Human Physiology / (Record no. 39038)
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| fixed length control field | 81700nam a22002657a 4500 |
| 003 - CONTROL NUMBER IDENTIFIER | |
| control field | CUTN |
| 005 - DATE AND TIME OF LATEST TRANSACTION | |
| control field | 20230620162403.0 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION | |
| fixed length control field | 230620b |||||||| |||| 00| 0 eng d |
| 020 ## - INTERNATIONAL STANDARD BOOK NUMBER | |
| International Standard Book Number | 9789354663444 |
| 020 ## - INTERNATIONAL STANDARD BOOK NUMBER | |
| International Standard Book Number | 9789354663499 |
| 041 ## - LANGUAGE CODE | |
| Language | English |
| 082 ## - DEWEY DECIMAL CLASSIFICATION NUMBER | |
| Classification number | 612 |
| Item number | JOH |
| 100 ## - MAIN ENTRY--PERSONAL NAME | |
| Personal name | John, Nitin Ashok, |
| 245 ## - TITLE STATEMENT | |
| Title | Human Physiology / |
| Statement of responsibility, etc | Nitin Ashok John |
| 250 ## - EDITION STATEMENT | |
| Edition statement | 14th |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. (IMPRINT) | |
| Place of publication, distribution, etc | New Delhi : |
| Name of publisher, distributor, etc | CBS Publishers & Distributors Pvt.Ltd, |
| Date of publication, distribution, etc | 2022. |
| 300 ## - PHYSICAL DESCRIPTION | |
| Extent | 1022p.: |
| Other physical details | ill.: |
| Dimensions | 8.5X11 |
| 505 ## - FORMATTED CONTENTS NOTE | |
| Title | CC Chatterjee’s Human Physiology, Volume 1 |
| -- | CC Chatterjee’s Human Physiology, Volume 2 |
| 505 ## - FORMATTED CONTENTS NOTE | |
| Title | 1. Cell Physiology: Structure and Functions<br/>of Cell Organelle 2<br/>Introduction 2<br/>Cell Structure 2<br/>Cell Membrane 2<br/>Cytoplasm and its Organelles 4<br/>Nucleus 6<br/>Chromatin 7<br/>Chromosomes 7<br/>Applied Physiology 7<br/>Intercellular Communication and Mode of<br/>Communication 7<br/>Special Structural Features of Cell and Intercellular<br/>Communication 7<br/>Molecular Motors 9<br/>Apoptosis 9<br/>Applied Physiology 9<br/>Methods used to Demonstrate the Functions of the Cells<br/>and its Product 10<br/>Exam-oriented Questions 13<br/>2. Homeostasis 14<br/>Introduction 14<br/>Role of Various Systems of Body in Homeostasis 14<br/>Role of Neuroendocrine Reflex in Homeostasis 14<br/>Feedback Homeostasis Regulations 15<br/>Examples of Negative Feedback Mechanism 15<br/>Examples of Positive Feedback Mechanism 16<br/>Internal Factors Influencing Homeostasis 17<br/>External Factors Influencing Homeostasis 17<br/>Exam-oriented Questions 17<br/>3. Transport Across Cell Membrane 18<br/>Introduction 18<br/>Introducing to Key Terms and Concepts 18<br/>Important Concepts in Transport Mechanism 18<br/>Ion Channels 18<br/>Types of Transport Mechanism 19<br/>Characteristic Features 21<br/>Osmosis 21<br/>Membrane Transport: Active Transport 22<br/>Primary Active Transport 22<br/>Secondary Active Transport 23<br/>Vesicular Transport Mechanisms 25<br/>Transport through Cellular Sheets 26<br/>Applied Physiology 26<br/>Exam-oriented Questions 26<br/>4. Membrane Potential 27<br/>Introduction 27<br/>Role of Ion in Generating Membrane Potential 27<br/>Ionic Mechanisms of Resting Potentials 27<br/>Physico-chemical Principles Involved in Generating RMP 27<br/>Nernst Potential 27<br/>Goldman-Hodgkin and Katz (GHK) Equation 27<br/>Gibbs-Donnan Membrane Equilibrium 27<br/>Recording of Membrane Potential 28<br/>Graded Potential and Action Potential 28<br/>Introduction 28<br/>Terms Associated with Membrane Potential 29<br/>Graded Potential 29<br/>Local Response of Graded Potential 29<br/>Types of Graded Potential 29<br/>Summation of Graded Potential 29<br/>Action Potential 29<br/>Characteristics of Action Potential 30<br/>Nerve Stimulation and Phases of Action Potential 30<br/>Ionic Basis of Action Potential 31<br/>Cardiac Action Potentials 31<br/>Property of Action Potential 32<br/>Ion Channel Studies 33<br/>Procedures 33<br/>Exam-oriented Questions 33<br/>5. Body Fluids and Blood Volume 34<br/>Introduction 34<br/>Total Body Water and its Distribution 34<br/>Extracellular Fluid Compartment 34<br/>Blood Volume 35<br/>Methods of Determination of Blood Volume 35<br/>Blood Volume 35<br/>Measurement of Plasma Volume 35<br/>Measurement of Interstitial Fluid Volume 35<br/>Interstitial Fluid (IF) 35<br/>Intracellular Fluid Compartment (ICF) 35<br/>Measurement of Body Fluid Compartments 36<br/>Total Body Water 36<br/>Extracellular Fluid Volume 36<br/>Intracellular Fluid Measurement 36<br/>Hydrogen Ion Concentration of the Body Fluids 37<br/>Regulation of Body Fluid Volume 37<br/>Exogenous and Endogenous Water Input 37<br/>Water Excretion and its Daily Output 37<br/>Maintenance of Electrolyte Balance 37<br/>Potassium Conc and its Balance 37<br/>Disorders of Fluid Volume 38<br/>Exam-oriented Questions 38<br/>Clinical Case Scenario 39<br/>General Physiology 39<br/>Contents<br/>Preface to the Fourteenth Edition v<br/>Preface to the First Edition vi<br/>Index of Competencies xix<br/>viiiHuman Physiology<br/>Section II Blood<br/>6. Composition and Functions of Blood 42<br/>Introduction 42<br/>Properties of Blood 42<br/>Composition of Blood 42<br/>Functions of Blood 42<br/>Relative Volume of Corpuscles and Plasma 43<br/>Exam-oriented Questions 44<br/>7. Specific Gravity of Blood 45<br/>Introduction 45<br/>Rise in Specific Gravity 45<br/>Fall in Specific Gravity 45<br/>Method of Determination 45<br/>Exam-oriented Questions 45<br/>8. Plasma Proteins 46<br/>Introduction 46<br/>Plasma Proteins Varieties 46<br/>Origin of Plasma Proteins 46<br/>Rate of Regeneration of Plasma Proteins: Whipple’s<br/>Experiment 46<br/>Whipple’s Experiment 46<br/>Relation of Diet to Plasma Proteins 46<br/>Functions of Plasma Protein 47<br/>Exam-oriented Questions 47<br/>9. Viscosity and Erythrocyte Sedimentation<br/>Rate (ESR) 48<br/>Introduction 48<br/>Viscosity: Characteristics 48<br/>Suspension Stability of Blood (Erythrocyte Sedimentation<br/>Rate or ESR) 48<br/>ESR Increased and Decreased 49<br/>Significance of ESR 49<br/>Physiological Variations in ESR 49<br/>Exam-oriented Questions 49<br/>10. Coagulation of Blood 50<br/>Introduction 50<br/>Importance of Coagulation of Blood 50<br/>General Characteristics of Coagulation 50<br/>Blood Coagulation Factors 51<br/>Factor I or Fibrinogen 51<br/>Factor II or Prothrombins 51<br/>Factor III or Thromboplastin 51<br/>Factor IV or Calcium 51<br/>Factor V or Labile Factor Accelerator Globulin or<br/>Proaccelerin 51<br/>Factor VII or Stable Factor or Proconvertin 51<br/>Factor VIII or Antihaemophilic Factor (AHF) or<br/>Antihaemophilic Globulin (AHG) or Platelet<br/>Cofactor I 51<br/>Factor IX or Christmas Factor or Plasma Thromboplastin<br/>Component (PTC) or Platelet Cofactor II 52<br/>Factor X or Stuart Factor 52<br/>Factor XI or Plasma Thromboplastin Antecedent<br/>(PTA) 52<br/>Factor XII or Hageman or Surface Factor 52<br/>Factor XIII or Fibrin-stabilising or Laki-Lorand Factor<br/>(LLF) 52<br/>Fitzgerald Factor also known as High Molecular<br/>Weight Kininogen 52<br/>Fletcher Factor also known as Prekallikrein 52<br/>Other Important Factors Participating in Coagulation<br/>Mechanism 52<br/>Thrombomodulin 52<br/>Protein C 52<br/>Protein S 52<br/>Anti-thrombin III 52<br/>Tissue Factor Pathway Inhibitor 52<br/>Extrinsic and Intrinsic Mechanisms of Coagulation of<br/>Blood 52<br/>Clot Retraction 53<br/>Fibrinolysis 54<br/>Plasminogen 54<br/>Natural Inhibitors of Coagulation 55<br/>Antithrombin Activities Remove Thrombin from<br/>Blood 55<br/>Intravascular Clotting or Thrombosis 55<br/>Thrombus 55<br/>Heparin as an anticoagulant 55<br/>Characteristics 55<br/>Applied Physiology 55<br/>Coagulation Disorders 55<br/>Bleeding Disorders 56<br/>Exam-oriented Questions 58<br/>11. Bone Marrow 59<br/>Introduction 59<br/>Key Points 59<br/>Red Bone Marrow 59<br/>Yellow Bone Marrow 59<br/>Vascular Arrangement in the Bone Marrow 59<br/>Functions of Bone Marrow 59<br/>Formed Elements of Blood 59<br/>Precursors of Blood Cells 60<br/>Applied Physiology: Bone Marrow Biopsy 62<br/>Exam-oriented Questions 62<br/>12. Red Blood Corpuscles (Erythrocytes) 63<br/>Introduction 63<br/>Size, Volume, Thickness, etc. of Red Blood<br/>Corpuscles 63<br/>Cytoplasm of the Red Cells 63<br/>Normal Red Cell Count 63<br/>Variations of Red Cell Count under Various Physiological<br/>Conditions 63<br/>Abnormal Forms of Erythrocytes 63<br/>Stages of Blood Formation in the Embryo and Foetus 64<br/>Site of Development 64<br/>Important Factors Controlling Erythropoiesis 64<br/>Maturation of Red Blood Cells 64<br/>Stages of Development 64<br/>Factors Regulating Erythropoiesis 66<br/>Energy Metabolism of RBC 66<br/>Key Points 66<br/>Functions of Red Blood Corpuscles 68<br/>Exam-oriented Questions 68<br/>13. Haemoglobin 69<br/>Introduction 69<br/>Chemistry 69<br/>Structure of Haemoglobin 69<br/>Properties 70<br/>Haemoglobin Varieties 70<br/>Haemoglobin and its Variant 70<br/>Synthesis of Haemoglobin 70<br/>Amount of Haemoglobin in Normal Blood 70<br/>Variations of Hb under Different Physiological<br/>Conditions 71<br/>Derivatives of Haemoglobin 71<br/>Exam-oriented Questions 72<br/>ixContents<br/>14. Iron Absorption, Transport, Storage and<br/>Excretion 73<br/>Introduction 73<br/>Daily Requirement 73<br/>Distribution of Iron 73<br/>Absorption and Transport 73<br/>Key Points 73<br/>Iron in Blood 73<br/>Storage of Iron 73<br/>Excretion 74<br/>Functions of Iron 74<br/>Applied: Iron Deficiency Anaemia 75<br/>Exam-oriented Questions 75<br/>15. Anaemia, Polycythemia, Osmotic<br/>Fragility and Blood Indices 76<br/>Introduction 76<br/>Other Causes 76<br/>Sickle Cell Anaemia 76<br/>Thalassemia 76<br/>Alpha Thalassemia 78<br/>Beta Thalassemia 78<br/>Glucose-6-Phosphate Dehydrogenase Deficiency 78<br/>Congenital Spherocytosis 78<br/>Blood Indices and Morphological Classification of<br/>Anemia 78<br/>Determination of Osmotic Fragility of Red Blood Cells 79<br/>Principle 79<br/>Procedure 79<br/>Precautions 79<br/>Applied Physiology: Haemolysis and Osmotic Fragility 79<br/>Polycythemia 80<br/>Exam-oriented Questions 80<br/>16. White Blood Cells and Platelets 81<br/>White Blood Cells 81<br/>Variations in Normal Count of White Blood Corpuscles 81<br/>Classification and Differential Count of White Blood<br/>Corpuscles or Leucocytes 81<br/>Granular Leucocytes or Granulocytes 82<br/>Neutrophil 82<br/>Arneth Count or Arneth Index (Modified by<br/>von Bonsdorff and Later by Cooke) 82<br/>Eosinophil (1–4%) 83<br/>Basophil (0–1%) 83<br/>Lymphocytes (20–40%) 83<br/>Small Lymphocyte 83<br/>Large Lymphocyte 83<br/>Monocytes (Large Mononuclear Cell, Transitional<br/>Cell, etc.) (2–8%) 84<br/>Characteristic Features 84<br/>Development of Leucocytes 84<br/>Development of Granular Leucocytes or Granulocytes 84<br/>Development of Lymphocytes 85<br/>Role of Lymphocyte in Immunology 86<br/>Development of Monocytes 86<br/>Life and Fate of Leucocytes 86<br/>Functions of WBC 86<br/>Applied Physiology: WBC Disorders 86<br/>Platelets 87<br/>Properties 87<br/>Total Number and its Variations 87<br/>Methods of Counting of Platelets 88<br/>Development of Platelets 88<br/>Functions of Platelets 88<br/>Exam-oriented Questions 89<br/>17. Blood Groups and Blood Transfusion 90<br/>Blood Groups 90<br/>A, B and O Groups 90<br/>Rh Antibodies and Rh Incompatibility 