PHYSIOLOGY day 2 second sem

MAG ARAL NA TAYO SECOND SEM NA =)

MAG SHARE NG TRANS KUNG AYAW NIYO BUMAGSAK KAYO,
BWAHAHAHAH. sarap kaya pumasa nang nag shashare kaysa
nagdadamot na bumagsak . bwahaha. chos lang =)

Proprioception= is transmitted at the spinal cord at the dorsal column. A

good deal of this go to the cerebellum; but some of them pass via the
medial lemniscal and the thalamic radiation to the cortex.
The organs that are involved are the:
A) slowly adapting spray ending =this are structures that resembles the
golgi tendon organ and probably the pacinian corpuscles but they are
located in the synovial and the ligaments. So impulses from these spray
endings, the touch receptors in the skin and other tissues together with
muscle spindles they are synthesize in the cortex in a conscious pattern in
the position of the body in space.
The organ involve in proprioception is the spray ending.
For temperature, experiments shown there are discrete cold sensitive and
warm sensitive spots in the skin, which is different from each other but are
located in discrete portions of the skin. There are 4 to 10x more cold spots
than warm spots.
The temperature sense organ is the naked nerve ending that respond to
absolute temperature, not to the temperature gradient across the skin.
a) The cold receptors respond to temperature between 10-40 C
b) The warm receptors respond to temperature between 30- 45 C
The afferent nerves for cold receptors are the A gamma and c fibers, while
the afferent nerves for warm are the C fibers.
This afferent relay information passes information to the post center gyrus

of the brain via the lateral spinothalamic tract and thalamic radiation.
These sense organs for temperature are located subepithelially.
The temperature of the subcutaneous tissue determines the response of this
sense organs; its not the temperature in the skin.
Below the skin temperature of 20C and above 40 C there will be no
adaptation, but between 20 and 40 C there is adaptation.
Above 45 C tissue damage will start and the sensation is not anymore warm
or cold but of pain.
Pain sensation:
Sense organ is the naked nerve ending, found in almost every tissue of the
body. this pain impulses it transmitted to the CNS by 2 types fibers:
1) Small myelinated A gamma fibers- 2-4 nanometer in diameter. one that
conducts at a rate of 12-30meters/sec
2) unmyelinated C fibers- minute fibers. 0.4-1.2 nanometer. Found in the
lateral division of the dorsal root also called dorsal root C fiber. This C
fibers that conduct pain in slow rate 0.5-2 meters/sec.
Both of this fiber groups
a) The A gamma fiber =terminate directly in neurons in lamina 1and 5.
b) The dorsal C fibers=terminate in neuron in lamina 1 and 2.
*The synaptic transmitter that is secrete by the primary afferent fibers
is substance P.
2 types of pain
1) Fast pain (1st)- due to activity in A gamma pain fibers
2) Slow pain (2nd)- due to activity in the C pain fiber
The farther from the brain is the stimulus is applied, the greater is the
temporal separation of the 2 components. If there is damage of the
thalamus this may be associated with the peculiar over reaction to painful
stimuli. A minor stimuli will lead to a prolonged severe and unpleasant
pain, t his condition is thalamic condition"

Deep pain- this is poorly localize, nauseating, and associated to sweating,

changes of BP. This pain is located deep in the body, they may produce
neurogenic shock.
In pain perception there is what is called adequate stimulus. Pain receptors
are pain is not produce by over stimulation of other receptors. Example you
want to produce pain, you stimulated the touch receptors thus it will not
produce pain. But there is "adequate stimulus for pain receptor although it
is not as specific as the other receptors because it can be stimulated by
variety of strong stimuli.
Pain receptors react to heat, to several others like, mechanical, electrical,
and especially chemical. Because pain is chemically mediated and the
stimuli that provoke it has the ability to liberate chemical agents that
stimulates the nerve endings.
The chemical agent that is connected with pain are:
=Kinin or histamine.
Muscle pain= when the muscle is made to contract with blood supply
occluded, or it is made to maintain contraction without any period of
relaxation in between this will compress the blood vessels supplying the
muscle so muscle pain is produce because of the release during contraction
of a chemical agent "Lewis's P factor" this causes pain if its local
concentration is high enough, when the blood supply is occluded, Or the
material is wash out or metabolize.
Hyperalgesia= a pathologic condition wherein the sensitivity of pain
receptors are altered.
2 types:
1) primary= area surrounding or injured area of body is the one that shows
this phenomena, and the threshold of pain is lowered so that just a little
stimuli will cause pain. This is due to substance P produce by antitromic
impulses in the primary afferent fibers
2)secondary= seen in the area affected itself, the threshold of pain is

elevated but the pain that is produce is unpleasant, prolonged, and very
severe. The area from which this response is obtain can extend well beyond
the site of injury, and the condition may not last like the primary. This is
due to central facilitation by impulses of the injured area of the pathways
that are responsible for the unpleasant afferent components of pain, and it
may be spinal subluminal frince effect or at the thalamic or even at the
cortical level where it happens.
Difference between somatic and visceral sensory mechanism.
=The viscera- it is similar to the skin but there are marked differences to
their distribution. There are no proprioceptions in the viscera and there are
few temperature and touch sensations in these organs.
Pain receptors are also in the viscera but sparsely distributed that in the
somatic structures there are certain types of stimuli that causes severe pain
in the viscera.
Afferent fibers from visceral structures reach the CNS via sympathetic and
parasympathetic pathways and their cell bodies are located in the dorsal
roots of the spinal cord and the homologous cranial nerve ganglia.
Specifically there are viscera afference- in the facial nerve, glossparyngeal
nerve, and vagus nerve; there are Also from the thoracic and upper lumbar
dorsal roots, and in the sacral roots.
There are also visceral fibers from the eyes through the trigeminal nerve.
Some substance P containing afference can also make connections via
collaterals to the post ganglionic sympathetic neurons like the inferior
mesenteric ganglia.
In the CNS visceral sensation travels in the same pathways as the somatic
sensation. This travel through the spinothalamic tract and the thalamic
radiation, and the cortical receiving areas for visceral sensations are located
intermixed with the somatic receiving areas or located in the post central
gyrus. So they follow the same pathway as the somatic sensation.

