45 NOTES TO PG

Dr. Ankit Yadavendra, M.B.B.S., Dr.V.M.G.M.C., Solapur

07-PHYSIOLOGY
viscosity measure-Osborn viscometer
pulse-Dudgeon sphygmograph
Surf Tension-STalagmometer
orexin-wakefulness, appetite, Alz ds
ACh secret eye-Amacrine cell
ANS
M1-stom(HCl)
M2-AV>SA node(conduct vel, ventricle rate)
M3-sm m(EDRF-vasodil), bronchospasm, GIT(motility), freq micturition, salivary,
lacrimal, sweat gld, constrictor pupillae, ciliary m
CELL
cell memb
fluid mosaic/Singer Nicolson model
lipid wt:prot wt=1:1
SA-carb:lipid:prot=3%:42%:55%
lipid bilayer-self sealing, hydrophobic-MI-phospholipid, FA-fluidity
cholesterol-fluidity buffer
temp>Tmfluidity
temp<Tmfluidity
highest prot-inner mitoch memb(70%)
highest lipid-Schwann cell memb
ubiquitin-tags prot for removal in 26S proteosome
phosphatidylserINe(marker for apopt)-flipflop movem, on INner layer, comes on
outer layer
FA&cholesterol-on both leaflet(outer&inner)
all glycOlipid-on Outer surf, CHOchain projecting Outside
RAFT-region within memb with high metab activity, rich in cholesterol& GPI anchored
prot-caveolin
lecithin bel pKa-surf potential> dipole movem
prot
extracell-Ig
transmemb(integral)-glycophorin, IgG superfamily
periph(on inner layer)-spectrin, ankyrin

intracell-Hb
lament
micro-weakest, endo,exocytosis-actin
intermed-join microtubule& microlament- laminin, keratin, vimentin, desmin, GFAP,
peripherin, neurolament
microTubule-sTrongest, mitotic spindle, separation of genetic material-tubulin
molecular prot
ATPase
kinesin-axoplasm trpt +ve end microtubule
dynein
cytosolic-move vesicle end of microtubule
axonemal-power ciliary& flagellar prot
myosin-m contract
GTPase
dynamin-endocytosis
jnal region b/n 2cell
desmoSome/macula adherenS-tensile Strength in Skin, gum, cx
gap jn/connexon(hemich=6connexin)-bidirect free passage of material b/n
2electrically coupled cell, 3, no synapt delay-heart
tight jn prot/zonula occludens
occludens
claudins
Jn Adhesion Molecule(JAM)
BBB,stom wall,UB wall
focal adhesion molecule-generate intracellular signal when subject to stress
gap jn prot
connexins(6subunit)
cell adhesion molec(CAM)
Cadherin(Ca depend cell adhesion molecule)
integrin-leucocyte adhes to endoth cell
selectin-leucocyte rolling
IgG superfamily-ICAM,PECAM
tpt prot
pore(aquaporin,perforin)-always open
ch-intermittent open
voltag gated-Na ch in n memb(blocked by tetrodoxin, saxidoxin)
ligAnd gated-ionotropic recept, GABA-A(Cl), nAChR-fast

metaBotropic recept-cNG gated, GABA-B, mAChR, cGMP gated(rods)

time gated-slow Ca ch(Purkinje bre)
mech gated-touch recept(skin)
carrier
facilitated diffusion
sec active tpt-GLUT,SGLT
pump
P-ATPase, E1-E2 ATPase, Na-K ATPase, SERCA
V-ATPase H+ trpt
F-ATPase
study of ch
patch clamp technique
best ve feedback mech-temp regulat> osmoregulat
urea tpt
UTA1,2,3,4-kidn
UTAB-RBC
prot synth in ribosome on RER initial folding of polypeptide chain in RER cis end
of Golgi app storage, conc, process, packaging, sorting in Golgi app trans end
Golgi app secret vesicle in cytosol cell memb exocytosis
exocytosis/cell vomiting/reverse pinocytosis/emeiocytosis
constitutive-continuous(mucus secretion, IgA secretion)
Ca
ATP
docking prot
syntaxin(key snare prot)
synaptobrevin
snare prot
SNAP-25
endocytosis
constitutive-continuous, no sp signal req(vit uptake)
Ca
ATP
clathrin(LDL uptake, ion uptake in GI cell)
caveolin(endoth cell for absorption of nutrition,FA)
dynamin/pinchase
ligand-recept complex in pinocytosis dissociate in endosome d/t acidic pH of vesicle
vesicular tpt(cytopempsis)

permeability across cell memb

H2O> indole> glycerol= urea> Try> glu> Cl> K> Na
total body H2O(60%)
ICF(40%)
ECF(20%)
interstitial fluid(15%)
plasma(5%)
spaces-pleural,pericardium(1.5%)
compartment-indicator
TBW-D2O>tritium oxide, antipyrine, aminopyrine
ECF-inulin(most accurate), sucrose, mannitol, Na thioSO4, Na22, I125 iothalmate
plaSma vol-EvanS blue(T1824), sr albumin label with I125
bld cell vol-Cr51 label RBC
interstitial fl vol=ECFpl vol
ICF=TBWECF
bioimpedance spectroscopy
RBF-PAH
GFR-most accurate(inulin), MC(creatinine)
Na-K pump
fn-cell vol regulat>RMP
heterodimer
(larger)
ECF side-K bind site, ouabain(digitalis) binding site
ICF side-Na binding site, ATP binding site, phosphorylat site(Asp376)
T3,T4-no.
aldosterone-no.,activity
insulin-activity
ANF,dopamine-activity
hypokalemia
hyperpolarisation
hyperkalemia
depolarization,excitat
heart stop in diastole
hypercalcemia
Ca-memb stabilising
heart stop in systole