91<br/>Erythroblastosis Foetalis 91<br/>M and N Factors: Medicolegal Significance 91<br/>H Blood Group System and Bombay Phenotype 92<br/>Blood Transfusion: Blood Groups 92<br/>Indications for Blood Transfusion 92<br/>Autologous Transfusion 92<br/>Mismatched Blood Transfusion 93<br/>Blood Bank 93<br/>Blood Storage 93<br/>Exam-oriented Questions 93<br/>18. Formation of Tissue Fluids 94<br/>Introduction 94<br/>Composition of Tissue Fluid 94<br/>Functions of Tissue Fluid 94<br/>Oedema and its Causes 95<br/>Aggregation of Tissue Fluid 95<br/>Lymph and Lymphatics 95<br/>Characteristic Features 95<br/>Properties of Lymph 95<br/>Composition of Lymph 95<br/>Solids 95<br/>Rate of Flow 95<br/>Factors Responsible for Formation of Lymph 97<br/>Functions of Lymph 98<br/>Lymph Node 98<br/>Structure of Lymph Node 98<br/>Functions of Lymph Node 99<br/>Structure of Spleen 99<br/>Splenic Pulp 99<br/>Marginal Zone 100<br/>Functions of Spleen 101<br/>Classification, Varieties and Distribution of RE Cells 102<br/>Functions of the Reticuloendothelial System 103<br/>Exam-oriented Questions 103<br/>19. Immunity 104<br/>Introduction 104<br/>Innate Defenses 104<br/>Complement 105<br/>Adaptive Defenses 106<br/>Development of the Acquired Immune System 106<br/>Humoral Immunity 107<br/>Acquired Humoral Response: Formation of Primary and<br/>Secondary Antibodies 107<br/>Types of Acquired Immunity 107<br/>Antibody Mediated Humoral Response 108<br/>Cell-mediated Immune Response 108<br/>T Cell Activation 109<br/>Function of T Helper Cells, Cytotoxic T Cells and<br/>Suppressor T Cells 109<br/>Organ Transplant 110<br/>Severe Combined Immunodeficiency (SCID)<br/>Syndrome 110<br/>Acquired Immune Deficiency Syndrome (AIDS) 110<br/>Hypersensitivity 110<br/>Exam-oriented Questions 111<br/>Clinical Case Scenario 112<br/>Blood 112<br/>Recent Advances: Innate Immunity 113<br/>x Human Physiology<br/>2008 Nobel Prize for Physiology and Medicine: HIV<br/>Virus 114<br/>Notable Contributions: Diseases, Drugs, Immunity and<br/>Recovery 114<br/>Section III Nerve and Muscle<br/>20. Structure and Functions of Neuron 118<br/>Introduction 118<br/>Histological Structure 118<br/>Neuron 118<br/>Structure of Nerve Fibres 118<br/>Neuroglia 120<br/>Functions of Neuroglia 120<br/>Axonal Transport and Nourishment of Neurons 121<br/>Role of Neurotrophins in Neuronal Development 121<br/>Exam-oriented Questions 121<br/>21. Properties, Classification of Nerve<br/>Fibres and Nerve Action Potential 122<br/>Introduction: Properties of Nerve Fibres 122<br/>Excitability 122<br/>Generation of Action Potential and Excitability<br/>of the Nerve 122<br/>Ionic Basis of Excitability of Nerve 122<br/>Excitability Depends upon Following Factors 124<br/>Compound Action Potential 124<br/>Conductivity 124<br/>Factors Affecting Conductivity and Excitability 125<br/>All-or-none Law 126<br/>Refractory Period 126<br/>Summation 126<br/>Adaptation 126<br/>Accommodation 126<br/>Unfatigability 126<br/>Heat Production in Nerve Fibre 126<br/>Classification of Nerve Fibres 127<br/>Mechanism of Conduction of the Nerve Impulse 127<br/>Saltatory Conduction in the Myelinated<br/>Nerve Fibre 128<br/>Physiological Properties of the Nerve Fibres 129<br/>Degeneration and Regeneration of Nerve 129<br/>Sunderland Classification of Nerve Injury 129<br/>Regeneration 130<br/>Degeneration and Regeneration of Nerve 130<br/>Transneuronal Degeneration 130<br/>Applied Physiology 130<br/>Cathode Ray Oscilloscope (CRO) 130<br/>Exam-oriented Questions 131<br/>22. Neuromuscular Junction 132<br/>Introduction 132<br/>Anatomical Considerations 132<br/>Neuromuscular Junction 132<br/>Presynaptic Terminal 132<br/>Synaptic Cleft 133<br/>Post-synaptic Membrane 133<br/>Synthesis of Acetylcholine in Motor Neuron 133<br/>Sequence of Events in Neuromuscular Transmission 133<br/>Neuromuscular Blockers 134<br/>Applied Physiology 134<br/>Exam-oriented Questions 135<br/>23. Classification of Muscular Tissue 136<br/>Introduction 136<br/>Muscle Classification 136<br/>Exam-oriented Question 137<br/>24. Structure of Skeletal Muscle 138<br/>Introduction 138<br/>Distribution 138<br/>Origin and Development 138<br/>General Features 138<br/>Histological Structure of Muscle Fibres 138<br/>Myofibrils: Characteristic Features 138<br/>Myosin Filaments 139<br/>Actin Filament 140<br/>Sarcotubular System 141<br/>Blood Vessels, Lymphatics and Nerves of Skeletal<br/>Muscle 141<br/>Ending of Muscle in Tendon 141<br/>Exam-oriented Questions 142<br/>25. Muscle Contraction 143<br/>Introduction 143<br/>Mechanism of Contraction 143<br/>Molecular Mechanism of Muscle Contraction (Sliding<br/>Filament Theory of AF Huxley and HE Huxley) 143<br/>Changes during Muscular Contraction 146<br/>Role of Creatine Phosphate or Phosphagen and<br/>Adenosine Triphosphate (ATP) 146<br/>Muscular Contraction and its Relationship with the<br/>Breakdown of ATP 147<br/>Oxygen Utilization and CO2<br/> Production 147<br/>Cori Cycle 147<br/>Thermal Changes 148<br/>Electrical Changes 148<br/>Strength–Duration Relationship—Chronaxie and<br/>Rheobase 148<br/>Muscular Disorders 149<br/>Exam-oriented Questions 149<br/>26. Properties of Skeletal Muscle 150<br/>Introduction 150<br/>Excitability and Contractility 150<br/>Refractory Period 154<br/>Tonicity 154<br/>Conductivity 154<br/>Extensibility and Elasticity 154<br/>Contraction of Skeletal Muscle 154<br/>Exam-oriented Questions 155<br/>27. Cardiac Muscle 156<br/>Introduction 156<br/>Blood Vessels, Lymphatics and Nerves of Cardiac<br/>Muscle 158<br/>Exam-oriented Questions 159<br/>28. Smooth Muscles 160<br/>Introduction 160<br/>Histology 160<br/>Contractile Mechanism 161<br/>Properties of Plain (Smooth) Muscles 161<br/>Excitability and Contractility 161<br/>Functions of the Muscular Tissue 163<br/>Rigor Mortis 163<br/>Exam-oriented Questions 163<br/>Clinical Case Scenario 165<br/>Nerve Muscle 165<br/>Recent Update: A Newly Discovered Muscle: The Tensor of<br/>the Vastus Intermedius 166<br/>xiContents<br/>Section IV Cardiovascular System<br/>29. Introduction to Cardiovascular System 170<br/>Introduction 170<br/>Anatomical Considerations of the Heart 171<br/>Key Points 171<br/>Valves of the Heart 172<br/>Action of the Valves 173<br/>Histology of the Cardiac Muscle 174<br/>Valves of the Veins 176<br/>Blood Vessels (Vasa Vasorum) 176<br/>Factors that Maintain Circulation 176<br/>Special Junctional Tissues 176<br/>Sino-atrial Node (Keith and Flack, 1907) 177<br/>Atrioventricular Node (Tawara, 1906) 177<br/>Bundle of His 178<br/>Bundle Branch 178<br/>Purkinje Fibres 179<br/>Exam-oriented Questions 179<br/>30. Initiation and Spread of Cardiac Impulse 180<br/>Origin of the Heartbeat 180<br/>Initiation of Impulse and Localisation of Pacemaker 180<br/>Conduction Over Atrial Muscle 180<br/>Conduction Over AV Node 180<br/>Conduction Over Bundle of His and the Right and Left<br/>Bundle Branches 181<br/>Conduction through Purkinje Systems 181<br/>Conduction through Ventricular Muscle 181<br/>Heart Block 181<br/>Exam-oriented Questions 182<br/>31. Properties of Cardiac Muscle 183<br/>Introduction 183<br/>Rhythmicity 183<br/>Excitability 183<br/>Conduction 184<br/>Contraction 185<br/>All-or-none Response 185<br/>Staircase Phenomenon 185<br/>Refractory Period 185<br/>Tone 185<br/>Functional Syncytium 186<br/>Exam-oriented Questions 186<br/>32. Cardiac Cycle 187<br/>Introduction 187<br/>Cardiac Cycle Time 187<br/>Summary of the Sequence of Events in Cardiac<br/>Cycle 190<br/>Time Relations of the Various Events 191<br/>Summary of the Time Relations 191<br/>Exam-oriented Questions 192<br/>33. Haemodynamics of Circulatory System and Pressure<br/>and Volume Changes during Cardiac Cycle 193<br/>Haemodynamics of Circulatory System 193<br/>Blood Flow through Vessel 193<br/>Structural Overview 193<br/>Overall Blood Flow in Circulation 193<br/>Pattern of Blood Flow 193<br/>Blood Flow Resistance (Peripheral Resistance) 194<br/>Velocity of Blood Flow 194<br/>Lumen of the Blood Vessel 194<br/>Effect of Gravity on Mean Blood Pressure 194<br/>Regulation of Blood Flow 195<br/>Acute Control of Local Blood Flow 195<br/>Long-term Control of Local Blood Flow 195<br/>Role of Humoral Vasoconstrictors and Vasodilators 195<br/>Pressure Volume Changes 196<br/>Methods of Study 196<br/>Pressure Changes 196<br/>Intraventricular Pressure Changes and Assessment 196<br/>Ventricular Systole 196<br/>Ventricular Diastole 196<br/>Intra-atrial Pressure Changes 197<br/>Jugular Pressure Tracing (Venous Pulse) 197<br/>Ventricular Volume Changes 198<br/>Composite Representation of the Sequential Changes in the<br/>Pressure and Volume events in the Heart and Blood<br/>Vessels during the Cardiac Cycle Correlating with<br/>Phonocardiogram and Electrocardiogram 198<br/>Heart Sounds 199<br/>Exam-Oriented Questions 201<br/>34. Electrocardiogram 202<br/>Introduction 202<br/>Methods of Recording Electrocardiogram 202<br/>Electrocardiographic Leads Used both Clinically and<br/>Experimentally 203<br/>Unipolar Limb Leads 205<br/>Augmented Unipolar Limb Leads 206<br/>Normal ECG Recorded in Chest Leads 207<br/>Significance of Various Leads and their Limitations 207<br/>Electrocardiographic Appearances under Certain<br/>Cardiac Disorders 208<br/>ECG Changes in Atrial Tachycardia, Atrial Flutter<br/>and Atrial Fibrillation 208<br/>Ventricular Premature Beat or Extra Systole 209<br/>Ventricular Paroxysmal Tachycardia 209<br/>Ventricular Fibrillation 209<br/>Wolff-Parkinson-White Syndrome 209<br/>Myocardial Infarction 210<br/>Myocardial Infarction: Coronary Ischaemia and<br/>Current Injury 210<br/>Mean Electrical Axis of the Heart 210<br/>Determination of Electrical Axis 210<br/>Ventricular Conditions that may Cause Axis<br/>Deviation 211<br/>Exam-oriented Questions 212<br/>35. Innervations of Heart and Heart Rate 213<br/>Introduction 213<br/>Nerves of the Heart and their Action 213<br/>Vagus Nerves 213<br/>Tonic Action of the Vagus Nerves 214<br/>Sympathetic Nerves 214<br/>Cardiac Centres 214<br/>Heart Rate 214<br/>Factors Affecting Heart Rate 214<br/>Regulation of Heart Rate 215<br/>Applied Physiology 217<br/>Exam-oriented Questions 217<br/>36. Cardiac Output 218<br/>Introduction 218<br/>Normal Values: 5–6 Litres/Minute 218<br/>Important Terminology and Definitions 218<br/>Distribution of Cardiac Output 218<br/>Cardiac Reserve 218<br/>Factors Affecting Cardiac Output 219<br/>Control of Cardiac Output 219<br/>Preload Depends on Ventricular Filling and Venous<br/>Return 219<br/>xiiHuman Physiology<br/>Cardiac Contractility 219<br/>Afterload 220<br/>Methods of Measuring Cardiac Output 221<br/>Dye Method: Stewart and Hamilton’s Dye Dilution<br/>Method 221<br/>Employing for Measuring Cardiac Output<br/>Fick Principle Using O2<br/> and CO2 221<br/>Physical Method: Ballistocardiography 222<br/>Thermo-dilution Method (Cold Saline Method) 222<br/>Applied Physiology 222<br/>Doppler Echocardiography 222<br/>Calculation 222<br/>Exam-oriented Questions 222<br/>37. Blood Pressure 223<br/>Introduction 223<br/>Basal Blood Pressure 223<br/>Physiological Variations 223<br/>Significance of Blood Pressure 224<br/>Systolic Pressure 224<br/>Diastolic Pressure 224<br/>Pulse Pressure 224<br/>Physiological Significance of Blood Pressure 224<br/>Measurement and Recording of Blood Pressure 224<br/>Arterial Blood Pressure 224<br/>Venous Pressure 226<br/>Determinants of Blood