
expired in see

Air
left hurgs§ after forceful
normal
of
]
•
in 80% Tvc -
Tvc = 5L

> ex =

normal
RV FEU , ,
% normal 80%
t
after EXES
-
FTZC FEV ,
= 4L

FEV , -1 .

=FE#
Tvc
✗ 100 =

¥ ✗ 100 = 80%

air in
lungs at Rest FRC
=

ITP -2 & FEY % 280% in OLD

mmHg
=

IAP = 0
mmteq normal FEW % in RLD
 d d

Best inv .
to Dfw RLD El OLD anatomical Ds alveolar Ds

is FEV it .
normal 150mL normal 0 ml

→
a
normal led
physiological DS = Aunt -1
DS
Atv Ds

Record VC OLD
-
-

✓↳ AV = (500-150) ✗ 121min
normal told =
4.2 21min
healthy RLD

ventilation perfusion
¥
: -

TLC : Total Ratio

lung capacity
of all 4 volume indicates
gas exchange
→
sum

- IRV 1- ERV + Tv + Rv ↳ Air

coming 1min =L : ideal

normal 6L blood
coming 1min exchange
Spiro fail ←
to
give Rv ,
FRC, The best
exchange
^

É f- -1=1 :
¥
miss match :
poor

/ /
d exchange
1C Rv

i. i
- -

Hypoxic hypoxia : Tissue

get less

Oz to
1-
|
use .

FRC hPa Oz & dspoz : as less 02 enter

} Rv
blood other
hypoxia normal Paoz
TLC = VC -1 Rc or

1C + FRC • Anemic : less 02

VENTILATION •
stagnant / Ischemic : less blood flow
TO tissue
Pvlmv =

pulmonary or minute vent .

• thisto toxic -
shock
,
HF

air
going in el out
of lungs 1min Tissue
fail to use 02

= TV XRR = 12 -161min despite normal blood 02

=
500mL ✗
121min eg :
cyanide ① complex IV ETC

6000 me / min
cyanosis
=

H ⑦
hypoxic :
lung D. ha
-

Av : Alveolar Venti .

A- -0
air
getting exchange Fermin "
WGS anemic : Ussstlb

µ
na

normal paoz
AV =
(Tv -
Ds ) ✗ RR 5- stagnant : less
flow ⑦ ha
Dead
space is air not
getting
H histo -0
exchanged in airway and alveoli : Tissue D. na
-
 V10 > 1 : air > > blood d area Elt thickness :
poor 02 differs
"

air
left un
exchanged called as membrane

↳ 9T
physio DS
diffusion disorder eg KD, ARDS .

Best
"

eg pal : embolism
, emphysema Inv : Duco

Diffusion Capacity in
lungs for co
Normal v19 of whole lung = 0.8

1
(02 TRANSPORT
apex v19 1.3 = Max : >

due to poor perfuss? 4 me % or 200 ml / min

Base v10 = 0.6 min

physio DS 1) Dissolved Coz : 10% or 0.4 ml %

Max Poz at apex :3 I 2) Bicarbonate : 75% Or 3mL % : main

also in TB 3) Casts amino

form : 15% or 0.6mL -1 .

Max
perfusion at base due to
gravity
Max ventilator at base : Max
space 02 Transport -
250 me / min

or 5 met .

PARTIAL PRESSURE Hb bound 02 Dissolved 02

11lb bind 402 0.3 met .

Igm carry 1.3mL paoz depend

02
only on

dissolved 02
worm tolls 12
lbgmt
-
.
.

d d
gas exchange by simple passive
diffusion by Fick 's 18-19 mly HENRY LAW
carry
Lang
.

02
<

Rate of diffusion Depends on 02 -

Hhs Dissociation Curve
1) Gas : size & lipid solubility %
coz is
faster then 02 ( 20 times Saturah
Right

$
Release 02
2) PP : more PP, more diffusion left shift for tissue
differs
"
T Poz 902
eg 02 therapy : →
lung
BOHR
T Paoz correct
hypoxia .
T love effect
3) Resp .
membrane -
029

Area thickness affinity Poz

normal 70mF normal 902
0.5 Um
binding
HALDANE EFFECT
Double Bohr in placenta even in sleep .