hypocalcemia
excitability
Cl ch(anim,bact)-dimer
epith Na ch-trimer
K ch,aquaporin-tetramer
Cl ch(human),lig gate ACh ch-pentamer
RBC memb at rest most permeable-Cl
RBC RMP(10mV) d/t-Na K pump
neuron RMP(70mV) d/t-K
neuron RMP close to-K
neuron RMP equal to-Cl
organ max hydrostatic press-kidn(46mmHg)
organ with max Kf(ultraltration constant)-Kidn
max permeable capillary-liver
CVS
cardiac m(striated,involunt)
intercalated disc-Zline-cell adhesion, provide electromech tethering
gap jn-fnal syncytium
sarcotubular system-Zline
voltage sensor-dihydropyridine
Ca source-ECF(maj)+ sarcopl reticulum
unphosphorylated phospholamban-SERCA
1T tubule/sarcomere along Z line
elasticity-titin
myosin heavy light chain
,-fetal heart
-adult atrium
-adult ventr
internodal path(AMP-BWT)
Ant-Bachman
Mid-Wenkebach
Post-Thorel
bundle of His-gives lt br, continues as rt br
gate cell merge with-Purkinje bre
ventr AP
RMP=90mV
0-depolarisat-Na influx

1-early repolarisat-K efflux

2-plateau-Ca influx
3-late repolarisat-K efflux
4-hyperpolarisat-delayed closure K ch
SAnode AP
RMP=60mV
0-depolarisat-K efflux, opening funny ch(Na>K), Ca influx(Ca ch-main)
3-repolarisat-K efflux
4-prepotential phase-delay closure K ch
sympath-Gprot cAMP phosphorylat prot depolar time HR
parasympath-(cAMPdepolar time), (open KACh ch in ph4slope of ph4) HR
CNX slope of prepotent(pacemaker potential) HR
Purkinje bre-prepotent AP
Depolarisat heart(DAN)
1st-SA AV atria ventr(1st-lt upper part intervent septum rt), Apex,
eNdocardium
last-base epicardium
repolarisat
ventr(1st-base,epicard last-apex,endocard)
part-conduction speed(m/s)
SA node=0.05
AV node=0.05
bundle His=1
Purkinje bre=4
part-impulse(gen/s)
SA node=80-100
AV node=40-60
Purkinje bre=15-40
+cHRonotropic-HR
+Dromotropic-conDuction
+inoTRopic-conTRactility
+bathmotropic-excitability
adenosine affer arteriole constrict(A1), coronary vasodilatat
vasomotor centre

nucleus tractus solitarius

cauDalVLM(meD)-Depressor
rostralVLM(lat)-pressor
stimul-cortex, limbic syst, pain, chemorecept, pO2, pCO2, MAP<60mmHg
nucleus ambiguus(parasympath)-HR
carotid sinus
b/l transectHR, BP
b/l clamping above carotid bifurcatHR(1st), BP
exerc does not reduce bld supply-brain
max bld flow/min-liver
max bld flow/min/100g-kidn
max O2 consump/min-liver
max O2 consump/min/100g-heart
max AV diff at rest-heart
min AV diff at rest-kidn
Fahraeus-Lindquist effect
diam<2mm-diamviscosity
diam>2mm-diamviscosity
most potent vasoconstrict-endothelin
most pot circulat vasoconstr-urotensin
most potent vasodilat-NO
heamatocrit in venous bld-Cl
capacitance vess-less elastic ts& sm m
ENDOCRINE
amine-T3,4, NE,epinephrine, dopamine
steroid-cortisol,mineralocorticoid, vitD3, testosterone,E,P
peptide-other
shortest peptide h-TRH
longest peptide h-hCG
shortest t-catecholamine(few s)
longest t-vitD(15D)
shortest latency of act-oxytocin(few s)
longest latency of act-thyroxin(48h)
T3-starvation, postoperative, c/c illness, a/c illness
T4-c/c illness, liver dysfn