Pressure 226<br/>Adjustment of Blood Pressure 226<br/>Efferent Pathways of this Self-adjustment or<br/>Homoeostasis of Blood Pressure 227<br/>Vasomotor System 227<br/>Afferent Pathways 228<br/>Role of Sino-aortic Mechanism in the Regulation of<br/>Normal Blood Pressure 228<br/>Sino-aortic Mechanism 228<br/>Chemoreceptors Location 229<br/>Aortic Bodies 230<br/>Vascular Receptors other than Sino-Aortic for the<br/>Control of Blood Pressure and Flow 230<br/>As Chemoreceptors 231<br/>Mechanism of Regulation of Blood Pressure 231<br/>Short-term Regulating Mechanisms 231<br/>Intermediate Mechanism of Regulation of<br/>Blood Pressure 232<br/>Long-term Regulation of Blood Pressure 232<br/>Role of other Hormone in Regulation of Blood<br/>Pressure 232<br/>Role of Humoral Vasoconstrictors and Vasodilators 232<br/>Humoral Vasoconstrictors 232<br/>Humoral Vasodilators 233<br/>Chemical Control of Blood Pressure Influenced by<br/>Vasomotor Mechanism 233<br/>Exam-oriented Questions 233<br/>38. Velocity of Blood Flow and Radial Pulse 234<br/>Introduction 234<br/>Velocity of Blood 234<br/>Methods of Measurement of Velocity of Blood 234<br/>Radial Pulse 234<br/>Pressure Pulse 235<br/>Recording of Radial Pulse 235<br/>Clinical Features of Radial Pulse 235<br/>Special Varieties of Pulse 235<br/>Applied Physiology 236<br/>Exam-oriented Questions 236<br/>39. Regional Circulation 237<br/>Introduction 237<br/>Coronary Circulation 237<br/>Anatomical Considerations 237<br/>Venous Drainage 238<br/>Methods of Study 238<br/>Normal Values 238<br/>Variations of Coronary Inflow during Different<br/>Phases of Cardiac Cycle 239<br/>Coronary Inflow 239<br/>Factors Influencing Coronary Circulation 240<br/>Circulatory Status of the Cardiac Muscle under<br/>Certain Diseased Conditions 241<br/>Aortic Stenosis 241<br/>Pulmonary Hypertension 241<br/>Aortic Insufficiency 241<br/>Mitral Stenosis 241<br/>Aortic Coarctation 241<br/>Hypertensive Cardiovascular Disease 241<br/>Ischaemic Heart Disease 241<br/>Coronary Spasms and Intercoronary Reflexes 241<br/>Pathological Physiology of Angina Pectoris and<br/>Acute Myocardial Infarction 241<br/>Cerebral Circulation 241<br/>Anatomical Considerations 241<br/>Method of Study: Nitrous Oxide Method:<br/>Fick Principle 242<br/>Vasomotor Supply 242<br/>Normal Values of Cerebral Circulation 242<br/>Regulation of Cerebral Circulation 243<br/>Existence of Auto-regulation of Cerebral Blood Flow 243<br/>Key Points 243<br/>Factors Controlling Cerebral Circulation 243<br/>Cerebrovascular Resistance 243<br/>Pulmonary Circulation 244<br/>Anatomy of Circulation 244<br/>Method of Recording Pulmonary Arterial Pressure 244<br/>Vasomotor Supply 244<br/>Normal Values of Pulmonary Circulation 244<br/>Functions of Pulmonary Circulation 245<br/>Control of Pulmonary Circulation 245<br/>Peculiarities of Pulmonary Circulation 246<br/>Pulmonary Vascular Reflex 246<br/>Circulatory Status in Different Cardiopulmonary<br/>Diseases 246<br/>Mitral Stenosis 246<br/>Emphysema 246<br/>Pulmonary Embolism 246<br/>Atelectasis 246<br/>Removal of Lung 247<br/>Diffuse Sclerosis of Lung Vessels 247<br/>Pulmonary Fibrosis 247<br/>Hepatic Circulation 247<br/>Vascular Arrangement 247<br/>Vasomotor Supply 247<br/>Normal Values of Hepatic Circulation 247<br/>Factors Modifying Hepatic Circulation 248<br/>Peculiarities of Hepatic Circulation 248<br/>Splenic Circulation 249<br/>Control of Blood Flow 249<br/>Renal Circulation 249<br/>Capillary Circulation 249<br/>Histology 249<br/>Methods of Study of Capillary Circulation 249<br/>Vasomotor Supply 249<br/>Control of Capillary Circulation 250<br/>Interchange in the Capillary Area 251<br/>Cutaneous Circulation 251<br/>Anatomy of Cutaneous Circulation 251<br/>Rate of Blood Flow 251<br/>xiiiContents<br/>Regulation of Blood Flow: Nervous Control 251<br/>Vascular Response of Skin 252<br/>Auto-regulation of Skin Blood Flow 252<br/>Normal Colour of the Skin 252<br/>Skeletal Muscle Circulation 253<br/>Vascular Arrangement in Skeletal Muscle 253<br/>Rate of Blood Flow Through Muscle 253<br/>Basal Tone of Arterioles 253<br/>Control of Skeletal Muscle Blood Flow 253<br/>Exam-oriented Questions 254<br/>40. Physiology of Exercise 255<br/>Introduction 255<br/>Muscular Exercise 255<br/>Changes in Cardiovascular System 256<br/>Heart Rate Changes during Exercise 256<br/>Circulatory Status during Exercise 257<br/>Changes in Respiration 258<br/>Blood Cell Changes during Exercise 258<br/>Body Temperature 258<br/>Body Fluid Changes during Exercise 259<br/>Kidney Function in Exercise 259<br/>Digestive System 259<br/>Endocrine Status 260<br/>Aerobic Training 260<br/>Isometric and Isotonic Exercises 260<br/>Cardiovascular and Cardiorespiratory Response to Isometric<br/>Exercise 260<br/>Sedentary Lifestyle and Health Implication 261<br/>Introduction 261<br/>Health Implication in Sedentary Lifestyle 261<br/>Role of Nutrition in Exercise 262<br/>Over-exercising and Ill Effects on Health 262<br/>Cardiorespiratory Changes under Different<br/>Environmental Conditions (Heat and Cold) 262<br/>Exam-oriented Questions 262<br/>41. Applied Cardiovascular Physiology:<br/>Haemorrhage, Heart Failure,<br/>Hypotension, Hypertension and Shock 263<br/>Haemorrhage 263<br/>Compensatory Changes after Haemorrhage 263<br/>Heart Failure 264<br/>Types of Heart Failure 264<br/>Role of Compensatory Mechanisms in Heart Failure 265<br/>Management and Prevention 265<br/>Hypotension 265<br/>Orthostatic Hypotension 265<br/>Hypertension 265<br/>Signs and Symptoms 265<br/>Pathophysiology of Hypertension 266<br/>Shock 267<br/>Types of Shock 267<br/>Clinical Features of Shock 267<br/>Stages of Shock 267<br/>Physiology of Treatment in Shock 270<br/>Applied Physiology: Cardiovascular System 270<br/>Cardiac Disorders 270<br/>Exam-oriented Questions 271<br/>Clinical Case Scenario 272<br/>Cardiovascular System 272<br/>Important Cardiovascular Research Study:<br/>Framingham Heart Study 273<br/>First Cardiac Catheterization and Future<br/>Development of Technique 273<br/>Open-heart Surgery 273<br/>Recent Advances in Cardiovascular Research 273<br/>Section V Respiratory System<br/>42. Functional Organization of Respiratory System 276<br/>Structure of the Respiratory Tract 276<br/>Trachea 276<br/>Functions of Respiratory Tract 276<br/>Reflexes Help in Clearing Irritating agents from<br/>Respiratory Passage 277<br/>Respiratory Units 277<br/>Broncho-pulmonary Anastomosis 277<br/>Pulmonary Alveoli 277<br/>Respiratory Functions of Lung 278<br/>Pleural Cavity and Intra-pleural Pressure 279<br/>Intra-pleural Pressure 279<br/>Surface Tension at the Fluid–Air Interface within the<br/>Alveoli and the Role of Surfactant 279<br/>Pressure Changes in the Pleural Cavity and its Relation to<br/>Volume Changes in the Lungs 280<br/>Exam-oriented Questions 280<br/>43. Mechanics of Breathing 281<br/>Introduction 281<br/>Diaphragm 281<br/>Intercostal Muscles 282<br/>Motion of the Ribs during Inspiration and<br/>Expiration 282<br/>Accessory Muscles of Respiration 283<br/>Resistance to Breathing 283<br/>Elastic Resistance 283<br/>Lung Compliance 283<br/>Measurement of Lung Compliance and Pressure–<br/>Volume Curve 283<br/>Viscous or Non-elastic Resistance 284<br/>Elastic Forces and Characteristics of Compliance Pressure–<br/>Volume Curve 284<br/>Elastic Forces of Lung Tissue 284<br/>Alveolar Radius and its Relation to Surface tension 284<br/>Energy Utilization for Respiration 285<br/>Applied Physiology 285<br/>Exam-oriented Questions 286<br/>44. Pulmonary Volumes and Capacities (Spirometry) 287<br/>Introduction 287<br/>Lung Volumes 288<br/>Tidal Volume (TV = 500 ml) 288<br/>Respiratory Minute Volume (RMV) 288<br/>Inspiratory Reserve Volume (IRV) 288<br/>Expiratory Reserve Volume (ERV) 288<br/>Residual Volume (RV) 288<br/>Lung Capacities 288<br/>Inspiratory Capacity (IC) 288<br/>Functional Residual Capacity (FRC) 288<br/>Total Lung Capacity (TLC) 288<br/>Vital Capacity (VC) 288<br/>Forced Expiratory Volume (FEV) 289<br/>Functional Residual Capacity (FRC) 290<br/>Forced Vital Capacity (FVC) 291<br/>Forced Expiratory Volume in 1 (FEV1) Second 291<br/>FEV1/FVC Ratio (FEV1<br/>%) 291<br/>Forced Expiratory Flow (FEF) 291<br/>Peak Expiratory Flow (PEF) 291<br/>Breathing Reserve (BR) 292<br/>Applied Physiology: Obstructive and Restrictive<br/>Lung Disease 292<br/>Exam-oriented Questions 292<br/>xivHuman Physiology<br/>45. Alveolar Ventilation and Gases Exchange<br/>in Lungs 293<br/>Alveolar Ventilation 293<br/>Respiratory ‘Dead Space’ 293<br/>Definition 293<br/>Measurement of Dead Space Volume 293<br/>Nitrogen Meter Method 293<br/>Intrapulmonary Gas-mixing or Even Distribution of<br/>Inspired Air 294<br/>Methods of Detection of Uneven Ventilation 294<br/>Alveolar Air 294<br/>Composition of Alveolar Air 294<br/>Partial Pressure of Gases in Inspired Air, Expired Air<br/>and Alveolar Air 295<br/>Effect of Voluntary Hyperpnoea on Alveolar Air 295<br/>Breath-holding Time 295<br/>Effects of High Altitude on Alveolar Oxygen 296<br/>Factors Controlling Alveolar pCO2 296<br/>Anatomical Shunt 296<br/>Physiological Shunt 297<br/>Applied Physiology 297<br/>Hyperventilation and Hypoventilation 297<br/>Exam-oriented Questions 297<br/>46. Ventilation and Perfusion in Lungs 298<br/>Diffusion 298<br/>Factors Controlling Diffusion 299<br/>Summary of Factors Affecting Diffusion through<br/>Fluids and Respiratory Membrane 299<br/>Diffusion through Respiratory Membrane 299<br/>Pulmonary Diffusing Capacity for O2<br/> (DO2<br/>) 299<br/>Diffusion of CO2 300<br/>Perfusion 300<br/>Applied Physiology 300<br/>Exam-oriented Questions 300<br/>47. Transport of Oxygen and Carbon<br/>Dioxide in Blood 301<br/>Introduction 301<br/>Oxygen Transport 301<br/>Percentage Saturation of Haemoglobin 302<br/>Dissociation Curve for Haemoglobin 302<br/>Nature of the Curve 303<br/>Explanation of the Sigmoid Shape of the Curve 303<br/>Oxygen Exchange in the Lungs 304<br/>Oxygen Transport in the Tissues 304<br/>Applied Physiology 305<br/>Carbon Dioxide Transport 305<br/>CO2 Content and Tension of Blood 305<br/>Transport 305<br/>Carbon Dioxide Dissociation Curves 306<br/>Summary: Transport of Oxygen and Carbon<br/>Dioxide in Blood 308<br/>Exam-oriented Questions 308<br/>48. Regulation of Respiration 309<br/>Introduction 309<br/>Respiratory Centre 309<br/>Dorsal Respiratory Group (DRG) of Neurons and<br/>Inspiratory Ramp Signals 310<br/>Ventral Respiratory Group of Neurons 310<br/>Mechanism of Rhythmic Respiration 310<br/>Role of Abdominal Muscles in Respiration 310<br/>Role of Reflex in Respiration 310<br/>Voluntary Control of Respiration 313<br/>Chemical Control of Respiration 313<br/>CO2<br/> and Respiration 313<br/>Nervous Factors Influencing Respiration in Exercise 315<br/>Periodic Breathing 315<br/>Cheyne-Stokes Breathing 315<br/>Factors Involved in Development of Cheyne-Stokes<br/>Breathing Pattern 315<br/>Mechanism of Cheyne-Stokes Breathing 317<br/>Kussmaul’s Breathing 317<br/>Exam-oriented Questions 317<br/>49. Hypoxia 318<br/>Definition 318<br/>Classification of Hypoxia 318<br/>Anoxic Hypoxia or Arterial Hypoxia 318<br/>Causes of Arterial Hypoxia 318<br/>Anaemic Hypoxia 319<br/>Stagnant Hypoxia or Hypokinetic Hypoxia 319<br/>Histotoxic Hypoxia 319<br/>Altitude Hypoxia 319<br/>Oxygen Therapy in Hypoxia 320<br/>Dyspnoea 321<br/>Dyspnoea due to Alteration in Chemical Composition<br/>of