Tissue
high & shallow
? irregular
: Pcoz It is

BOHR EFFECT Pons make it Regular ,

Smith

Hb will load coz & unload 02 & good Vol .

rm
Medulla lesion :
Resp stop green
Pons lesion : Irr shallow run

mid poutine lesion : Afarensis

& vagotoiuy Resp stop in

Ierspi .

Reg of Respi by chemoreceptor

.
.
:

sense & correct

hypoxia ,

TP coz by stim .
Respi centre

hyperventilate CTTV ,
TRR)

HBF : 2 a & 2 r (gamma)

2
globin chain
chemoreceptor
NO 13 -
chain ,
NO 2-3 BPU
binding ↳
↳ so , Hbf has
higher 02
affinity Ccc) Central peripheral CPD
Maternal ventral BBB
hence extract 02 from -
in

tels A medulla CSF blood

CO poisoning : co has 210 times

only stim.by stimul.by
T H+ in CSF blood chemo
more
affinity for Hb than
+
02 TH in blood
( acidosis)
9Pacoz &
cotlls carboxy : tels to paces

cherry Red
] via Oz sensitive
-

fire in closed Room Kt channels

of
<
abnormal 1lb
glowers cells CPD

wont Release 02 : Death Bifurcate

anemic
hypoxia Pcp carotid sinus :
of ccn-i.HN
)
of
)
aortic sinus : Arch : ✗ N

Pacemaker of Respi : in medulla aorta

L
*-
Pre bot
zinger complex or Dru Stimulate Respi .
center

↳ stimulate Resp muscle .

& produce automatic Invol Resp .

.
 I &
tet can't cross BBB contract & Relax & file
H+ in blood pump
only
"
stim
"
Pc

Ht in CSF CC

PC ATRIA
Hypoxia act
by 0.1sec 0.7s =
0.8

coz can cross BBB & stimulate -

late active filling

both Pc & cc (
by making Htinspi) of vent .

It is the main for stimulus J

Respiratory Regulation .
VENT .
0.3sec 0.5s = 0.8

Cvs → Pacemaker of Heart

Avgopen
→ SA node RA CA close :S ,
Tricuspid mitral
due to max
frequency 70-1001 > : early
win
RV LV tilling
put .
Aortic
due to phaseII close
impulses Sz → Azpz

µ sl[ Open
make automatic - so
:

pacemaker potential ✗ >

:
early
1) early closure channel Kt Aorta ejection
/ Nat
2)funny leaky channel
systole Diastole

3) Cant channel transient) Si

) Sz Si
- -

ISO V01 "

/
eject
.

main cause
of ph.LT Av close contr
Lv=
izommteg
RA LA
TVP RV 25
mmtlg
-

Tricuspid mitral

Conducting pathway
RV LV
SL
em .
anic
open
% ☒
SA -
AV node - bundle of HIS

-
atria -
slowest d Sz - si Ar close

|
0.05m / Sec Bundle branches
RA ↳

Is" " Filling

RV LV
#

&
"
AV
Delay ¢-0 § Relaxt easy passive late active

lol see ) dup Avvopen ⑤ ④

maxgap-sunc.EE Purkinje fibre zero

mmHg
ventricles
PRESSURE
-

Fastest 4m / see
-

1) LA pressure
Cardiac Cycle mmHg
5-10 =

=
pcwp : pulmonary
cap wedge p
i. .

→ 0.8sec

events in one Heart beat 2) RAP : WP = Central venous pressure

mmHg &
# 0-5
0-8 Antero

Systole Diastole all blood from body in RA ( venous Return )

 V01
Shock :& body perfusion
CVP
.

Changes
I 1) EDV : end diastolic volume
low
high blood filled in Veutri .
during diast .

v01 Shock normal ml

hypo cardiogenic 120 130
•
• -

distributive shock VR
te
Depend on
;)
or
,

) pump
shock can't TEDV : T load on vent .
even
"
PRELOAD
1- It : IV
fluids ,
Iouotnps & before contract →

Adrenalin Diuretics 2) Stroke v01 ( su) : norm → To -80mi

blood beat
pumped per
• LV
[
-

> D
S =
120
mmHg

mmHg
> 120 ( LV)
3) EF : it
of blood

100
ejected per beat
65% normal
{¥y
O

(
- = ✗ =

80 ( Elastic
-

•
Aorta

[
>
RV S 25 Recoil) EF fall in veutri failure 240 -45%
mmHg
• - -
.