TSH-postoperative, a/c illness

Wolf Chaikoff effect-organic bind of I2
thyroxin binding prot
freeT3=0.2%, freeT4=0.02%
thy bindin globulin(maj thy h bind prot)
thyroxin binding albumin
thyrox bindin prealbumin(transthyretin)
paracrine regulat
factor release by 1cell act on adjac cell
pancreat somatostain-insulin secret
autocrine regulat
factor release by a cell act on same
IGF1-chondrocyt,breast epit,gonad cell
ANP-HR,BP
sec messenger for GnRH-phospholipaseC
hormesis
dose response phenom
low dose-, high dose-
J/invert U shape
effect of chemotactic peptide on neutrophil adhesion
proopiomelanocortin(285AA)
ACTH,MSH
lipoprot h
lipoprot h
endorphin
CLIP(CorticotropLike Intermlobe Peptide)
P metab
NaPiIIa-absorpt in PCT-by PTH
NaPiIIb-absorpt in duod,SI
NaPiIIc-absorpt in PCT
GH-early division spermatogenesis
-exercise, fasting, stress
-REM sleep
age
h-aldosterone, calcitonin, GH, prolactin, renin, E

h-PTH, FSH, LH, NE

h-cortisol, epinephrine, insulin, T3,T4, testosterone, GLP1)
PTH(84AA polypeptide)
sr Ca++sr PTH
action
-Ca resorp fr bone, Ca reabsorp fr DCT
liver angiotensinogen(2globulin) (JGcell renin) angiotensin I (ACE)
angiotensin II (aminopeptidase) angiotensin III (angiotensinase) active
fragm
aldosterone cytoplasm recept transcription of mRNA in ren tubule synth of
Aldosterone Induced Prot(ATP)/NaK ATPase& subunit of amiloride sensitive Na ch
mineralocorticoid
recept-DCT, cortical CD, sal gld, colon, brain(hippocamp), myocard, periph vasc
resist, brown adipose ts, sweat gld
-hyperkalemia> angiotensin II> ACTH> hyponatremia
vassopressin recept(GPCR)
V1/1A-Ca,IP3-glycogenolysis(liver), vasoconstrict, PLT aggregat, intest contraction
V2-cAMP-H2O reabs fr CD, release factorVIII& vWF
V3/1B-Ca,IP3-ACTH
erythropoietin
synth-peritubular capillary(juxtatubular interstitial cell) in renal cortex(85%)+
perivenular hepatocyte liver(15%)
insulin secret
-glucagon, pl glu
-sympath stim, somatostatin, salicylate
GIT
taste
bitter-GPCR, intracell Ca(IP3DAG)
salty-amiloride sensit Na ch
sour-intracell H+ close K ch
sweet-GPCR, cAMP close K ch
umami-Glu recept(MSG, diNaGMP, diNaI MP)
electrical activity of sm m
RMP=50-60mV

basic electric rhyth-d/t oscillat in activity of Na-K pump(variable freq)=5-15mV

max freq-duod(12/min), min freq-caecum(2/min)
enteric NS
intrinsic
MYenteric/Auerbach plex-Motility
SubmucoS/MeiSSner plex-Secret, bld Supply
extrinsic
parasymp
sympath
Migrating MOTor compLex(MOTiLin)-fasting, ring of contract-body of stom dist
ileum, fn-clearing action, occur>2h after last meal, cycle=5cm/min90min
massive active contraction-colon during defecation
max postprand motility-sigmoid colon> descend colon> transv colon
pacemaker cell of GIT-interstitial cell of Cajal-midportion of stom
pacemaker potential SI-duod
Revers peristalsis-Rectum
segmentation/mixing contraction
promote progressive mixing of food particle
duod<12/min
term ileum=8-9/min
stimulus for receptive relaxation of stom-entry of food
GI h
stom
chief/zymogen/peptic-pepsinogen
G(pyloric antrum)-Gastrin
D1/oxyntic/parietal-ghrelin, HCl, intrinsic factor of Castle
D-somatostatin
ECL-histamine
SI
I-CCK
S-Secretin
K-GZP
L-GLP1
M-Motilin
-somatostatin
pancr
-glucagon
-insulin,amylin,C peptide
-somatostatin
E-ghrelin
F-pancr polypeptide

gastrin
HCl,delay gastric emptying
CCK
CCK-prod of prot digest
GB contract, pancr enz secret, secretin action, satiety, NT
secretin
HCO3 in bile& pancr juice GIP(Glu dep Insulinotropic Peptide)
insulin
ghrelin
ghrelin-sleep deprive, anorexia
orexigenic, fat deposition, choice of food, memory, GH
salivary secretion
HCO3, amylase, lingolipase(Ebner gld on tongue dome), lysozyme, kallikriene, K(max
amount)
phase-cephalic(MI), oral, gastric
gastric secretion
pepsin, G-lipase, HCl(MI)(bactericidal, pepsinogen pepsin, Fe+++ Fe++)
phase-cephalic,gastric,intest
intest secretion
Paneth/ZYMOgEn-lysOZYME
N-Neurotensin
L-gLucagon
disaccharidase, di&tripeptidase, enterokinase(trypsinogen trypsin)
colon secretion
K(max conc)
bile salt
amphipathic nature
emulsicat fat in SI detergent action
bile uptake by hepatocyte-Na dep
absorption
stom-weak acid, weak base, salicylate,alcohol
duod-Fe++(max), Ca, Na, Cl, vit, FA, AA, SO4, sugar
jejunum-carb, prot, fat(long chain), alcoh(max), FA(max), Na(max),
H2O(max-5500ml), Ca(max), vitB9(max), Ab
dist ileum-90%bile salt(max), vitB12(max)
colon-5%bile salt, electrolyte, H2O(1000ml), short chain FA(by colonic bact)