Blood 321<br/>Factors Affecting Diffusion of Gases Across the<br/>Alveolo-capillary Membrane (Alveolo-capillary<br/>Block Syndrome) 321<br/>Excessive Work of the Respiratory Muscles 322<br/>Applied Physiology 322<br/>Psychogenic or Emotional Dyspnoea 322<br/>Exam-oriented Questions 322<br/>50. Compressed Air Sickness and Deep Sea Diving 323<br/>Dysbarism (Caisson Disease) 323<br/>Exam-oriented Question 323<br/>51. Respiration in Abnormal Conditions 324<br/>Asphyxia 324<br/>Definition 324<br/>Classification 324<br/>Essential Conditions of Asphyxia 324<br/>Hyperpnoea 324<br/>Causes 324<br/>Effects of Voluntary Hyperpnoea 324<br/>Orthopnoea 326<br/>Cyanosis 326<br/>Factors Causing Cyanosis 326<br/>Applied Physiology 326<br/>Exam-oriented Questions 327<br/>52. Artificial Respiration or Resuscitation 328<br/>Methods of Artificial Respiration 328<br/>Manual Methods 328<br/>Sylvester’s Method 329<br/>Holger-Nielsen Method 329<br/>Mouth-to-mouth Method 329<br/>Eve’s Rocking Method 329<br/>Instrumental Method 329<br/>Drinker’s Method 329<br/>Resuscitator 329<br/>In the Newborn Baby 329<br/>Exam-oriented Questions 331<br/>53. Acclimatisation 332<br/>Compensatory Changes at Moderately High<br/>Altitude 332<br/>Changes in Acclimatisation 332<br/>Natural Acclimatisation of Natives Residing at High<br/>Altitude 332<br/>Acute Mountain Sickness 333<br/>xvContents<br/>Mountaineering 333<br/>Atmosphere High Altitude Physiology 334<br/>Hypoxia 334<br/>Problem Faced by Aviators 334<br/>Radiation Hazards 335<br/>Dysbarism at High Altitude (Decompression<br/>Sickness) 335<br/>Explosive Decompression 335<br/>Effect of Centrifugal Acceleratory Forces 336<br/>Protection of Body against Centrifugal Acceleratory<br/>Forces 336<br/>Parachute Jump 337<br/>Weightlessness in Space (Zero-G State) 338<br/>Exam-oriented Questions 338<br/>54. Underwater Physiology 339<br/>Introduction 339<br/>Nitrogen 339<br/>Oxygen 339<br/>Mechanism of Oxygen Poisoning 340<br/>Carbon Dioxide 340<br/>Helium 340<br/>Underwater Respiration 340<br/>SCUBA Diving 341<br/>Exam-oriented Question 341<br/>55. Vocalisation and Basic Life Support (BLS) 342<br/>Vocalisation 342<br/>Articulation and Resonance 343<br/>Basic Life Support (BLS) 343<br/>Basic Life Support Sequence 343<br/>Collapsed Victim 343<br/>CAB 344<br/>Compressions 344<br/>Automated External Defibrillators (AEDs) 344<br/>Airway and Ventilations 345<br/>Opening the Airway 345<br/>Ventilations 345<br/>Choking 346<br/>Adult Choking Sequence 347<br/>Unresponsive Victim 347<br/>Chain of Survival 347<br/>Exam-oriented Questions 347<br/>Clinical Case Scenario 348<br/>Respiratory System 348<br/>Recent Advances 348<br/>Section VI Gastro-intestinal Tract<br/>56. General Outline of Digestive System 350<br/>Introduction 350<br/>Anatomical Consideration 350<br/>Histological Structure 351<br/>Innervation of the Digestive Tract 351<br/>Functions of the Digestive System 352<br/>Histology of Tongue 352<br/>Glands 355<br/>Nerve Supply 355<br/>Functions 355<br/>Salivary Glands 355<br/>Histology of Salivary Glands 355<br/>Pharynx or Throat Cavity 357<br/>Oesophagus 357<br/>Histology 357<br/>Stomach 358<br/>Histology of Stomach 359<br/>Functions of Stomach 360<br/>Small Intestine 360<br/>Vermiform Appendix 362<br/>Large Intestine 362<br/>Rectum 362<br/>Anal Canal 362<br/>Brief Summary of the Chief Identifying Features of Different<br/>Parts of the Digestive Tract 362<br/>Exam-oriented Questions 362<br/>57. Digestive Juices 363<br/>Introduction 363<br/>Saliva 363<br/>Characteristics 363<br/>Composition 363<br/>Functions 363<br/>Gastric Juice 364<br/>Composition 364<br/>Characteristics 364<br/>Functions 364<br/>Pancreatic Juice 364<br/>Characteristics 364<br/>Succus Entericus 365<br/>Characteristics 365<br/>Composition 365<br/>Intestinal Juice Enzymes 365<br/>Carbohydrate Splitting 365<br/>Functions 365<br/>Biles 365<br/>Introduction 365<br/>Composition of Bile 366<br/>Functions of Bile 366<br/>Bile Salts 367<br/>Variety and Chemistry 367<br/>Synthesis of Bile Salts 367<br/>Enterohepatic Circulation and Fate of Bile Salts 367<br/>Functions of Bile Salts 367<br/>Bile Pigments 368<br/>Chemistry and Varieties 368<br/>Origin and Formation 368<br/>Site of Formation, Circulation and Fate 368<br/>Exam-oriented Questions 370<br/>58. Mechanism of Secretion of Various<br/>Digestive Juices 371<br/>Introduction 371<br/>Saliva 371<br/>Nerve Supply of Salivary Glands 371<br/>Significance of Double Nerve Supply 372<br/>Salivary Secretion and Reflexes 372<br/>Reflex Control of Rate of Flow and Composition of<br/>Saliva 373<br/>Disturbances of Salivary Secretion 373<br/>Gastric Secretions 373<br/>Cephalic Phase 374<br/>Gastric Phase 375<br/>Gastric Phase Characteristic Features 375<br/>Intestinal Phase 375<br/>Action of Other Hormones on Gastric Secretion 376<br/>Interrelation between the Different Phases 377<br/>Gastric Function Test 377<br/>Investigation of Gastric Secretion in Man 377<br/>Other Functional Tests 378<br/>Origin and Character of the Important Constituents<br/>of Gastric Juice 379<br/>Hydrochloric Acid 379<br/>Applied Physiology: Peptic Ulcer 379<br/>Pepsin 380<br/>Mucin 380<br/>Intrinsic Factor 380<br/>xviHuman Physiology<br/>Neuropoietic Factor 380<br/>Pancreas 380<br/>Development 381<br/>Mechanism of Pancreatic Secretions 381<br/>Nervous Phase 381<br/>Chemical Phase 382<br/>Influence of Various Foodstuffs on Pancreatic<br/>Secretion 383<br/>Applied Physiology 383<br/>Liver 383<br/>Anatomy 383<br/>Gall Bladder: Structure and Functions 383<br/>Mechanism of Bile Secretion 384<br/>Mechanism of Secretion 384<br/>Mechanism of Expulsion of Bile 385<br/>Factors Controlling Movements of Gall Bladder 385<br/>Functions of Gall Bladder 386<br/>Applied Physiology 386<br/>Mechanism of Secretion of Succus Entericus<br/>(Intestinal Juice) 386<br/>Mechanism 387<br/>Applied Physiology 387<br/>Summary of Secretions of the Various Digestive<br/>Juices 387<br/>Exam-oriented Questions 388<br/>59. Movements of Alimentary Canal 389<br/>Introduction 389<br/>Facts about Movement 389<br/>Cause of Movements 389<br/>Relation with Degree of Activity 389<br/>Deglutition (Swallowing) 389<br/>Common Disturbances in the Swallowing 391<br/>Movements of Stomach 391<br/>Applied Physiology 393<br/>Vomiting (Emesis) 393<br/>Movements of Small Intestine 395<br/>Frequency 395<br/>Movements of Villi 397<br/>Applied Physiology 397<br/>Movements of Large Intestine 397<br/>Functions of Large Intestine 398<br/>Rate of Progress of Barium Meal 398<br/>Applied Physiology—Large Intestine 400<br/>Defaecation 400<br/>Mechanism 400<br/>Exam-oriented Questions 400<br/>60. Digestion and Absorption of Foodstuffs 401<br/>Introduction 401<br/>Digestion of Carbohydrates 401<br/>Introduction 401<br/>Different forms of Carbohydrates 401<br/>Digestion of Proteins 402<br/>Introduction 402<br/>Different Forms of Protein 403<br/>Digestion of Nucleoprotein 403<br/>Digestion of Casein 403<br/>Digestion of Milk 404<br/>Digestion of Collagen and Gelatin 404<br/>Digestion of Mucin 404<br/>Digestion of Lipids 404<br/>Digestion in the Pancreatic Juice 404<br/>Absorption 405<br/>Definition 405<br/>Absorption of Carbohydrates 405<br/>Absorption of Proteins 405<br/>Fats Absorption 406<br/>Process of Absorption 406<br/>Water Absorption 406<br/>Absorption of Electrolytes 406<br/>Faeces 407<br/>Contents and Characteristics 407<br/>Exam-oriented Questions 407<br/>61. Gastro-intestinal Hormones 408<br/>Introduction 408<br/>Gastrin 408<br/>Cholecystokinin (CCK) or Pancreozymin 409<br/>Regulation of Secretion of Cholecystokinin 409<br/>Glucagon-like Peptide-1 409<br/>Gastric Inhibitory Polypeptide (GIP) 409<br/>Vasoactive Intestinal Peptide (VIP) 409<br/>Urogastrone 409<br/>Villikinin 409<br/>Enterocrinin 410<br/>Motilin 410<br/>Neurotensin 410<br/>Somatostatin 410<br/>Gastrin Releasing Peptide 410<br/>Ghrelin 410<br/>Peptide YY 410<br/>Substance P 410<br/>Bombesin 410<br/>Exam-oriented Questions 410<br/>Clinical Case Scenario 411<br/>Gastrointestinal Tract 411<br/>Recent Advances: Treatment of Peptic Ulcer 411<br/>Recent Advances: Capsule Endoscopy 412<br/>Section VII Renal Physiology<br/>62. Functional Anatomy of Excretory System 414<br/>Introduction 414<br/>Kidneys 414<br/>Characteristic Features 414<br/>Nephron 415<br/>Uriniferous Tubules 416<br/>Types of Nephrons 416<br/>Renal Tubules 419<br/>Proximal Convoluted Tubule (PCT) 419<br/>Henle’s Loop 419<br/>Distal Convoluted Tubule (DCT) 420<br/>Collecting Tubule 421<br/>Juxtaglomerular Apparatus 421<br/>Regulation of Renin Secretion 422<br/>Renal Circulation 423<br/>Peculiarities 423<br/>Peculiarities of Renal Circulation 425<br/>Exam-oriented Questions 426<br/>63. Urine Formation by Kidneys: Renal Blood Flow<br/>and their Control 427<br/>Introduction 427<br/>Autoregulation of Renal Blood Flow 427<br/>Nervous Control 428<br/>Other Factors 429<br/>Blood Glucose Level 429<br/>Hormones Influencing Renal Functions 429<br/>Measurement of Renal Blood Flow 429<br/>Functions of Kidney and Glomerulus 430<br/>Functions of Kidney 430<br/>Exam-oriented Questions 430<br/>xviiContents<br/>64. Urine Formation by the Kidney: Glomerular<br/>Filtration Rate and their Control 431<br/>Introduction 431<br/>Key Points 431<br/>Glomeruli as Ultrafilter 433<br/>Functions of Glomerulus 433<br/>Applied physiology: Chronic Kidney Disease and<br/>Glomerular Filtration Rate 435<br/>65. Tubular Reabsorption and Tubular Secretion (Urine<br/>Formation): Water and Electrolytes Balance and<br/>Counter-current Mechanism 436<br/>Introduction 436<br/>Methods of Study of Tubular Functions 436<br/>Selective Reabsorption 436<br/>Glucose 436<br/>Water 437<br/>Sodium and Chloride 439<br/>Potassium 439<br/>Bicarbonate 441<br/>Phosphate 442<br/>Reabsorption of other Substances 442<br/>Tubular Secretion 442<br/>Formation of Some New Substances 442<br/>Exam-oriented Questions 444<br/>66. Renal Function Test, Urine, Urinary<br/>Characteristic and its Mechanism of Formation 445<br/>Introduction 445<br/>Assuming 445<br/>I. Test for measurement of GFR 446<br/>Inulin Clearance (A Measure of Glomerular<br/>Filtration Rate) 446<br/>Creatinine Clearance Test 446<br/>II. Test to Measure Excretory Function 446<br/>Urea Clearance Test (Van Slyke) 446<br/>III. Test to Estimate Tubular Secretion Capacity 447<br/>IV. Test to Measure Renal Blood Flow 447<br/>Urine, Urinary Characteristic and its Mechanism of<br/>Formation 447<br/>Introduction 447<br/>Other Characteristics 448<br/>Colour 448<br/>Reaction 448<br/>Specific Gravity 448<br/>Turbidity 448<br/>Odour 448<br/>Osmotic Pressure 448<br/>Composition of Urine 448<br/>Normal Constituents of Urine 448<br/>Abnormal Constituent of Urine 449<br/>Protein 449<br/>Glucose 450<br/>Ketone Bodies 450<br/>Presence of Blood in Urine 450<br/>Pigments 450<br/>Calculi and Casts 450<br/>Pus 450<br/>Hormones 450<br/>Factors Affecting Formation of Urine 451<br/>Reaction of Urine 451<br/>Mechanism of Regulation of Blood Reaction by<br/>the Kidneys 451<br/>Bicarbonate Mechanism 451<br/>Phosphate Mechanism 452<br/>Ammonia Mechanism 453<br/>Elimination of Acids 453<br/>Elimination of Alkalis 454<br/>Glycosuria 454<br/>Glycosuria due to Hyperglycaemia 454<br/>Glycosuria due to Less Tubular Reabsorption 455<br/>Factors Controlling Volume of Urine 455<br/>Abnormal Volume of Urine 456<br/>Applied Physiology 456<br/>Exam-oriented