> D
-
o
mmHg 4) ESV : end
systolic volume
blood
s
left after systolic
pul -

[ 25 ( RV )
( elastic Recoil)
ESV = EDV - SV

SUMMARY
> 10

JVP : from Internal Jugular vein • blood

filled - EDV = bowl
↳ 0-5 d •
blood pumped 80mL
mmHg Sv
= =

blood
same RA
Reflect RA
changes left Esv 40mL
as • = =

value b/w blood EF

↳
-

no the two •
% =
=
66%
+ pressure : wave

d pressure : Decent

Atria contract = a wave factors Affecting VR

Veutri .
Contract = c- wave

close Av ( Si) : Bulge Av upward 1) Gravity / posture : Max v12 in

supine
Relax descent
Atria = ✗ 2) Mus .

pump : calf muscle eg : solves

fill by TVR
eg Walking
atria vena cava = v wave : ,
Exercise

atria
empty when Av open =y descent 3) Venous valves : Prevent backflow .

4) Insp : ve ITP : pull blood towards tB

M
-

↳ TVR
5) syrup :X Veno constrict TVR,
"

"

✗ y
↳ loss
of sym : veuodilat : I v12

Neurogenic shock : NE / phenylepitaph .

6) Deep fascia : Thick & Tight in
legs 2)
Capacitance vessel Systemic veins =

keep muscles & veins comps TVR .

high compliance they stretch →

& store blood ( help compensate loss

CARDIAC Output of blood)

blood pumped by ear vent .

per min 3 contain 50-60.1 .

blood
"
Estm 1) Echo 2) Dye dilut

3) Thermo dilution 3) Exchange V :

capillaries
4) co : Sv ✗ HR =
54min -

permeable
towel
721min
512min -

simple sq .
endothelial cells .

( % blood )
))
Co : LV = RV =
54min -
min Vol 5

during excer.co t
by 20 -254min -
d pressure & Resistance

RESERVE mini

(
called CARDIAC
as
Speed
-

edema
if increase

MECHANISM :

I
T SV
(1 Max Cross sectional area ( CSA)

due to billions
of cats .
in
parallel .

Frank starting Arteries fast

Ionotropic effect speed =

TEDV 2 Svt Tca" : contract Turbulent flow : Noisey

filling Reynol names

[
more ,
more Tsv without £2000 : leminar -

pumping EDV
change > > 3000 : Tests

eg
: Iv
turrids ,
d
workout
left shift of 4) Resistance vessels
sv
frank Stevin law muscular arteries & arterioles

Ionotropic Agent muscles & Relax

•
•
: Smooth : contract
eg
-

E. NE > Dobutaurinep , -

change diameter & control BF

EDV
digoxin ,
-0 Not

p, oiler : ④ chrono Pump Tca" Arterioles : main Resistance vessel

syrup
£9
- 9 conduct
Sv : ① Ionotropic
"
: ⑦ Dromotropic
Max

Rich
smooth muscles

sympathetic supply
+
excitability : ⑦ Bathmotoopic
#
T
types
Kessel vessel :
of VESSELS al

Vaso const
132
vasodilation
1) Wind
large elastic

eg Aorta arteries -

everywhere -

few sites : muscle,

stretch in syst El Recoil Inward Diastole Skin 41T ,

, kidney sweat
glands ,

↳ compress blood to produce DBP etc uterus

80 mmHg & Maintain Blood flow

in diastole
Arterioles (60-85)
offer R.at tissue level DBP 80 mmHg
=

-
periphery to heart ,
hence It is due to elastic Recoil & depend
PR
it is main site
of on PR
mainly
*
TPR will T load on vent
after PP :
pulse pressure : indicates
"
Blood
flow &
they start contract
AFTER LOAD
so called
↳ SBP -
DBP
arterial compliance

→ mean

F P Pressure MBP/ MAP ! normal 95-100

:
mmthg
=

Blood -12 : Resistance mainly MBP =

DBP + Yz PP

Arterioles at MBP
flow Tissue level
2-3 DBP +
b- SBP
=

(vs "
Organs can control their own blood flow Regal at centre
medulla
by changing their R .
called as in

Auto regulation
#
eg
: +
flow to muscles =TP_ =
syrup will VMC Cvc

↳ IR TSBP vasomotor Cardio

exercise vagal
-
-

metabolites vasodilator center centre

(,
cause called
"
RVCM ! Rostro vagal
as
Autoregulat .
-
nuclei __ NTS
,

NA
lactic acid tpcoz.lv Poz Ventrolateral T
,
parasynip
K+ ,
H+ Adenosine ,
T
temp etc medulla by vagus N .