Fe(prox duod)
food(ferric Fe+++) absorb(ferrous Fe++) tpt(Fe+++) store(Fe++) <1mg in
stool
heme Fe absorpt=65%
hepcidin(Fe metab regulat h)-produce by liver, in anem of c/c ds-ve regulator of
absorpt-lysosomal destruct of ferroportin, a/c phase reactant
fru absorpt GIT-facilitat diffusion
orexigenic
agouti related peptide(AGRP)
melanin concentr h(MCH)
neuropeptide Y
orexin A,B
endorphin
galanin
AA-Glu,GABA
cortisol
ghrelin
GHRH
anorexigenic(CCALSIBhiGiliNahi)
CRH
Cocaine Amphetamine Regulat Transcript(CART)
Alp Melanocyte Stim H(MSH)
Leptin
Serotonin
Insulin
Bombesin
GLP
NE
high glycemic index-corn flakes
sirtuin(SIRT)
metab(NAD dep deacetylase 5)
1-intranucl
2-cytoplasm
3,4,5-mitochondria
6-heterochromatin assoc nucl
7-nucleolar
LES tone

-ACh,neostigmine,SCh,morphine
-NO,VIP,atropine
GI peristalsis
-ACh,subsP
-VIP,NO,ATP
KIDNEY
Angiotens II act on Eff arteriole, (low conc)-GFR, (high conc)-GFR
Epinephrine-act on Aff arteriole, GFR
(A attack E, E attack A)
renal handling of diff subst
not lt-prot
freely lt, not reabs, not secret-inulin
freely lt, compl reabs-glu, AA, HCO3(MI buffer, 24mEq/l)
freely lt, partl reabs-electrol, urea(52%), H2O(99.5%)
freely lt, compl secret-PAH(low conc)
freely lt, partl secr-PAH(high con), creat
glomerulotubul balance, max H+ secret by-PCT
acidication urine-CD
1st part kidn affect in hypoxia-medulla
GFR max-3rd decade
pacemaker ureter-minor calyces
DCT secrete-NH3
collecting duct
P(Principal) cell-Na reabsorpt, ADH stimulat H2O reabsorpt
I(Intercalated) cell-H+ secret, HCO3 tpt
Ca
99% reabsorb=65%PCT+ 25-30%thick ascend limb Henle loop+ 4-9%DCT,CD
free H2O clearance
urine is hyPOtonic with plasm-POsitive
urin hypertonic with pl-ve
isotonic=0
aquaporin
1-basolat&apical memb PCT, thin desc limb loop Henle
2-lumin memb CD
3-basolat memb CD

4-basolat memb CD,brain

5-sal,lacrim,resp
9-WBC,liver,lung,spleen
JG apparatus(cortic nephr)
JG cell-tunica med of affer arteriole, secrete renin
macula denSa/modif tubular epith cell, beginning of DCT, Sensor for Na&Cl
Lacis/extraglom mesangial cell-take up immune complex in GNephritis
countercurrent mech
muLtipLier-Loop HenLe(create interstit hyperosmolarity-max=1200mosmol/l), driven
by conc of Na
exChange-vasa reCta(maintain medullary hyperosmol)
glu abs in kidn
prox PCT-SGLT2,GLUT2
distal PCT-SGLT1,GLUT1
GLUT1-constitutively express
GLUT2-glu exit
GLUT3-neuron
GLUT4-insulin dep,m,adipose ts
GLUT5-fru
SGLT1-GIT(1Na:2glu)
SGLT2-kidn(1Na:1glu)
SGLT3-kidn(1Na:1glu)
NS
BBB d/t-tight jn b/n endoth cell> astrocyte
CNS-1oligodendrocyte:20axon
PNS-1Schwann cell-b/n 2node Ranvier
AP in spinal motor neuron arise in-init seg(high Na ch per unit area)> axon hillock
AP in sens neuron arise in-init node of Ranvier(max Na ch per unit area)
AP
cathode ray oscilloscope-patch clamp techn
RMP=70mV
ring level=55mV
depolar-Na influx
overshoot=+30mV(close to equilibrium potential Na)
repolar-Na permeability, delay K permeab(K efflux)
afterdepolar-slight K effux rate

hyperpolar=71-72mV
cell with K efflux depolar-haircell cochlea
cell with Ca efflux depol-heart(SA node)
Na-2gate(M-activat, H-deactivat), 3possible state
K-1gate(M)
demyelinat upto 3node Ranvier-stop AP propagation in n
refractory period
absolute-depolarisat repolarisat
relative-repolarisat start of afterdepolarisation
fastest velocity
n-low Ra(resist), high Rm(memb resist), low Cap
node Ranvier-low Rm, high cap
rheobase-min strength current response
utilisation time-time taken by rheobase response
chronaxie=time 2rheobase response
lesser chronaxie-more excitable ts
n<sk m<card m<sm m
n A<A<A<A<B<C
multiple sclerosis
demyelinatspace constant
classif of n bre
ERLANGER&GASSER
(sens,mot,aut)
A(myelin)
(I)-somatic motor, sens propriocept
(II)-sens propriocept(m spindle), vibrat, deep press, touch
-motor to m spindle
(III)-fast pain(glut), temp, cold
B(myelin)-preganglionic autonomic
C(unmyel)(IV)-sens, autonomic, slow pain(subP), cold+warm, crude touch, press,
postgang sympath
LLOYD&HUNTS NUMERICAL
I(A)-sens(m spindle)
IB()-sens(golgi tendon organ)
II()-deep press
III()-mot to m spind