Questions 457<br/>67. Micturition 458<br/>Introduction 458<br/>Structure of Urinary Bladder 458<br/>Mechanism of Filling of Bladder 459<br/>Mechanism of Micturition 459<br/>Key Features 459<br/>Micturition Reflex 460<br/>Centres of Micturition 461<br/>Effect of Lesion of Autonomic Nerves 461<br/>Applied: Pathological Conditions involving Bladder<br/>Control Physiology 462<br/>Artificial Kidney 463<br/>Exam-oriented Questions 463<br/>68. Skin, Body Temperature and its Regulation 464<br/>Introduction 464<br/>Structure 464<br/>Epidermis 464<br/>Dermis (Cutis Vera or True Skin) 465<br/>Functions of Skin 465<br/>Glands in the Skin 466<br/>Mechanism of Secretion of Sweat 466<br/>Composition of Sweat 467<br/>Sebaceous Glands 467<br/>Composition of Sebum 467<br/>Control 467<br/>Special Structures of Skin 469<br/>Nails (Ungues) 469<br/>Hair (Pili) 469<br/>Body Temperature and its Regulation 470<br/>Introduction 470<br/>Factors Affecting Body Temperature 470<br/>Regulation of Body Temperature 471<br/>Mechanisms of Heat Production (Thermogenesis) 471<br/>Mechanisms of Heat Loss (Thermolysis) 472<br/>Nervous System and Thermotaxis 472<br/>Interaction of Central and Peripheral Factors 473<br/>Role of Endocrines 474<br/>Temperature Regulation in the Newborn Infant 474<br/>Mechanism of Regulation of Body Temperature 474<br/>Decreased Body Temperature and Responses 474<br/>Other Factors 474<br/>Effects of Exposure to High and Low Atmospheric<br/>Temperature 474<br/>Physiological Alterations of Body Mechanisms on<br/>Exposure to Hot Atmosphere 474<br/>Life in Deserts 475<br/>Physiological Alterations of Body Mechanisms on<br/>Exposure to Cold Atmosphere 476<br/>Effect of Sudden Change of Atmospheric<br/>Temperature 476<br/>Pyrexia 476<br/>Physiological Responses due to Pyrexia (Fever) 476<br/>Hypothermia 476<br/>Physiological Responses to (Deliberate)<br/>Hypothermia 476<br/>xviiiHuman Physiology<br/>Applied Physiology 477<br/>Exam-oriented Questions 478<br/>69. Regulation of Reaction of Blood and<br/>Disturbances in Acid–Base Regulation 479<br/>Introduction 479<br/>Respiratory H+ 479<br/>Metabolic H+ 479<br/>Acid–base, Hydrogen Ion Concentration and pH 479<br/>Acid and Base 479<br/>Hydrogen Ion Concentration 480<br/>pH 480<br/>Calculation of pH 480<br/>Calculation of [H+] Ion Concentration 480<br/>The pH Scale 480<br/>Physiological Importance of Maintenance of pH 481<br/>Buffers, Lungs and Kidney 482<br/>Buffer Action 482<br/>Bicarbonate Buffer System 482<br/>Bicarbonate Buffer System and its importance as<br/>Extracellular Buffer 482<br/>Role of Kidney and Lung 482<br/>Role of Respiration in Acid–Base Balance 484<br/>Role of Kidneys in Acid–Base Balance 484<br/>Disturbances in Acid–Base Regulation 485<br/>Respiratory Acidosis 485<br/>Definition 485<br/>Pathophysiology 485<br/>Compensatory Mechanism 485<br/>Metabolic Alkalosis 485<br/>Definition 485<br/>Respiratory Compensation 486<br/>Renal Compensation 486<br/>Metabolic Acidosis 486<br/>Definition 486<br/>Compensation 486<br/>Respiratory Alkalosis 486<br/>Definition 486<br/>Renal Compensation 487<br/>Assessment of the Acid–Base Status 487<br/>Exam-oriented Questions 487<br/>Clinical Case Scenario 488<br/>Kidney 488<br/>Applied Physiology 489<br/>Peritoneal Dialysis 489<br/>Renal Transplantation 489<br/>Multiple Choice Questions<br/>General Physiology 492<br/>Blood 496<br/>Nerve and Muscle 500<br/>Cardiovascular System 504<br/>Respiratory System 508<br/>Gastro-intestinal Tract 511<br/>Renal System 515<br/>References 519<br/>Appendix A1–A5<br/>Index I1–I |
| 505 ## - FORMATTED CONTENTS NOTE | |
| Title | ntroduction 522<br/>Storage, Destruction and Excretion 523<br/>Mode of Action 523<br/>Cyclic AMP and Hormone Action 523<br/>Cyclic Guanosine Monophosphate (cGMP) as Second<br/>Messenger 524<br/>Diacylglycerol (DAG) and Inositol 1,4, 5-Triphosphate<br/>(IP3) as Second Messenger 524<br/>Ca2+ as a Second Messenger 524<br/>Synthesis of Enzyme at the Nuclear Level 524<br/>Other Mechanisms 526<br/>Control of Endocrine System: Regulation of Secretion of<br/>Hormones 526<br/>Negative Control Mechanism 527<br/>Endocrine Glands 527<br/>Essential Properties of a Hormone 528<br/>Major Endocrine Glands and Hormones in Controlling<br/>Body Functions 528<br/>Neuroendocrine Interrelations 528<br/>Hypothalamic Hypophyseal Portal System 528<br/>Hypothalamo-hypophyseal Peripheral Gland Axis 529<br/>Exam-oriented Questions 530<br/>71. Hypophysis (Pituitary Gland) 531<br/>Introduction 531<br/>Structure and Functions of Adenohypophysis (Anterior<br/>Pituitary) 533<br/>Blood Supply 534<br/>Functions of the Anterior Lobe of Pituitary Gland 534<br/>Growth Hormone or Somatotropin (GH or STH) 534<br/>Chemistry 534<br/>Synthesis of Growth Hormone 535<br/>Growth Hormone Secretion 535<br/>Mechanism of Action 535<br/>Actions of Growth Hormone (GH) 535<br/>Regulation of Growth Hormone Secretion 536<br/>Applied Physiology (Growth Hormone Pathological<br/>Disorders) 536<br/>Growth Hormone Disorders 536<br/>Hyperactivity of Somatotropes 536<br/>Hypoactivity of Somatotropes 536<br/>Gigantism 536<br/>Characteristic Features 537<br/>Acromegaly 537<br/>Characteristic Features 537<br/>Dwarfism 538<br/>Lorain-Levy Type (Infantilism) 538<br/>Brissaud Type (Fat Body of Dickens) 538<br/>Mixed Type 538<br/>Acromicria 538<br/>Preface to the Fourteenth Edition v<br/>Preface to the First Edition vi<br/>Thyrotropic Hormone or Thyrotropin or Thyroid-Stimulating<br/>Hormone (TSH) 538<br/>Chemistry 538<br/>Control of TSH Output 538<br/>Control of Thyrotropin-Releasing Hormone Output 539<br/>Gonadotropic Hormones (GTH) or Gonadotropins:<br/>FSH and LH 539<br/>Functions of FSH 540<br/>Functions of LH 540<br/>Prolactin (PRL) 540<br/>Control of Prolactin Secretion 540<br/>Reflex Stimulation of Prolactin 540<br/>Action of Prolactin 541<br/>Physiological Functions 541<br/>Central and Peripheral Organizations of Anterior<br/>Pituitary Hormones 541<br/>Mechanism of Releasing Factors 542<br/>Disorders of Pituitary Gland 542<br/>Pars Intermedia 544<br/>Pars Tuberalis or Infundibularis 544<br/>Structure and Functions of Neurohypophysis<br/>(Posterior Lobe) 544<br/>Posterior Lobe of Pituitary Gland 544<br/>Blood Supply 544<br/>Nerve Supply 545<br/>Synthesis, Transport and Storage of the<br/>Neurohypophyseal Hormones in the<br/>Hypothalamo-hypophyseal System 546<br/>Chemistry 546<br/>Vasopressin (Pitressin) 546<br/>Chemistry 546<br/>Synthesis 546<br/>Regulation of Secretion 546<br/>Units of Vasopressin 547<br/>Mode of Action 547<br/>Control of the Secretion of Vasopressin (ADH) 547<br/>Non-osmotic Stimuli of ADH Secretion 548<br/>Actions of ADH 548<br/>Applied Physiology 548<br/>Oxytocin (Pitocin) 548<br/>Source 548<br/>Synthesis 548<br/>Unit of Oxytocin 548<br/>Regulation of Secretion 548<br/>Control of Secretion of Oxytocin 548<br/>Actions of Oxytocin 549<br/>Integrative Action of Neuroendocrinology 550<br/>Introduction 550<br/>Conclusion 550<br/>Neuroendocrine Integration 551<br/>Exam-oriented Questions 551<br/>72. Thyroid Gland 552<br/>Introduction 552<br/>Anatomy 552<br/>Histology 553<br/>Contents<br/>viiiHuman Physiology<br/>Thyroid Hormones 554<br/>Synthesis, Storage, Release and Transport of Thyroid<br/>Hormones–Iodine Metabolism 554<br/>Synthesis of Thyroid Hormones 554<br/>Transport of Thyroid Hormones 554<br/>Degradation and Excretion of Thyroid Hormones 555<br/>Mechanism of Action of Thyroid Hormone via its<br/>Nuclear Receptors 555<br/>Iodine Requirement and Anterior Pituitary Control in<br/>Secretion of Thyroid Hormone 556<br/>Iodine 556<br/>Role of Anterior Pituitary 556<br/>Physiological Actions of Thyroid Hormones 556<br/>Regulation of Thyroid Hormones 557<br/>Functions of Thyroid Hormones 557<br/>Metabolism 557<br/>Thermogenesis and Body Weight 557<br/>Growth and Differentiation 557<br/>Cardiovascular System 559<br/>Central Nervous System 559<br/>Reproductive System 559<br/>Calorigenic Effect: Heat Regulation 559<br/>Relation with Vitamins 559<br/>Effect on Bone and Mineral Metabolism 559<br/>Secretion of Milk 559<br/>Other Functions 559<br/>Thyroid Disorders 559<br/>Hypothyroidism 559<br/>Cretinism 559<br/>Myxoedema 560<br/>Goitre 560<br/>Hyperthyroidism Thyrotoxicosis 561<br/>Graves’ Disease (Basedow’s Disease or<br/>Exophthalmic Goitre) 561<br/>Treatment of Thyrotoxicosis 562<br/>Thyroid Function Tests 562<br/>Blood Tests 562<br/>Autoimmune Markers 563<br/>Tests Based on Use of Nuclear Medicine 563<br/>Thyroid Ultrasound 563<br/>Fine Needle Aspiration Biopsy 563<br/>Thyrotropin-Releasing Hormone (TRH) Response<br/>Test 563<br/>Control of Thyroid Secretion and Endocrine<br/>Interrelationship 563<br/>Role of Anterior Pituitary 563<br/>Role of Sympathetic and Parasympathetic Nerves<br/>(Vasomotor Regulation) 563<br/>Stress Phenomena 563<br/>Thyroid–Gonadal Interrelationship 563<br/>Antithyroid Compounds 563<br/>Exam-oriented Questions 564<br/>73. Calcium Homeostasis: Role of Parathyroid Gland 565<br/>Calcium 565<br/>Sources 565<br/>Distribution of Calcium in the Body 565<br/>Blood Calcium 565<br/>Absorption of Calcium from the Gut 565<br/>Applied Physiology 566<br/>Calcium Excretion 566<br/>Calcium Balance 566<br/>Functions 566<br/>Daily Requirement 567<br/>Phosphorus 567<br/>Sources 567<br/>Distribution 567<br/>Blood Phosphorus 567<br/>Absorption 567<br/>Control of Phosphorus Metabolism 567<br/>Excretion of Phosphorus 567<br/>Functions 567<br/>Daily Requirement 568<br/>Relationship between Plasma Ionized Calcium and<br/>Phosphate 568<br/>Calcitriol 568<br/>Formation of Calcitriol 568<br/>Excretion 568<br/>Action of Calcitriol 568<br/>Therapeutic uses 568<br/>Functions of Calcitriol 568<br/>Role of Other Hormones in Regulating Calcium<br/>Metabolism 568<br/>The Parathyroid 568<br/>Anatomy 568<br/>Histology 569<br/>Parathyroid Hormone 569<br/>Control of Parathyroid Secretion 569<br/>Physiological Functions of Parathyroid Gland 569<br/>Tetany in Man 570<br/>Disorders of Parathyroid Secretion 571<br/>Calcitonin 572<br/>Introduction 572<br/>Chemistry 572<br/>Synthesis 572<br/>Regulation of Secretion 572<br/>Action of Calcitonin 572<br/>Bone 573<br/>Composition of Bone 573<br/>Structure of Bone 573<br/>Bone Formation and Resorption 573<br/>Functions of Bone 574<br/>Applied Physiology 574<br/>Exam-oriented Questions 574<br/>74. Pancreas 575<br/>Introduction 575<br/>Endocrine Pancreas 575<br/>Histology 575<br/>Nerve Supply 576<br/>Insulin 576<br/>Chemistry 576<br/>Synthesis, Storage and Release of Insulin 576<br/>Glucose Transporters 577<br/>Insulin Secretion 577<br/>Fate and Degradation of Insulin 578<br/>Regulation of Secretion of Insulin 578<br/>Control of Insulin Secretion 579<br/>Action of Insulin 579<br/>Glucose Tolerance Test 580<br/>Somatostatin 580<br/>Synthesis 580<br/>Action of Somatostatin 580<br/>Applied Physiology 580<br/>Pancreatic Polypeptide 580<br/>Secretion 580<br/>Action 580<br/>Applied Physiology 580<br/>Glucagon 580<br/>Synthesis of Glucagon 581<br/>Secretion of Glucagon 581<br/>Metabolism and Degradation 581<br/>Action of Glucagon 581<br/>Applied Clinical Physiology 581<br/>Applied Physiology 581<br/>Hypoglycaemia 581<br/>Hyperinsulinism 582<br/>Hyperglycaemia 582<br/>Glycosuria 583<br/>Diabetes Mellitus 583<br/>Exam-oriented Questions 586<br/>75. Adrenal (Suprarenal) Glands 587<br/>Anatomy 587<br/>Blood Supply 587<br/>Nerve Supply 