Hypoxia in
lungs : VC
Tsym : TSU , THR ,

rest : VD TBP

&
"
Best antoregulat •• brain Ach Mz receptor
vagus :

(adenosine) ( coz) & to

*

8µn÷ length
12 . iswsity & BP

↳
radius CM.int : power)
with
BARO RECEPTER -

control BP

↳ &
"
Double resistance or → 2 times via VMC cvc
2
- stretch in Arteries
16 times
Receptor , , mainly
fall in r Sensed reg .
MBP
BP
.

Range of 60 - 180
mmllg
SBP 120 mmHg (90-130) set point too
mmtlg
= =

& ahoay I BR IHR

"
is due to vent contract depend break and
It .

They act as
,

on co
mainly by ④ Cvc ( Nts) & -0 VMC
Destroy BR : TBP due to VMC
glomerular capillaries →
filter plasma
uncontrolled & substances enter Tubules

Neurogenic HTN ✓
#
① VMC
Reabsorption secretion

Aortic sinus BR : IN
] ] IBP HR
good solutes Bad & wastes
-
-

- -
,

④ we water solutes
car sinus BR : IN
eg
:
glucose ,

Nat , I
AAS
eg drugs toxins,
-

,
.
,

MAREY 'S LAW due to BR -

enter blood CPC) metabolites Alid , ,

from urine tubules uric acid etc

BP
In HR -

from blood Cpc)

tubules)
"
due to BR correct to Urine
patho
-

shock :& BP : THR by syrup BR Pc • 3

of
steps
g.
Reflex Tachycardia Urine formation
-

Reals & plasma clearance

CNS Ischemia
cold
cherishing Reflex : TILT → TBP 1) Filtration :
glomerular functh
dtlk by BR 2) Reals
]
-
Tubular fuuctu
Reflex bradycardia 3) see

URINARY SYSTEM Glomeruli filth Membrane

1) endothelial cells
of as opening b/w :

"

#
cells called as
fenestrat -90hm 70 .

Cortex Medulla 2) Basement membrane : -

rely charged
inner Siah
outer proteins and
heparan sulphate
- -

of rely
"
unit
of life Nephron:
They Repel & prevent filter
-
-

= 1- 1.3 million / charged plasma proteins

each
kidney
3) epithelial cells of Bc : Podocytes &
foot processes .
 "

They have filterat slits : 10 -2ohm in medulla :

hypertonic : more osm

1200 mosm /L their plasma

Net
pore size : 4- 8hm 300 mosmtl

subs 24hm Size are

freely Medulla will
pull water from Urine

filtered & make concentrated

hypertonic
water Inulin Nta mosmll
eg :
, , glucose ,
urine 1200 in Desc .

loop
& CD : also need AAH

> 8hm : not

filtered
eg RBC >
WBC
plts , ,
✗ B macro longer the
loop → more cone .

power
↳ medullary Nephrons
globulin Juxta

Myoglobin not
fit .
as bound to branch of Pc : Vasa Recta
Capillary
plasma proteins
((
.

system : counter

if b/w 4- 8mm
depends on
charge current : t love
of Urine

Albumin 17
eg
)
nm

to
but not
filtered due -
ve
charge cc
multiplier cc
exchanger
loss
of charge
eg Nephrotic :
synd create
high medulla Maintain Medulla

↳ Albumin urea osmolarity Choo) OSM by

by accumulating water Reabp
PCT : Max ATP , 02 & blood flow solutes
(> Vasa Recta

see El Reabp occur

ascending loop
-

Max

All
"
#
'
Thick
Sub Max
Reabp except Mg .
Thin
Na -11<+24
←
-

NK cc :
Asc
loop Nat
Uco Transport ,

all sub

'
max

DCT
except Transport
(p cell)D
see

↳ medulla
IN at
1 blocked
K+
/ K -

za
-

by loop
& Area in thin loop of heute 1200 diuretics : loss

Max acid see in PCT & Defect in Barter -1

of all solutes

Max
Buffers in PCT
Syndrome in urine

→-
HW5 MHz
-

poi
-

DCT :
early part : Ncc

main , need carbonic anhydrase Nata co

Transport
-

block # Defect
water
permeable
LOH ! Desc : come .
urine Thiazide Uitalman synd
Asc : solute permeable : Dilute
hypotonic urine
loss ADH
of all
Except can