IV(C)-slow pain, touch, press

myelinated-conduct vel=6diam
unmyelinated-CV=diam
fastest conduct-propriocept
suscept to(PHir Laya ABC BABa)
Press-A>B>C
Hypox-B>A>C
Local anaes-C>B>A
order of block-aut> sens[temp(cold> hot)> pain> touch> press> propriocept)> motor]
order of recovery-motor> sens> autonomic
reflex
asynaptic
axon reflex
blunt inj(Lewis triple response) red rxn (hist)+ FLare(axon reFLex)+ wheal(hist+
bradykinin)
monosynaptic
DTR
stimul-m LEngth
recept-m spindLE
affer-IA,II
centre-spinal cord
effer-A
response-m contract, maintain m tone
no. of synapse=1
bisynaptic
inverse sTrEtch reflex
stimul-m TENsion
recept-Golgi TENd org(1GTO/13-15m bre)
affer-I
centre-spinal cord
effer-A
response-m relaxat
no. of synapse=2
m spindle
intrafusal m bre(A)
nuclear bag(1-3)
dyNamic-aNNular spiral ending(IA)
Static-flower Spray ending(IA,II)
nuclear chain(4-5)

static(IA,II)
extrafusal bre(A-contraction)
axonotmesis-motor march
degeneration& regeneration of n
Wallerian degeneration(CAM)-change in distal stump+ prox stump upto 1node of R
24-48h-Chromatolysis(n cell body swell, Nissle granule disapp)
upto3d-distal stump carries AP
3-6d-Axonal degenerat distal stump
6-10d-Myelin degenerat
10d-oil droplet in empty tube
15d-repair start-sprouting fr prox tube, Schwann cell proliferat
80d-repair completed(80% diam)
axoplasmic tpt
Ca
ATP
microtubule(&tubulin)
molecular motor-kinesin, dyenin, myo V
fast(kinesin)
Antegrade(400mm/d) Assembl(+) end
retrograde(200mm/d) disassembl() end-rabies virus(3mm/h), TT, nGF
slow(dyenin-antegrade)
0.5-10mm/d
microlament
neurolament-maintain diam of axon
receptor-sensation
Rapidly adapting(RMP)
Meissner corpuscle-ne touch, low freq vibration(80Hz)
PaciniaN corpuscle-vibratioN
Slowly adapting(SMR)
Merkel disc-crude touch, pressure, texture, ne touch
Rufni end organ-crude touch, sustain pressure, jt position
other
free n ending-touch, pain, pressure
hair end organ-movem of object on body
Krause end bulb-cold
thermal receptor
A&C-cold, C-warmth

10C24C(max activat)40C
overlap-30-40C
response to cold
environm temp<23.8C sympath system periph vasoconstriction
non shivering thermogenesis-3 uncoupling of oxidative
phosphorylation(UCP1=10-15%) heat
shivering
heat loss at ambient temp(21C)-radiation
receptor for mod cold-CMR1
neurotrophin-recept
nGF-TrkA
BDGF(Brain Derived GF), NT4,5-TrkB
NT3-TrkC
trp(transient receptor potential) ch
family of excitat ch
vanilloid recept-TRPV1,4-noxious heat, Chem(Capsaicin), pain
acid sensing ion ch-H+
Purinergic recept-P2X,P2Y-Pain
ankyrin recept-cold
menthol recept-mod cold
neurotransmitter
small molecule, rapidly acting
ACh
amine
epinephrine
NE(locus cErulEus)
D(substantia nigra)
hist
5HT(raphe magnus)
Gly(inh), GABA(A-open Cl ch,B-close K ch), Glu, Asp
gas-NO
large molecule, slowly adapting
neuropeptide
hypothalamic peptide(GnRH,TRH)
pituitary peptide(ACTH,TSH)
gut-CCK
class

I-ACh
II-amine-hist, epinephrine, D, NE, 5HT
III-AA-Glu, GABA, Gly
IV-small molecule-NO, adenosine
transmission in sympath ganglia
fast EPSP-ACh(ms)
slow EPSP-AChM1(s)
slow IPSP-AChM2(s)
late slow EPSP-GnRH(min)
sweat gld secret-sweat+VIP
NM ds
presynaptic-tetanospasmin, botulinum toxin, Lambert Eaton synd
postsynaptic-myasth gravis, strychnine
decortication
damage to corticoretic tract-mod rigidity
decerebration
damage to corticoretic& basal ganglia tract-severe rigidity
sk m(striate,voluntary)
contractile prot
AcTin(polymer of f-actin, 2strand in double helix, ATPase activit)
myosin II
regulating prot
tropomyosin(1molecule cover 1active site on actin)
troponin(I-actIn, T-Tropomyosin, C-Ca)
struct prot
actinin(bind actin to Z-line)
titin(largest prot, 3million Dalton, attach Z-line to M-line, elasticity to m)
desmin(attach Z-line to plasma memb)
sarcolemmal prot
laminin(EC matrix, attach dystroglycan)
dystroglycan(connect laminin dystroglycan)
Bet dystroglycan(within memB)
syntropin(attach dystroglycan on inner side memb)
dystrophin-(connect syntropin actin) Duchenne(absent)-Becker(less) m dystrophy
sarcoglycan(outer side cell memb)-limb girdle dystrophy
perlecan(EC matrix, endoth cell)
sarcospan(within memb)