587<br/>Adrenal Cortex 588<br/>Histology 588<br/>Active Principles of Adrenal Cortex and their Functions 588<br/>Active Principles 588<br/>Adrenal Corticoids 588<br/>Biosynthesis of Adrenal Steroid Hormones 590<br/>Transport, Metabolism and Excretion 590<br/>Mechanism of Action of Adrenal Steroids 590<br/>Functions of Adrenal Hormones 591<br/>Functions of Adrenal Cortex 591<br/>Hypofunction of Adrenal Cortex 592<br/>Addison’s Disease 592<br/>Hyperfunction of Adrenal Cortex 592<br/>Cushing’s Syndrome 592<br/>Hyperaldosteronism 593<br/>Adrenogenital Syndrome 593<br/>Laboratory Studies for Adrenocortical Functions 594<br/>Control of Cortical Secretion 594<br/>Hormonal Control 594<br/>Nervous Control 594<br/>Inorganic Control 594<br/>Blood Volume 595<br/>Mineralocorticoids 595<br/>Renin-Angiotensin Mechanism 595<br/>Function of Mineralocorticoids (Aldosterone) 595<br/>General Adaptation Syndrome 596<br/>Adrenal Medulla 597<br/>Histology 597<br/>Electron Microscopic Structure of Adrenal Medullary<br/>Cells 597<br/>Adrenal Medullary Hormones 597<br/>Biosynthesis of Adrenomedullary Hormones 597<br/>Release of Catecholamines 598<br/>Epinephrine (Adrenaline) 600<br/>Norepinephrine (Noradrenaline) 602<br/>Functions of Adrenal Medulla 603<br/>Applied Physiology 603<br/>Methods of Functional Study of Adrenal Medulla 603<br/>Endocrine and Metabolic Complications of Obesity and<br/>Metabolic Syndrome 605<br/>Psychiatric and Psychological Manifestation in Metabolic<br/>Syndrome 606<br/>Exam-oriented Questions 606<br/>76. Local Hormones 607<br/>Introduction 607<br/>Erythropoietin 607<br/>Physiological Basis 607<br/>Action 607<br/>Renin 607<br/>Histamine and Heparin 607<br/>Synthesis 607<br/>Action 607<br/>The Prostaglandins 608<br/>Chemistry 608<br/>Distribution 608<br/>Mode of Action 608<br/>Synthesis of Prostaglandins 608<br/>Actions 608<br/>Functions of Prostagladins 608<br/>Conclusion 609<br/>Serotonin 610<br/>Synthesis 610<br/>Actions 610<br/>Bradykinin 610<br/>Synthesis 610<br/>Actions 610<br/>Endothelins 610<br/>Synthesis 610<br/>Actions 610<br/>Atrial Natriuretic Peptide 610<br/>Synthesis 610<br/>Actions 610<br/>Adrenomedullin 611<br/>Adenosine Derivatives 611<br/>Gastrointestinal Hormones 611<br/>Exam-oriented Questions 611<br/>77. Thymus 612<br/>Introduction 612<br/>Anatomy 612<br/>Development 613<br/>Histology 613<br/>Blood Vessels and Nerve Supply 613<br/>Clinical Evidences of Thymic Function 614<br/>Applied Physiology 614<br/>Thymic Disorders and Genesis 614<br/>Exam-oriented Questions 614<br/>78. The Pineal Body 615<br/>Introduction 615<br/>Anatomy 615<br/>Histology 615<br/>Concretions 615<br/>Changes with Age 615<br/>Melatonin 615<br/>Control of Synthesis and Release of Melatonin 615<br/>Important Characteristics of Melatonin and Functions of<br/>Pineal Glands 617<br/>Exam-oriented Questions 617<br/>Clinical Case Scenario 618<br/>Section IX Reproductive System<br/>79. Gonads and Reproduction 622<br/>Introduction 622<br/>Gonadal Function 622<br/>Reproduction 622<br/>Puberty 623<br/>Puberty Changes 623<br/>Development of Gonads 623<br/>Applied Physiology 623<br/>Psychological and Clinical Correlation in Adolescence 624<br/>Genetic Basis of Sex Differentiation 624<br/>Sex Chromatin 625<br/>Chromosomal Abnormalities in Sex Differentiation 626<br/>Abnormalities due to Maternal Nondisjunction 626<br/>Abnormalities due to Paternal Nondisjunction 626<br/>Other Chromosomal Abnormalities in Sex<br/>Differentiation 627<br/>Sex Differentiation due to Hormones 628<br/>Practical and Psychiatric Implication of Sex<br/>Determination 628<br/>Exam-oriented Questions 628<br/>80. Male Reproductive Organs 629<br/>Introduction 629<br/>Testis 629<br/>Anatomy 629<br/>Histology 630<br/>Seminiferous Tubules 631<br/>Interstitial Cells (Cells of Leydig) 631<br/>Functions of Testis 631<br/>Androgens 632<br/>Chemistry and Varieties 632<br/>Sources 633<br/>ixContents<br/>x Human Physiology<br/>Biosynthesis of Androgens in the Testis 633<br/>Mode of Action of Testosterone and other<br/>Androgens 633<br/>Transport, Metabolism and Excretion of<br/>Testosterone 634<br/>Functions of Androgens: Testosterone 634<br/>Hormonal and Neural Control of Testosterone<br/>Secretion 636<br/>Other Testicular Hormones 636<br/>Life History of Spermatozoa (Sperms) 636<br/>Histology 636<br/>Spermatogenesis 638<br/>Stages of Spermatogenesis 639<br/>Control of Spermatogenesis 639<br/>Motility and Fertilizing Power of Sperm 640<br/>Fate of Spermatozoa 640<br/>Metabolism of Spermatozoa 640<br/>Hyaluronidase 640<br/>Fertilization of the Ovum 640<br/>Semen (Seminal Plasma or Fluid) 641<br/>Functions of the Constituents of Seminal Fluids 642<br/>Applied Physiology<br/>Impotence 643<br/>Male Sexual Act 643<br/>Hypogonadism 644<br/>Prostate 644<br/>Histology 644<br/>Functions 644<br/>Control of Prostate 644<br/>Proof 644<br/>Applied Physiology: Prostatic Hypertrophy 645<br/>Summary: Functions of Testosterone 645<br/>Exam-oriented Questions 646<br/>81. Female Reproductive Organs 647<br/>Introduction 647<br/>Anatomy 647<br/>Fallopian Tube 647<br/>Histology 647<br/>Cervix 648<br/>Vagina 648<br/>Ovary 648<br/>Structural Anatomy 648<br/>Histology 648<br/>Functions of Ovary 649<br/>Life History of Vesicular of Graafian Follicles 650<br/>Development and Histology 650<br/>Maturation of the Ovum 651<br/>Covering of the Ovum 651<br/>Control of Maturation of Ovum 651<br/>Ovulation 652<br/>Fertilization 654<br/>Implantation 654<br/>Fate of Graafian Follicles 655<br/>Functioning of Graafian or Vesicular Follicle 655<br/>Atretic Follicles 655<br/>Life History of Corpus Luteum 655<br/>Maintenance of Corpus Luteum 656<br/>Hypophyseal and Other Factors in Luteolysis 657<br/>Oestrogens 657<br/>Definition 657<br/>Types 657<br/>Synthesis of Oestrogens 658<br/>Metabolism and Excretion 659<br/>Mechanism of Action of Oestrogens 659<br/>Actions of Oestrogen 659<br/>Functions of Oestrogen 660<br/>Progesterone 661<br/>Sources 661<br/>Varieties and Chemistry 661<br/>Synthesis of Progesterone 662<br/>Metabolism and Excretion 662<br/>Mechanism of Action 662<br/>Action of Progesterone 662<br/>Functions of Progesterone 663<br/>Relaxin 663<br/>Androgens 663<br/>Control of Ovarian Functions 663<br/>Menstruation 664<br/>Definition 664<br/>Changes and Influence of Hormone in Menstrual<br/>Cycle 664<br/>Menopause or Female Climacteric 667<br/>Role of the Central Nervous System (CNS): In Hypophysealovarian Axis 668<br/>Exam-oriented Questions 669<br/>82. Pregnancy 670<br/>Introduction 670<br/>Physiological Changes during Pregnancy 670<br/>Other Changes 671<br/>Pregnancy Tests 671<br/>Biological Tests 671<br/>Placenta 672<br/>Formation and Development 672<br/>Histology 672<br/>Functions of the Placenta 673<br/>Hormonal Regulation in Pregnancy 676<br/>Exam-oriented Questions 677<br/>83. Parturition 678<br/>Introduction 678<br/>Process of Parturition 678<br/>Involution 679<br/>Applied Physiology 679<br/>Twins and Multiple Births 679<br/>Exam-oriented Questions 679<br/>84. Foetal Circulation 680<br/>Introduction 680<br/>Peculiarities in Foetal Circulation 680<br/>Course of Circulation 680<br/>Challenges of New Existence 682<br/>Changes in Circulation after Birth 682<br/>Changes in the Lungs and Respiration 683<br/>Cardiovascular System Status at Time of Birth 683<br/>Blood Cell Count in Newborn 683<br/>Gastrointestinal Functions in Newborn 683<br/>Renal Functions in Newborn 683<br/>Regulation of Body Temperature in Newborn 683<br/>Applied Clinical Physiology: Inborn Errors of Metabolism in<br/>the Newborn 684<br/>Galactosaemia 684<br/>Phenylketonuria 684<br/>Infancy 684<br/>Exam-oriented Questions 685<br/>85. Development of Breast and Lactation 686<br/>Introduction 686<br/>Control of Breast Development and Lactation 686<br/>Development of Mammary Glands 686<br/>Lactogenesis: Secretion of Milk 686<br/>Galactopoiesis (Maintenance of Lactation) 686<br/>Ejection of Milk 687<br/>Effects of Suckling 687<br/>Inhibition 688<br/>Colostrum 688<br/>Nutritional Needs of Infant 688<br/>Human Milk 688<br/>Applied Physiology 689<br/>Exam-oriented Questions 689<br/>86. Controlled Reproduction and Family Planning 690<br/>Introduction 690<br/>Physiological Methods 690<br/>Use of Some Barriers to the Entry of Sperms into the<br/>Cervix at the time of Coitus 690<br/>Use of Chemical Spermicidal Agents before or after<br/>Intercourse 690<br/>Interruption of Normal Paths of the Sperms or Ovum 691<br/>IUCD 691<br/>Contraceptive Pills 691<br/>Different Varieties of Pills 692<br/>Side Effects of the ‘Pills’ 692<br/>Infertility and IVF 692<br/>Infertility 692<br/>Procedure of IVF 693<br/>Role of IVF in Management of Infertility 693<br/>Other Methods 694<br/>Exam-oriented Questions 694<br/>Clinical Case Scenario 695<br/>Reproduction 695<br/>In Vitro Fertilization: 2010 Nobel Prize for Physiology and<br/>Medicine 695<br/>Section X Nervous System<br/>87. Introduction to Nervous System 698<br/>Introduction 698<br/>Central or Somatic Nervous System 698<br/>Spinal Cord 698<br/>Brain 699<br/>Meninges, Ventricles and Cerebrospinal Fluid 701<br/>Blood Supply 705<br/>Metabolism 705<br/>Exam-oriented Questions 705<br/>88. General Principles of the Nervous System 706<br/>Introduction 706<br/>Afferent and Efferent 706<br/>General Functions of Nervous System 706<br/>Classification of Neurotransmitters 707<br/>Nature of Transmission in the CNS: Small Molecule<br/>Transmitters 707<br/>Acetylcholine: Cholinergic Transmission 707<br/>Central Adrenergic Transmission: Epinephrine and<br/>Norepinephrine 709<br/>Dopamine 709<br/>Other Transmitters 709<br/>Role of other Neuroactive Peptides: Large Molecule<br/>Transmitters 711<br/>Applied Physiology 711<br/>Exam-oriented Questions 711<br/>89. Synapse 712<br/>Introduction 712<br/>Classification 712<br/>Anatomical Classification 713<br/>Physiological Classification 713<br/>Anatomical Structure of the Synapse 713<br/>Mechanism of Synaptic Transmission 714<br/>Neuromuscular Junction 715<br/>Excitatory and Inhibitory Postsynaptic Potentials 715<br/>Excitatory Postsynaptic Potential (EPSP) 715<br/>Inhibitory Postsynaptic Potential (IPSP) 715<br/>Properties of Synapse 716<br/>Synaptic Response 716<br/>Law of Forward Conduction (Sherrington) 716<br/>Synaptic Delay 716<br/>Seat of Fatigue 716<br/>Synaptic Inhibitions 716<br/>Convergence and Divergence of Nerve Impulses 717<br/>Synaptic Block 717<br/>Summation 717<br/>Occlusion 718<br/>Ephaptic Transmission 718<br/>Synaptic Plasticity 718<br/>Applied Physiology: Synaptopathy 719<br/>Exam-oriented Questions 719<br/>90. Nerve Endings and Receptors 720<br/>Definition 720<br/>Histology 720<br/>Functions 720<br/>Receptors 720<br/>Receptor as a Biological Transducer 722<br/>Initiation of Impulse in Sensory Receptors 722<br/>Source of Generator Potential 723<br/>Mechanism of Initiation of Generator Potential 723<br/>Properties of Receptors 723<br/>Classification and Varieties of Nerve Endings 724<br/>General Senses 725<br/>Myotactic or Stretch Reflex 727<br/>Mechanism of Stretch Reflex 727<br/>Summary 728<br/>Receptors 728<br/>Motor Endings 728<br/>Exam-oriented Questions 728<br/>91. Reflex Action 929<br/>Definition 729<br/>Varieties of Reflexes 729<br/>Reflex Arc 729<br/>Varieties of Reflex Arc 729<br/>General Characteristics of Reflex Action 730<br/>Irradiation 730<br/>Delay 730<br/>Summation 730<br/>Occlusion 