Prevent Renal stones #

9 SIADH It D.Insipi .

CD : ( in
2 types of cells DCT also) TCD : water Id

1) I - cells : acid see make acidic urine permeable

99 water reals It
min PH
of Urine = 4.5
#
limiting PH into medulla

2) P -
Cells : Principle cells

←→
Kt see Nat Reals Conc .
hypertonic Hypotonic Urine

& blood K+ by ENac Urine 1200 MOS /C 50 -100 mom L /

# Ts -
Na
'-
epithelial
q in sodium channel low urine
high Urine V01 .

Liddle
synd blocked
by Vol . 33L / day
Amiloride -

polywria ,

Doc : Liddle syn polydipsia

lithium Induced DI

④
RBF = Renal blood flow =
1200mi min /
P -
cell ← aldosterone : 4s .
Nat RPF Renal plasma flow =
625mi / min
#
f.filter
99 It as .k+

CONN ADDISON

→ Doc : conn AFR : Amt

of plasma 125m11 min
=

Aldo .

antagonist :
spironolactone filtered 1min
d-
milk
←
gynecomastia 1) If only tilt .
occur (no seed reabp)
clear ml
we can 125
plasma
CD : water & urea
premealsle with
equal to AFR

↳ ADH ↳ clearance : 125 ml / min = UFR

by aguaporins UT -3 area
eg inulin CL used for AFR Estm .

t Transporter -3
a
9 water Reabp 2)
"
TTCL
make medulla
If secret accuse :

hypertonic CL → UFR
↳

by V2 Receptors of ADH Cviconst .

( tilt -1sec) only tilt
in P -
cell
of CD
eg
: creatinine

CL : 130mL / min ( > GFR)

It is Sec & fil both but little secret?

 CL is close to UFR Ja APPARATUS
cells
3 types of
-

Most accurate for UFR : Thulin

most used
for UFR : creatinine 1) lace's cells :
Meseugial cells act

as
Macrophage
If full see then
. 100%
plasma
cleared → Cl = RPF @ 25
) 2) Ja cells in
Aff .
asteroids

& Release
eg
: Pate : Para amino
hippwric acid sense RBF

HF, d Nat )
"
↳ RPF estimate Renin
if less
flow ( shock IBP ,
etc

3)
If Reabp : tr ch
I renin

liver
L AFR
angiotentiowgen AT I
→
CL -

eg Urea
or = to -90mL
/ min
RAAS
lungs L Ace
Covid
fitted Reabpcfor cc system) AT -
II
ia
bind
)

(3)
loot .

Reabp ,
of . cleared 1) Vasoconstriction

in urine ,
ch is zero 9 Nat 2) T Thirst

glucose ?
-

: AAS T V01 ADH

eg ,

PCT T BP 4) T Aldosterone
100.1 .

Realsp in

by SULT -2

3) Macule Densa cell in DCT

TMU -

Transport Max
glucose UFR
Regulation : Tubulo

Max
glucose Reals per min
glomerular feedback
normal : 375
mg / min 1st check AFR
by Nat d- levels
,

in Tubular fluids .

Ft : Filtered load Tatts t→tNa+ a-

amount
of subs tilt .

per min then correct atte

If EL > TMU : not .

100% Reabp -
Arteriole
glucosuria occnre .
Intra
glomerular
diameter
ayy Mesengial cell

99 FC I TMU # const
eg shock
.
-

contractile cells

•
DM •
Tubular D .
Tufte data ✗ i astound ac
" #
Fanconi syn art Pilot
off relax
•
.
.
contract

Dopamine & area t area

eg :

1^12=13--1,9 hydrostatic truth tutte

Pressure TUFR
 ( Oz
Eff Art .
Constriction
eg
AT I -
CSF -
Nutrition , glucose ,
AAS
,