2T tubule/sarcomere(at jn of I&A band)

DHPR(T tubule), RYR(L tubule)
1thick lam surround by-6thin lam
1thin lam surround by-3thick lam
thin:thick=2:1
1thick lam=500myosin molecule
1thin lam=7actin+3troponin+1tropomyosin
Sarcomere-Struct unit m
motor unit-fnal unit m
sarcotubular syst-AI jn
voltage sensor-voltage gated Ca ch
Ca source-sarcopl reticulum
H(Hexagon) zone-only myosin
pseudoH zone-reversal of polarity of myosin head(no myosin head)
A(Anisotropic,dArk) band-myosin+over lapping actin
I(Isotropic,lIght) band-actIn
Z line-b/n 2sarcomere, centre of I band
M(Myomesin) line-centre of A band
sarcomere=I+A+I
during contract
I-
H-
A-no change
Z lines-come closer
M line-more prominent
CM(Contraction M) band-at 1.5
CZ(Contract Z) band-at 1.25
walk along theory-1ATP-1cycle
Huxley sliding lament/Rachet/walk along theory
cross bridge power stroke ATP hydrolysis recocking
type1 m(SOR1)
Small,Slow
Oxidative metab
Red
longer twitch
more mitoch
more Mb
slow sustain contract
delay fatiguability
standing-ATP store=7-8s

type2a m
mod oxidat metab
mod glycolysis
walking
type2b m
fast fatiguable
running
energy supply
100m-85% glycolysis
2mile-20% glycolysis
marathon-5% glycolysis
at optimum lth sarcomere-max overlap b/n actin&myosin, max no.actin-myosin
cross bridge, max tension
slow twitch motor unit
recruit 1st,100-500m bre, innervat by motor neuron
fast motor unit
1000-2000m bre, motor neuron
sm m(unstriate, involuntary)
prot-actin, myosin, tropomyosin(relation prot), calmodulin(Ca binding prot), no
troponin
sinGle unit(Gap jn+)-GIT
multiunit(gap jn)-iris, ciliary body
contract of sm m
Ca influx Ca calmodulin complex myosin light chain kinase phosphorylation
myosin head myosin ATPase actin-myosin cross bridge format(latch mech)
relaxat
phosphatase/dephosphorylase enzyme
thin:thick=15:1
no Z line,dense bodies
ascend tract
post column(ne touch, vibrat, conscious propriocept, 2pt discriminat, localisat,
stereognosis, ability to judge of press)
fasciculus Cuneatus(tract of BurdaCh)-UL
fasciculus Gracilis(tract of Gall)-LL
1st order-DRG(recept i/l medulla)
2nd order-i/l medulla c/l thalamus(VPL)
3rd order-c/l thalamus c/l postcentral gyrus(BA-3,2,1)
sensory homunculus(grotesque gure of Peneld& Rasmussen)-max-lip,
min-genitalia
ant spinothalamic tract(crude touch, itch, tickle, sexual, detection of press)

lat spinothalamic(pain, temp)

1st order-DRG(recep i/l dorsal horn)
2nd order-i/l dors horn c/l thal(VPL)
3rd order-c/l thalam c/l cortex
spinocerebellar(unconscious proprioception)
dorsal(uncross)
ventral(cross)
internal arcuate bre medulla-internal arcuate bre
Fast pain
sharp/prick/stab, epicritic, good, A bre, mech/therm stimulus, NT-Glu, lat
spinothalamic tract(lamina Five substantia gelatinosa)
slow pain
dull/diffuse/aching/burning, protopathic, bad, autonomic sympath, C bre, ischem,
NT-substance P, tract goes to reticular formation(sleep wake cycle), periaqueduct
grey, periventr hypothal(ANS) terminate in thalamus(lamina II of substantia
gelatinosa of Rolando)
endogen pain inh
endogenous opioid(enkephalin, endorphin)-at site of stimulus, dorsal horn, rostral
site
gate control theory of Melzac& Wall-large diam A inh C bre
descend pain inh pathw-periaqueduct grey, raphe magnus(5HT), enkephalin
thalamus
sens relay nuclei
non-specic
midline
intralaminar
ant thal nuclei-Papez circuit-emotion, learning, short long term memory
conversion
specic
VPL-somatic sensation
VPM-taste
LGB-visual sens
MGB-audit sens
ventroant, ventrolat-proc msg fr basal ganglia& cerebellum
Papez circuit
med temp lobe/hippocampus mammillary body of hypothalamus
(mammilothalamic tr) ant thalam nucl basal forebrain (amygdala/limbic
syst-window ),(neocortex-stored)