730<br/>Subliminal Fringe 730<br/>Facilitation 730<br/>Inhibition 731<br/>Recruitment 731<br/>After-discharge 732<br/>Fatigue 732<br/>Reciprocal Innervations 732<br/>Rebound Phenomenon 733<br/>Unconditioned Reflexes 733<br/>Classification of Reflexes 733<br/>Superficial Reflexes 733<br/>Deep Reflexes or Tendon Reflexes 734<br/>Patellar Tendon Reflex or Knee Jerk 734<br/>Reflex Path 734<br/>Ankle Jerk 735<br/>Stretch Reflex (Myotatic Reflex) 737<br/>Importance of Stretch Reflex 737<br/>Electrophysiology of Spinal Reflexes 737<br/>Monosynaptic Reflex 737<br/>Polysynaptic Reflex 737<br/>Withdrawal Reflexes 737<br/>Motor Unit and Electromyogram (EMG) 739<br/>EMG 739<br/>Applied Physiology: Startle Reflex 741<br/>Exam-oriented Questions 741<br/>92. Sensory Systems 742<br/>Introduction 742<br/>Sensory Mechanism 742<br/>Properties of Sensations 742<br/>Modality 742<br/>Quality 742<br/>Intensity 742<br/>Adaptation 743<br/>xiContents<br/>xiiHuman Physiology<br/>Extent 743<br/>Duration 744<br/>Localisation or Projection 744<br/>Classification of Sensations 744<br/>General Sensations 744<br/>Pain 746<br/>Theories of Pain 747<br/>Pain Pathway 748<br/>Itch and Tickle 751<br/>Applied Physiology 751<br/>Pain Management 751<br/>Exam-oriented Questions 752<br/>93. Arrangement of Grey and White Matters in the<br/>Spinal Cord 753<br/>Introduction 753<br/>Central Canal 753<br/>Grey Matter 753<br/>White Matter 754<br/>The Spinal Nerve 754<br/>Mixed Nerves 754<br/>Anterior Spinal Root 754<br/>Posterior Spinal Root 754<br/>Distribution of the Terminal Branches of Spinal Nerves 754<br/>Exam-oriented Questions 755<br/>94. The Ascending and Descending Tracts 756<br/>Introduction 756<br/>Definition: Tracts 756<br/>Ascending Tracts (Sensory Tracts) 756<br/>Descending Tracts (Motor Tracts) 757<br/>Ascending Tracts (Afferent Tracts) 757<br/>Afferent Tracts in the Posterior Column (Funiculus) 757<br/>Afferent (Sensory) Tracts in the Lateral Column 759<br/>Afferent (Sensory) Tracts in the Anterior Column 761<br/>Summary of the Pathways of Various Sensations 762<br/>How Posterior Spinal Root Ends? 763<br/>Descending Tracts 765<br/>Motor Tracts or Efferent Tracts 765<br/>Pyramidal or Corticospinal Tracts 765<br/>Corticobulbar (Corticonuclear) Tracts 769<br/>Extrapyramidal Tracts 770<br/>Rubrospinal Tract (Monakow’s Bundle, Prepyramidal<br/>Tract) 770<br/>Tectospinal Tract and Tectobulbar Tract 770<br/>Reticulospinal Tracts 771<br/>Vestibulospinal Tracts 772<br/>Olivospinal Tract (Bulbospinal Tract or Tract of<br/>Helweg) 773<br/>Descending Medial Longitudinal Fasciculus 773<br/>Functions of Extrapyramidal Tracts 773<br/>Intersegmental Fibres (Both Ascending and Descending<br/>Fibres) 773<br/>Effects of Section of the Anterior Root 774<br/>Degenerative Changes 774<br/>Functional Changes 774<br/>Effects of Section of the Posterior Root 774<br/>Degenerative Changes 774<br/>Effects of Section of the Mixed Spinal Nerve 774<br/>Degenerative Changes 774<br/>Functional Changes 774<br/>Hemisection of the Spinal Cord 774<br/>Degenerative Changes 774<br/>Functional Changes 775<br/>Regional Peculiarities of Hemisection of the Spinal<br/>Cord at Different Levels 776<br/>Applied Considerations on Spinal Transections 776<br/>Complete Transection of the Spinal Cord 776<br/>Incomplete Transection of the Spinal Cord 777<br/>Spinal Animal (Animal with Transection of the Spinal<br/>Cord) 777<br/>Effects of Lesions at Various Levels of the Central<br/>Nervous System 777<br/>Lemniscus or Fillet 778<br/>Definition 778<br/>Varieties 778<br/>Exam-oriented Questions 778<br/>95. Brainstem 780<br/>Introduction 780<br/>Midbrain (Mesencephalon) 780<br/>Red Nucleus 781<br/>Connections 781<br/>Characteristic Features of Red Nucleus 782<br/>Functions of Red Nucleus 783<br/>Superior Colliculi 783<br/>Pons Varolii 783<br/>Anatomy 783<br/>Function 784<br/>Medulla Oblongata (Spinal Bulb) 784<br/>Anatomy 784<br/>Function of Medulla Oblongata 785<br/>Exam-oriented Questions 789<br/>96. Cerebellum 790<br/>Anatomy 790<br/>Anatomical Classification 790<br/>Functional and Morphological Subdivision of<br/>Cerebellum 790<br/>Phylogenetic Subdivisions 791<br/>Functional Subdivisions 791<br/>Cerebellar Nuclei 791<br/>Histology 792<br/>Connections 794<br/>Inferior Cerebellar Peduncle (Restiform Body) 794<br/>Middle Cerebellar Peduncle (Brachium Pontis) 795<br/>Superior Cerebellar Peduncle (Brachium<br/>Conjunctivum) 796<br/>Functions of Cerebellum 797<br/>Role of Archicerebellum (via Vestibulocerebellum<br/>and Spinocerebellum Connections) in Maintenance<br/>of Posture and Equilibrium 797<br/>Role of Paleocerebellum (via Spinocerebellar<br/>Connections) in Maintenance of Muscle Tone 797<br/>Role of Neocerebellum in Control of Movements 797<br/>Comparator of a Servomechanism 798<br/>Cerebellum Learning 798<br/>Other Cerebellar Functions 799<br/>Applied Clinical Physiology: Cerebellum 799<br/>Cerebellar Lesions 799<br/>Exam-oriented Questions 800<br/>97. Thalamus 801<br/>Introduction 801<br/>Connections 802<br/>Medial Nuclear Mass 802<br/>Lateral Nuclear Mass 802<br/>Midline Nuclei 803<br/>Intralaminar Nuclei Group 803<br/>Pulvinar Nuclei 803<br/>Functions of the Thalamus 803<br/>Applied Physiology 804<br/>Thalamic Syndrome 804<br/>Prion Disease 804<br/>Exam-oriented Questions 805<br/>98. Mammillary Bodies and Internal Capsule 806<br/>Introduction 806<br/>Internal Capsule 806<br/>Applied Physiology 806<br/>Exam-oriented Questions 806<br/>99. The Basal Ganglia 807<br/>Introduction 807<br/>Characteristics of the Basal Ganglia 807<br/>Interconnections 807<br/>Basal Ganglia Connections of Physiological Importance 808<br/>Corpus Striatum 809<br/>Anatomy 809<br/>Connections of the Corpus Striatum 809<br/>Substantia Nigra 809<br/>Connections of Substantia Nigra 809<br/>Body of Luys or Corpus Luysi (Subthalamic<br/>Nucleus) 809<br/>Functions of the Basal Ganglia 810<br/>Applied Physiology 810<br/>Clinical Manifestations Associated with the Diseases<br/>of the Basal Ganglia 810<br/>Parkinsonism: Paralysis Agitans 810<br/>Progressive Hepatolenticular Degeneration or<br/>Wilson’s Disease 811<br/>Chorea 811<br/>Athetosis 811<br/>Torsion Spasm 811<br/>Hemiballismus or Hemichorea 812<br/>Exam-oriented Questions 812<br/>100. The Reticular Formation 813<br/>Introduction 813<br/>The Ascending Reticular Activating System 813<br/>Wakefulness and Alertness 813<br/>Feedback Theory for the Maintenance of Activation<br/>of the Reticular Activating System 814<br/>Applied Physiology 814<br/>The Descending Reticular System 814<br/>Descending Inhibitory Reticular Projection 815<br/>Descending Facilitatory Reticular Projection 815<br/>Functions of the Reticular Formation 815<br/>Exam-oriented Questions 816<br/>101. Muscle Tone and Posture 817<br/>Introduction 817<br/>Muscle Tone 817<br/>Posture 818<br/>Postural Mechanism 818<br/>Afferent Impulses for Muscle Tone and Posture 818<br/>Higher Centres for Muscle Tone and Posture 818<br/>Thalamic Animal (Vide Functions of Thalamus) 819<br/>Decerebrate Preparation 819<br/>Determination of Posture and Distribution of Muscle<br/>Tone 820<br/>Autogenic Inhibition: Clasp-knife Reflex 821<br/>Midbrain Component 822<br/>Inputs from Vestibular System 822<br/>Flexion Reflexes 822<br/>Spinal Preparation 822<br/>Supraspinal Control of the Stretch Reflex in Relation to<br/>Muscle Tone and Posture 823<br/>Postural Reflexes and Postural Connection 825<br/>Righting Reflexes and Postural Connection 825<br/>Control or Co-ordination of Willed Movement 826<br/>Exam-oriented Questions 827<br/>102. Vestibular Apparatus 828<br/>Introduction 828<br/>Functions of Vestibular Apparatus 830<br/>Vestibular Function Tests 830<br/>The Semicircular Canals 830<br/>Anatomy 830<br/>Histology 831<br/>Mode of Action 833<br/>Functions 833<br/>The Otolithic Organ 833<br/>Anatomy 833<br/>Histology 833<br/>Mode of Action 833<br/>Functions 834<br/>Unilateral Extirpation of the Labyrinths 834<br/>Bilateral Extirpation of the Labyrinths 835<br/>Applied Physiology 835<br/>Exam-oriented Questions 835<br/>103. Path of Vestibular Impulse 836<br/>Introduction 836<br/>Vestibulospinal Tract (from Deiters’ Nucleus) 837<br/>Habituation 837<br/>Exam-oriented Question 837<br/>104. Cerebrum 838<br/>Introduction to Evolution 838<br/>Anatomy 838<br/>Grey Matter (Cortex) 839<br/>White Matter 840<br/>Structure of the Cerebral Cortex and Functions of its<br/>Different Layers 840<br/>Regional Peculiarities 841<br/>Functions of Different Layers of the Cerebral Cortex 843<br/>Functions 843<br/>Localisation of Brain Function 843<br/>Methods of Localisation of Functions in the Cerebral<br/>Cortex 843<br/>Areas and Centres in the Cerebral Cortex 844<br/>Frontal Lobe 844<br/>Precentral Cortex (Areas 4, 6, 8, 44) 844<br/>Prefrontal Cortex (Areas 9, 10, 11, 12, 32) 845<br/>Connections of the Prefrontal Lobes 846<br/>Connections between Different Lobes 846<br/>Functions of the Prefrontal Lobes 846<br/>Applied Physiology: Effects of Removal of the Prefrontal<br/>Lobes 847<br/>Frontal Lobe and the Seat of Intelligence 847<br/>Parietal Lobe 848<br/>Sensory Areas (Areas 3, 1 and 2) 848<br/>Motor Area (Adversive) 848<br/>Temporal Lobe 849<br/>Sensory Area (Auditosensory) 849<br/>Association Area (Auditopsychic) 849<br/>Motor Area (Adversive) 849<br/>Applied Physiology: Temporal lobe Syndrome 849<br/>Occipital Lobe 849<br/>Sensory Area (Visuosensory) 849<br/>Association Area (Visuopsychic) 849<br/>Motor Areas 850<br/>Functions of the Cerebrum 850<br/>Motor Functions 850<br/>Seat of Conditioned Reflex 850<br/>Sensory Functions 850<br/>Intellectual Functions 851<br/>Electrical Activity of the Cerebral Cortex 851<br/>Electroencephalography 851<br/>Applied Physiology: Electroencephalogram (EEG) 851<br/>Electroencephalogram (EEG) 851<br/>Conclusion 855<br/>Physiological Basis of EEG 856<br/>Evoked Cortical Potentials 856<br/>Other Types of Electrical Activity in the Cerebral<br/>Cortex 856<br/>Applied Physiology 857<br/>Brain Death 858<br/>Introduction 858<br/>Exam-oriented Questions 859<br/>xiiiContents<br/>xivHuman Physiology<br/>105. Limbic Lobe and Limbic System 860<br/>Introduction 860<br/>Afferent and Efferent Connections of Limbic System 860<br/>Interconnection 860<br/>Functions of the Limbic System 860<br/>Applied Physiology 861<br/>Exam-oriented Questions 861<br/>106. Speech 862<br/>Introduction 862<br/>Centre 862<br/>Development of Speech 862<br/>Applied Physiology: Aphasia 862<br/>Classification of Aphasia 863<br/>Head’s Classification of Aphasias 864<br/>Exam-oriented Questions 864<br/>107. Neurophysiology of Learning and Memory 865<br/>Introduction 865<br/>Learning 865<br/>Classical Conditioning of Pavlov 865<br/>Development of Conditioned Reflexes 866<br/>Classifications 867<br/>Conditioned Excitatory Reflexes 867<br/>Conditioned Inhibitory Reflexes 867<br/>Functions of Conditioned Reflexes 868<br/>Effects of Drugs upon Conditioned Reflexes 868<br/>Operant Conditioning 868<br/>Condition Avoidance or Avoidance Conditioning 868<br/>Instrumental Conditioning or Learning 868<br/>Discrimination Learning 868<br/>Physiological Basis of Conditioned Reflexes and<br/>Learning 869<br/>Memory and its Neurophysiological Basis 869<br/>Experimental Evaluation: Memory Consolidation and<br/>Storage 870<br/>Mechanism of Memory Encoding, Consolidation and<br/>Storage 870<br/>Applied Physiology 