I RBF but accumulate 4C ions etc)

egg
*
waste Removal
in
acaseff art is
-

Narrow -

maintain Temp , pH , osmolarity etc

99
hydrostatic pressure shock Absorber
-

El THR CSF is simmilar to

plasma but

lower cone
Leg glucose is 60% )
CNS except Pcoz , Hloz
-

, Mg
"
,
CI
-

concentrate
in
higher
Neurons &
glial cells
NT Release
↳ less ↳ more in numbers at
synapse
no new neurons d can form
birth
a-i.IE T
except cells →
after new
-
Axon

hippocampus -
Ap travel
AP
pnopogath
Glial
↳ initial segment
Types of cells

1)Microglia Macrophages phagocytes

: = Nissl granules in cell
body
2) oligodendrocytes make myelin : are
free Ribosomes : protein synthesis
↳ in aus -
Normal
Injury Cwalleriau Degenerate
it
PNS : Schwann cells make
change : break down
of
Wissel
myelin granules →
chromatolysis
3) Ependymal lining : cells
of ventricles
a) Astrocytes : supporting cells to RMP & AMP
Neurons Membrane is selectively permeable ,

& help endothelial K+ )

in BBB :
Tight at rest to
Diffusible
,
d- C ions

Junction not Perm . to Nat.ca?+Poy3- protein etc

Distribute
uneven
of Ions across em ,

Cst : 150 ml , daily product

"
called Gibbs Donnas
equilibrium
=
500m11 day or 20mL / hr
→ see choroid
:
plexus <
"
Arachnoid villi
Absorp ?

Cmain)
normal pressure : 50 -
130mm H2O
concentration
or Due to in
equal
will inside
Nat Caz -1
I come
-

,
5- 10 ,
mmHg & Kt will go outside :
equi 11 ?
.
 Stimulus
& Potential for this is called j
as
Equilibrium potential
↳ "

given by Werst eg amore ve

-
)

= I 61 5
log Come out
.
in

de

EP Values Depot .
at
synapse by NT : EPSP

1)
]
Nut
"

hyperpot
" "

: IPSP
"
= + 60mV cation .

2) can - + 100mV
Coming inhibitory post synaptic potential
inside creates + ve EP

3) E) coming
-

CI =
-70mV : Anion NT at
synapse bind Receptor open ,
ion

Inside : -
ve EP channels to produce EPSP / IPSP
4) K+ - -90mV : cation but at hillock : EPSP / 1 PSP

giving outside ,
loss of ⑦ inside → add to make AP : Do action

ve EP stemmata sensory IPSPIEPSP Motor

World -5¥ -
muscles

RHP -

Resting membrane potential

Input output
afferent efferent
K+ &
-

( tract )
Depends on CI

as car is not
permeable 1) watch
opening : Nat entry
✓ =nmP to Nat cast but Perm
, .
Detpolari I EPSP .

to kid a- at rest , mainly 1<+2 eg glutamate :

by NMDA Receptor
More permeable main
Excitatory NT in cars .

since both have -

ve EP

always 2) catch cat

RMP is ve
opening :
entry
-

=
Delopl / EPSP

RMP values Substance P Stirn sa cells

eg
:

1) Neurons → -70mV
of spinal cord substantia
gelatin Osa
et 1st Neuron d
2) Skin cardiac msl → -90mV -

of pain pathway
3) smooth msl
Thyroid ,
-50mV
pain sensation
SA node etc

3) Kt ch
4) RBC → -12 mv
opening : K+ efflux
5) Rods & cones → 30 mv
Hyper pot / 1 PSP
inhibit su cells
eg Morphine
:
G) hair cells →
yo mv

µ opioid Receptor algesia ,

⑦
pain analgesia
: : Dolor , Dolgia Alegria ,
4) Open a- channel
Memory
-

CI enter stored at in
:
synapses
hyper pot / IPSP NEO CORTEX NEURONS

eg
:
ghgciw
GABA in
in S .

brain
Cord
] -
Main

Inhibitory
Repeat
at
synapses
stimulus :

called
t Nts & 9

synaptic plasticity
Receptor

T Recall &
NT
faster Response
ch Nat ca
"

open : Depot : Exciting potential CLTP)

"
:
,
eg
:
Long Term

ch kt.cl
open : hyper fool : Inhibit by TT NMDA
receptors of glutamate
-

eg :
hippocampus CAI Neurons ,

AP : Threshold stimulus (+ lsmv) Use LTP to convert STN into LTM

cause AP ( loot .
) if less : no AP called Short ,
long term meuwry.FI
as all or none law

Sensory
.