descending tract
med,axial m,tone&posture
ant corticospinal
tectospinal
vestibulospinal
reticulospinal
ponS(Stim)
medulla(inh)
lat,dist m,ne skill movem
lat corticospinal(pyramidal)
rubrospinal/alternat pathw
hypothalamus(TR2 recept)
response to cOld-pOst
response to heAt-Ant
osmoreceptor-ant
hunger-lat
thirst(10mosmol/l)-lat(preoptic nucl)
rage-lat
satiety-ventromed(cocaine amphet regulated transcript)
reward-med forebrain bundle, nucleus accumbens(drug addict-D3), ventromed
self stimul-med forebrain bundle
agGREssive resp-periaqueductal GREy
Punishment-Periaqueductal grey
Circadian rhythm-supraChiasmatic
sleep-preoptic
sexual-Antmost(mAl)& postmost(fem) portion
brain area involving self stimulation
ventral tegmentum
med forebrain bundle
nucleus accumbens(D3)
frontal cortex
cerebellum(3part, 4nuclei, 5cell)
lat med-DEGF
neo/cerebrocerebellum-Dentate nucleus(largest), motor planning
palaeo/spinocerebellum-Emboliform(dist m)& Globosus nucl
archae/vestibulocerebellum-Fastigius nucl(oldest), floculonodular lobe-postural
balance
cell(GBSPG)
Granular(E)
basket(I)

stellate(I)
purkinje(I)
golgi(I)
afferent bre
inf oLIvary nucl (cLImbing bre) +Purkinje cell
other affer input (Mossy bre) +granular cell (parallel bre) Purkinje cell
greatest populat of neuron-cerebellum
silent area of brain-cerebellum(does not show evoke potential)
fnal unit-Purkinje cell, deep nuclei
vermis-maintain stand& walking posture
feed forward inh-basket, Purkinje cell
connection/tract of cerebellum(RO DEV MainCabSeThaVaha IC SauDinRaha)
afferent(cerebell peduncl)
inf-Reticulocerebellar, Olivocerebellar, Dorsal spinocerebellar, Ext arcuate br,
Vestibulocerebellar
Middl-Cerebropontocerebellar
Sup-Tectocerebellar, Ventr spinocerebellar
Efferent(cerebell peduncle)
Inf-Cerebellovestibular
Sup-Dentatorubrothalamocortical, Reticulospinal
Brodman area-fn
3,1,2(somat sensor, postcentral gyrus)-gen conscious, touch, pain, temp
4(prim motor)-initiat of movem
6,8(premotor)-neness movem, volunt eye movem
7(visuosensory, postcalcarine sulcus, occipit lobe)-visual sense
percept-homonymous hemianopia+ macular sparing
9,10,11,12(prefrontal)-intelligence, memory, ego, self respect, social behav,
personality
18,19(visuopsychic, parastriate, occipit lobe)-correlation of visual impulse with past
memory
22(Wernicke-sup temp gyrus)-audit agnosia/word deaf
41,42(prim auditary-lt temp lobe)-process semantic in speech& vision
44,45(Brocca-inf frontal gyrus)
brain bre-connection
association-different cortic area in same hemisphere
commissural-correspond area in 2cerebral hemisphere
projection-cerebral cortex with lower level
basal ganglia(CPPG)
1)Caudate nucleus

2)Putamen
3)Globus pallidus/pallidum
internum
externum
4)substantia nigra
pars compacta
pars reticulata
5)subthalamic nucl/body of Luy(excitat, glutamate)
striatum=1+2
lentiform nucleus=2+3
amygdala nucleus-med temp lobe
nucleus tractus solitarius(medulla)
NT-Glu, ACh, GABA, opioid
GVA
tonsil, pharynx, post tongue, carotid body& sinus CNIX
pharynx, larynx, trach, esoph, thorac&abd viscera CNX
SVA
ant tongue CNVII
post tongue CNIX
postmost tongue, epiglottis CNX
integrat centre-postural reflex
spinal cord-m tone,+ve supporting rxn, crossed extensor reflex
medulla-tonic labyrinthine reflex, tonic neck reflex
midbrain-righting reflex
cerebral cortex-hopping& placing rxn, long loop stretch reflex
Little Albert study-conditional stimulus to produce conditional reflex
nGF-ANS neuron growth
BBB
substance cross-H2O, CO2, O2, lipid soluble subst, free steroid h, glu(GLUT1)
cant cross-prot, polypeptide, prot bound steroid h, H+, HCO3
after spinal shock wears off
1st reflex-bulbocavernous(<2d)> flexor withdrawal> stretch reflex
CSF absorpt
->112mmH2O
-<112mmH2O

no-<68mmH2O
RS
generation resp tract
trachea-0
total=23
1st 16-conducting zone
last 7-resp zone
1st 7-hyaline cartil
last 16-no cartil, have sm m, gld, Kulchitsky cell, APUD cell
8-18-Clara cell
18-23-Achilles heel-mucociliary tpt weak
max sm m-terminal bronchiole
trach principle bronchi bronchiole terminal bronchiole respirat bronchiole
acinus(alveolar duct alveolar sac)
pneumocyte
typeI=60% in no., 5% of surf area
typeII=40% in no., 92% of surf area(produce surfactant)
typeIII=3% of surf area
anatDS-Fowler method-N2 analysis after 100% O2 inhalat
PhyDS-Bohrs meth
FRC-He dilut techniq, N2 washout meth, whole body plethysmography
other-spirometry
ventilation
start insppeak inspend expirat
pressure(mmHg wrt atm)
ITP-2.5-6-2.5
IPP-(0 1)-0-(+1 0)
TPP-+2.5-+6-+2.5
TPP=IPPITP
ITP-intrapleural/pleural/intrathoracic press
IPP-intrapulm/airway/alveolar press
TPP-transpulm/distend/transmural press
total press change during quiet resp= 2.5cmH2O
deep sigh/yawn=30cmH2O
1st cry neonat=60cmH2O(25cmH2O)
Muller maneuvre=120cmH2O
Valsalva maneuvre=+150cmH2O
O2 dissociat curve