871<br/>Exam-oriented Questions 871<br/>108. Sleep 972<br/>Introduction 872<br/>Sleep Rhythm 872<br/>Sleep Requirement 872<br/>Depth of Sleep 872<br/>Physiological Changes during Sleep 872<br/>Behavioural and EEG Changes during Sleep 873<br/>Types of Sleep 873<br/>Normal Sleep 873<br/>Role of Neuronal System in Sleep-Wakefulness<br/>Cycle 873<br/>Theories of Sleep 874<br/>Feedback Theories of Wakefulness and Sleep 874<br/>Applied Physiology 874<br/>Exam-oriented Questions 875<br/>109. Emotion 876<br/>Introduction 876<br/>Behavioural Changes in Emotion 876<br/>Neural Control of Emotion 876<br/>Hypothalamus 876<br/>Thalamus 877<br/>Cerebral Cortex and Limbic System 877<br/>Papez Circuit: Physiological Basis of Emotion 877<br/>Applied Physiology 878<br/>Exam-oriented Questions 878<br/>110. Cerebrospinal Fluid 879<br/>Introduction 879<br/>Character 879<br/>Composition 879<br/>Formation of Cerebrospinal Fluid 879<br/>Rate of Formation 879<br/>Circulation 880<br/>Nervous and Humoral Factors Controlling the<br/>Formation and Circulation of the Cerebrospinal<br/>Fluid 880<br/>Absorption 880<br/>Mechanism of Absorption 880<br/>Functions of Cerebrospinal Fluid 881<br/>Applied Physiology: Lumbar Puncture 881<br/>Ventriculography 881<br/>Hydrocephalus 881<br/>Blood–CSF and Brain Barrier 881<br/>Blood–Cerebrospinal Fluid Barrier 881<br/>Blood–Brain Barrier 882<br/>Cerebrospinal Fluid–Brain Barrier 882<br/>Exam-oriented Questions 882<br/>111. Autonomic Nervous System 883<br/>Introduction 883<br/>General Considerations 883<br/>General Arrangement 883<br/>Dual Supply 885<br/>Sympathetic (Thoracolumbar) System 885<br/>Sympathetic Ganglia 885<br/>Sympathetic Outflow 886<br/>Gastrointestinal Tract 888<br/>Parasympathetic (Craniosacral) System 888<br/>Parasympathetic Outflow 888<br/>Spinal Parasympathetic 890<br/>Higher Autonomic Centres 891<br/>Functions of Sympathetic and Parasympathetic<br/>Systems 891<br/>Control of the Autonomic Nervous System 893<br/>Nervous Control 893<br/>Applied Physiology 896<br/>Exam-oriented Questions 896<br/>112. Hypothalamus 897<br/>Introduction 897<br/>Nuclei of Hypothalamus 897<br/>Connections of Hypothalamus 897<br/>Afferent Connections 897<br/>Functions of Hypothalamus 899<br/>Controls the Autonomic Nervous System 899<br/>Takes Part in Regulation of Body Temperature 899<br/>Controls Emotions 899<br/>Related to Hunger Feeding, Obesity and Thirst 900<br/>Controls Circadian Rhythm 900<br/>Controls Sleep Wakefulness Cycle 900<br/>Maintenance of Homeostasis 900<br/>Regulation of Water Balance 900<br/>Regulation of Posterior Pituitary Gland Activity 901<br/>Regulation of Pituitary Gland Activity 901<br/>Cardiovascular Regulation 902<br/>Relation with Stress through Neurohormonal<br/>Mediation 902<br/>Applied Physiology 902<br/>Hypopituritarism 902<br/>Common Causes of Hypothalamic Dysfunction 902<br/>Recent Advances 902<br/>Hypothalamus and Odour Response 902<br/>Exam-oriented Questions 903<br/>113. Neurosecretion 904<br/>Introduction 904<br/>Modern Concept of Neurosecretion 904<br/>Nature of Neurosecretory Cells 904<br/>Significance of Neurosecretory Cells 904<br/>Exam-oriented Questions 904<br/>114. Cranial Nerves 905<br/>Introduction 905<br/>Applied Anatomy and Physiology 909<br/>Other Disorders of CNS 909<br/>Exam-oriented Questions 910<br/>Clinical Case Scenario 911<br/>Central Nervous System 911<br/>Section XI Special Senses<br/>115. Senses of Taste 914<br/>Introduction to Special Senses 914<br/>General Characters 914<br/>Taste (Gustation) 914<br/>Primary Taste Sensations 914<br/>Tongue 915<br/>Papillae and Histology of Tongue 915<br/>Taste Buds 915<br/>Histology 915<br/>Distribution 915<br/>Varieties 915<br/>Nature of Stimuli 915<br/>Receptor Stimulation 915<br/>Basic Modalities of Taste 916<br/>Chemical Constitution Related to Taste 916<br/>Threshold of Primary Taste Sensations 916<br/>Factors Influencing Taste Sensations 916<br/>Path of Taste Impulses 917<br/>Applied Physiology 918<br/>Exam-oriented Questions 918<br/>116. Sense of Smell (Olfaction) 919<br/>Introduction 919<br/>Olfactory Mucous Membrane 919<br/>Olfactory Epithelium 919<br/>Olfactory Receptors 920<br/>Olfactory Bulb 921<br/>Olfactometer 921<br/>Physiology of Olfaction 921<br/>Olfactory Discrimination 921<br/>Olfactory Adaptation 922<br/>Chemical Compounds and their Relation to Olfactory<br/>Sensation 922<br/>Relation of Odorous Substances 922<br/>Pathways of Olfactory Impulses 922<br/>Olfactory System: Primitive and New Olfactory<br/>System 922<br/>Pathophysiology of Altered Smell Sensation 923<br/>Exam-oriented Questions 924<br/>117. Physiology of Vision 925<br/>Introduction 925<br/>Tunics 925<br/>Conjunctiva 925<br/>Lacrimal Apparatus 925<br/>Eyeball 926<br/>Refractive Media of the Eyeball 926<br/>Optical Arrangement of the Eye 928<br/>Cornea 928<br/>Functions 928<br/>Histology 928<br/>Nutrition of Cornea 929<br/>Aqueous Humour 929<br/>Composition of Aqueous Humour 929<br/>Flow of Aqueous Humour 930<br/>Functions 930<br/>Aqueous Veins 930<br/>Crystalline Lens 930<br/>Histology 930<br/>Function 931<br/>Nutrition of Lens 931<br/>Vitreous Humour (Vitreous Body) 931<br/>Functions 931<br/>Blood-Vitreous Barrier 932<br/>Control of Eye Movement 932<br/>Co-ordination of Eye Movements 932<br/>Nervous Control 932<br/>Intercommunication of the III, IV and VI Cranial<br/>Nerve Nuclei 933<br/>Effects of Section of III Cranial Nerve 934<br/>Effects of Section of VI Cranial Nerve 935<br/>Effects of Section of IV Cranial Nerve 935<br/>Iris 935<br/>Effects of Sections 936<br/>Functions of Iris 936<br/>Pupil 938<br/>Functions of Pupil 938<br/>Pupillary Reflexes 938<br/>Argyll Robertson Pupil 940<br/>Accommodation 940<br/>Definition 940<br/>Mechanism of Accommodation 940<br/>Nerve Path for Accommodation Reflex 941<br/>Common Errors of Refraction 941<br/>Spherical Aberration 943<br/>Chromatic Aberration 944<br/>Applied Physiology: Contact Lens 944<br/>Advantages of a Contact Lens 944<br/>Retina 944<br/>Anatomy 944<br/>Histology 944<br/>Regional Peculiarities of the Retina 946<br/>Blood Supply of the Retina 947<br/>Functions of the Retina 947<br/>Rods and Cones 947<br/>Fine Structure 947<br/>Formation of an Image on the Retina 950<br/>Effects of Light on the Retina 950<br/>Phototransduction 950<br/>Photochemical Changes 950<br/>Neurophysiology of Vision 951<br/>Electrical Activity in the Retina 951<br/>Electrophysiological Changes 952<br/>Spectral Sensitivity: Scotopic Vision and Photopic<br/>Vision 953<br/>Light and Dark Adaptation 953<br/>Light Adaptation 954<br/>Visual Acuity 954<br/>Snellen’s Test Type 954<br/>Ophthalmoscopy 955<br/>Modern Ophthalmoscope 955<br/>Retinoscopy 955<br/>Field of Vision 955<br/>Definition 955<br/>Extent 955<br/>Mapping of the Field of Vision (Perimetry) 956<br/>xvContents<br/>xviHuman Physiology<br/>B |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc | Nitin Ashok John MD,DIH,FPGDMLE,PGDHA is currently Professor and Head, Department of Physiology,and Dean (Examination),All India Institute of Medical Sciences, Bibinagar, Hyderabad. Earlier, he was Professor and Head, Department of Physiology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, UP. He did his MBBS from Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, and MD from Indira Gandhi Government Medical College,Nagpur.In addition,he has received the Fellowship from Royal Society of Biology (London), Fellowship from Royal Society of Public Health (London) and Fellowship of Academy of Medical Educators (Cardiff). He has also completed his Post Graduate Diploma in Medical Law and Ethics from NLSU Bangalore, DIH from Annamalai University, Post Graduate Diploma in Hospital Administration from Algappa University and MA in Public Administration from Nagpur University. He has 27 years of standing experience in the medical profession which includes 23 years of experience as faculty and 4 years as medical officer/private practitioner.He has been the UG–PG assessors for Medical Council of India 2011–2019 and is the UG–PG assessor for National Medical Commission, New Delhi, 2019 onwards; President,Association of Physiologists of India,UP Chapter (2019-2020); Finance Secretary,Association of Physiologists of India (2014–2016); and member of various international and national scientific societies. He has conducted and supervised around 30 research projects including 8 funded projects and delivered more than 50 guest lectures at national and international levels at various scientific meetings. He has to his credit over 80 research papers published in national and international journals and written 8 textbooks in physiology. He is dedicated academician,excellent orator,excellent teacher and administrator,as well as author par excellence. |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc | Prof Nitin John took the challenge of editing the eleventh edition to match the prescribed syllabus and twelfth edition of CC Chatterjee’s Human Physiology was brought out in 2018. As the Medical Council of India recommended the Competency Based Curriculum, the thirteenth edition was structured to match the newly designed curriculum. The inputs flowing in from the academicians across the country were taken into consideration and the fourteenth edition of the book has been written as per the Competency Based Curriculum now adopted by National Medical Commission.<br/><br/>Salient Features of the Fourteenth Edition<br/>Text has been simplified and moulded into easy to understand and lucid language for a clear conceptual understanding of the subject.<br/>Recent advances have been added and facts of applied physiology updated throughout the text.<br/>Diagrams have been modified and simplified.<br/>Exam-oriented questions have been introduced to serve the requirements of the students.<br/>A number of new multiple choice questions has been added and others updated.<br/>Topics of exercise physiology, hemoglobin, red blood cells, white blood cells, coagulation, immunity, cardiac output, regulation of blood pressure, hypoxia, regulation of respiration, renal function test, glomerular filtration rate, regulation of body temperature, growth hormones, calcium metabolism, thyroid hormones, adrenal gland, family planning methods, synapses,pain, sleep, hypothalamus,cerebellum,basal ganglia,autonomic function tests,eye and ear have been updated for quick understanding and recapitulation<br/>Applied topics such as diabetes, obesity, pancreatic transplantation, types of exercises, dialysis, family planning methods and disorders associated with central nervous system has been restructured and made concise.<br/>Clinical Case Scenarios,an important component of the latest curriculum adopted by National Medical Commission, shall be immensely helpful in excelling for the candidates preparing for PLAB UK examination, USMLE and examinations of the Medical Councils of the other South East Asian countries.<br/>Historical features and scientific findings have been depicted in the text appropriately. |
| 856 ## - ELECTRONIC LOCATION AND ACCESS | |
| Uniform Resource Identifier | <a href="Physiology">Physiology</a> |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) | |
| Source of classification or shelving scheme | Dewey Decimal Classification |
| Koha item type | General Books |
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