Threshold change RMP from -

to to
System
-

55mV is FL :
voltage -55mV I ← ↳
gated Nat channel
open Latgale) Receptor pathway cortical
↳ Nat enter at cause Big t centers

Depolari Upto .
+35mV Called as

over shoot or
spike potential .
Properties
I 1) Threshold : need min certain
Nat channels close Ch gate) stimulus to
give Response
-

↳
Depot is over ( efflux)
eg :
hearing at 20 Hz .

K+ K+ J
on
open : goes out

2)
Membrane Return to -
ve ump specificity R respond mainly : . to
↳
Repolarization their
types of stimulus
&
eg :
light Rods cones
=

Nat K+ pump : pump 3 Nat out

3) :L
2kt In .

Adaptation Response on

To restore Ionic Cove .

Constant stimulation .
vibration

high Nat in ECF

eg : •
Rapid adapting : Touch smell,
-

,
"
(
adapting : Propriocept position)
K+
high in ICF Slow
•
-

non
adapting : train Cjelt all
•

the time till

healing occur .

4) Weber -
Fechner & Steven Power ten
stimulus ( s) ✗ "
Intensity of sensat
(1)
I✗ SA (
power)
 light
Dark : 11 cis-Trans

99

kt from endolymph
in Scala media
→

h "
Sens at
hot burning pain .

TASTE PAPILLA
1) Fungiform papilla : Tip
2) Foliate Vellate
:
leaf like : side
bitter
3) Circumvallate : Disk like : Back
y ← sour

) f- salty
Na-11kt
salty :
sugar T
sour : H+ / acid q sweat tip
sweet : a protein Receptor (cAMP )
bitter " " "
SSS somato

CNC
bind
poison
-

cyanide) sensory system

-
sensate from body :
pain temp
Umami : Msu → Mono sodium touch etc

glutamate Receptor : epidermis :

only
aziwomoto → Momo Skin , D Markel Disk
"

spicy / chilly is not Taste Joints , 2 point discriminant

•

but pain ↳ has

capsaicin muscles Best at
fingertips el lips
bind Vani void Receptor / V12 / TRPV ( I-2mn ) :
help bind read
 braille
script 3
Ascending Sensory Tract

Rest in Dermis in S . cord

1) Messner's :•2
point Disc, 1) Dorsal column : Rest all

fine Touch 2) lateral Spino Thalamic Tract

• low
freq vibration ↳ Pain & temp

3) Anterior ST :
Itching & crude

3) Pacini an
corpuscle : onion Touch & pressure

high frequency Pre central Psu

•

pressure gyms

/
•

warm cold I
4) Ruffini ending 5) Krause end

bulb

proprioception ( Joints)
Temp & pressure ( Dermis

6) Free Nerve
endings
Pain , temp itching
, ,
sexual sensate .

PAIN
Fast slow Post central gyrus :
sensory
Cortex
A Delta C-
unmyel .

1° 20
myelinated autonomic

Nerve
fibre Nerve fibre area 3. 1,2 area 5,7
-
skin
injury
-

angina ,
colic
,
I , 2,3 ,
4
,
5,6¥ 1°
#
↳
headache
sensory sensory
superficial or
Deep ,
visceral 2° Motor

somatic pain pain Motor cortex : 4,6

pyramidal beta cells

sharp et well Dull et ↳ give corticospinal or

pyramidal
localised Diffuse tract : CST 85 -90%
fibre cross
at lower end
of Medulla

-0 Radiation & -

v01 .

fine skilled movements

Referred Pain CST stimulate ✗ motor neuron

in anterior horn ( ✗ MAD

2 MN notes Nerve release
give
Arch C Nm) at NMJ

↳ contraction

UMN
control UMM vice Tract ( PT ,
EPT)

Tract lesion ✓
→ LMN lesion :
spastic
paralysis
LMN = ✗ MN

Muscle
control by Mater

nerve → Nerve lesion

↳
flaccid paralysis
Muscle >
length sensed & Regula

{
-

muscle
by
( MD
spindle
>Tension Tendon
goli
-

Cuto )
organ
Ms stretch
Reflex / DTR deep
:

Tendon
reflex
9
length
'
- contract

I
by stretch
length
I back
+
to ④

⑦ ms
É→ ✗ MN
fibre
Iutrafusal
muscle
fibre
T
✗ motor : cause muscle Tone 2
continuous muscle cont .

Basal
ganglia : planning of
movement
"
cerebellum : co -
ordinal &
correctn of movement