sO2pO2
95-97
90-60
75-40
+ve cooperativity(DOTR)
DeoxyHb OxyHb
Tense Relax
Hill coeff
n=1-no cooperativity
n>1-+ve cooperat
n<1-ve cooperat
shift rt
-p50, pCO2, H+, temp, 2,3DPG, HbS, GH, exercise, T3,T4, altitude, furasol DA
-afnity, pH, Hb
BohR effect-pCO2-shift Rt(+1-2%O2 delivery)
double Bohr effect-placenta, uterine a& umbilic a
Haldane effect-deoxyHb can bind CO2& H+>oxyHb
Hb afnity for CO-by HisE7
diffusion capacity of O2
-exercise, pulm hge, asthma, CHF
-ILD, sarcoid, berylium poisoni, secret of PDGF by alveolar epith
hypoxia
pulm arteriole-activat K ch vasoconstrict
syst arteriole-vasodilat
zone
standing
II-Pa>Palv>Pv(waterfall zone)
III-Pa>Pv>Palv
recumbent-zoneIII
matching of ventilat perfusion lung-lat decubitus, awake, close chest
resp centr
medulla
pacemaker-preBottzinger complex-generate resp rhythm
DRG(nucl tract solitarius)-I-quiet resp
sect at lower medulla-apnoea
VRG(nucl ambiguous&retroambiguous )-I&E-requirem
sect at upp medull-norm resp+ irregular rhythm+ gasping
pons

Pneumotaxic(nucl Parabrachialis, upper pons)-depth of insp

midsectio(bel pnemotax)-depth,slow
apneustic(lower pons)-depth of insp
CNX-depth of insp
strong vagal stim-apnoea
b/l vagotomy-depth,slow
midsection+b/l vagotomy-apneusis
resp chemorecept
periph
pO2(MI,satO2<90%,pO2<60mmHg),pH, pCO2,H+, lactic acid, CN, exercise
glomus1-cup like ending aff n, NT-D2, O2 sensit K ch Ca influx
glomus2-glia like, surround 4-6glomus 1 cell, no fn
PCR remove-hypoxic drive-100%, CO2 drive-30%
ACh-chemorecept discharge carotid body
central
surf of medulla
H+(mostpotent direct stim),CO2(most potent stim)
COPD,hypoxic hypoxia-sensitivity to H+
resp reflex
Hering Breuer inflation-lung inflat>1.0- 1.5ldepth of insp, durat expirat
Hering Breuer deflation-mark deflation depth of insp, durat expirat
Head paradoxical-inflat further inflat(1st breath neonat)
J recept(Dr ASPaintal,1970)-hyperinflat, pulm edema, pulm congest, pulm emboli
+J recept apnea rapid shallow resp BP HR
tidal resp-m spindle diaphr
jt propriocept +resp centr depth& rate of resp
Abbreviations
a-artery, AA-amino acid, abtc-antibiotic, AI-autoimmune
bef-before, bel-below, b/l-bilateral, bld-blood, b/n-between, bn-benign, br-branch,
Bx-biopsy
ca-carcinoma, carb-carbohydrate, c/i-contraindication, c/l-contralateral,
conc-concentration, cong-congenital, Cx-cervix
d-day, def-deficient, ds-disease, d/t-due to, Dx-diagnosis
E-estrogen
fem-female, fr-from
gld-gland, glu-glucose
h-hormone
idiop-idiopathic, i/l-ipsilateral, inf-infection, inj-injury
lig-ligament, LL-lower limb, l/t-leading to
m-muscle, maj-major, mal-male, MC-most common, met-metastasis, min-minor,
mtx-methotrexate, Mx-management
n-nerve, norm-normal
P-progesterone, pl-plasma, prot-protein, pt-patient

Rx-treatment
SCC-squamous cell carcinoma, sr-serum, Sx-surgery, sz-seizure
tm-tumour, ts-tissue
UL-upper limb, u/l-unilateral
vag-vagina, VC-vocal cord, vel-velocity, vert-vertebra, vit-vitamin, vol-volume
w-week, wt-weight
Xr-X ray
y-year
#-fracture
-degree
-(N.B.-THESE NOTES ARE ONLY FOR THE PURPOSE OF GUIDANCE AND HELP
TO PG ASPIRANTS, NOT FOR COMMERCIAL OR OTHER PURPOSE. REFERENCE
HAS BEEN TAKEN FROM VARIOUS STANDARD TEXTBOOKS. FOR ANY
FEEDBACK/QUERY PLEASE CONTACT- ankit.yadavendra@facebook.com or
dr.ankityadavendra@gmail.com )