Visceral pain= is poorly localized but can be very severe. The receptors on
the hollow viscera are specially sensitive to distention of the organ , and the
pain may wack and wayne? can go off and on thus called " intestinal
colic"
Traction in the mesenteric also cause severe pain, visceral pain also has
reflex connections that can even initiate nausea, vomiting, and other
autonomic effects because of reflex mechanism.
Visceral pain like deep somatic pain initiates reflex contraction of nearby
skeletal muscles. So this is usually in the muscle of the abdominal wall and
makes the abdominal rigid when there is severe visceral pain. It is most
marked when theres visceral inflammatory process that involve the
peritoneum like patient with peritonitis, the spasm is very severe we call it
muscle Guarding" which is 1 sign of acute inflammation of the
peritoneum.
Classic sign of inflammation in abdominal viscera
=pain,tenderness, hypotension, spasm, sweating.
We also have referred pain= if there is an irritation of the viscera, this
frequently produces pain felt not in the viscera itself but in other organs
that with considerable distance away. When the visceral pain is both local
and referred it sometimes seems to spread and we call it radiating pain;
from the local to the distant site.
Examples:
=When there is pain in the tip of the shoulder due to the irritation of the
center tendon of the diaphragm. That is a referred and radiating pain.
=Pain in the testes due to distention of the ureter.
When pain is referred= usually refers the pain to a structure that develops
in the same embryonic segment or dermatome. The referred pain is usually
to a structure that developed to the same structure where the pain originates
called "Dermatomal rule"

Role of experience- important in referred pain, usually in the midline in

patients who had abdominal surgery due to referred of their surgical scar
called role of experience in visceral pain"
Role of convergence- there are more sensory fibers in the peripheral nerve
than there are axons in the spinothalamic tract. So there is a considerable
degree of convergence of peripheral sensory fibers on the spinothalamic
neuron.
1 theory of the mechanism of referred is based in this rule. So If 1 viscera is
sub serving pain and converging to other pain areas of the body then due to
convergence the pain from that viscera would be referred to that part of the
body that it converged.
Subliminal fringe effect?= incoming impulses from the visceral structures
will lower the threshold of this spinothalamic neuron receiving the afferent
somatic areas so that minor activity in the pain pathways from the somatic
areas passes on to the brain. So even the stimuli from the somatic area or
pain is very minimal because they converge in the spinothalamic tract, the
threshold for pain in the fibers carrying pain from the somatic area, the
threshold may be lower because of the pain from the viscera would be
referred to somatic area where it converge called Facilitation effect
Example:
= Pain in angina pectoris, it can be referred to left upper arm
Pain transmission or perception is also subjected to inhibition or
modification
Central inhibition and counter irritants= pain transmission and
perception is subject to inhibition or modification. So inhibition in central
sensory pathways may explain the efficacy of counter irritants that we use
for peripheral pain.

One site of inhibition of pain transmission is the dorsal horn because it is

the gate where the pain impulse reaches the lateral spinothalamic system.
So stimulation of large fiber afference from an area from which pain is
being initiated reduces the pain. And collateral fibers from the dorsal root,
like touch fibers will also enter the substantia gelatinosa and impulses from
this collaterals are interneurons from which they end and they inhibit the
transmission from the dorsal root pain fibers to the spinothalamic neurons.
There are opioid receptors in the substantia gelatinosa and it may be in this
substance P containing terminals of the nociceptive afference that inhibits
the substance P release. Thats why morphine is a strong analgesic
Others sensations:
a) Itch and tickle=There are itch spots, there are many naked nerve
ending of the unmyelinated fibers. The C fibers responsible are not
the same as that which is responsible for pain.
b) Synthetic senses= separate receptors exist like touch, warm, itch,
pain, if there is a combination of these sensation patterns of
stimulation and in some of them will cause cortical compensation
and they are synthesize to sensations of "vibratory
sensibility/sensation"
*The receptors involve in the vibratory sensibility are the receptors for
touch specially the pacinian corpuscle which are also carried in the dorsal
column of the spinal cord.
2 point discrimination= minimal distance by which 2 touch stimuli must
be separated in order to be perceive as separate. Magnitude varies from
place to place in the body, and the 2 point threshold is smallest when the
touch receptors are most abundant.
Stereo gnosis= ability to identify objects by handling them without looking
at them. This is impaired when there is lesion in the parietal lobe posterior
to the post central gyrus.

Special senses:
Vision:
a) retina= is organized in 10 layers and contains the rods and the cones
rods and cones= which are next to the choroid synapse with the bipolar
cells , then the bipolar cell synapse with the ganglion cells. The axon of the
ganglion cells converge and leave the eye as the optic nerve
4 types of neurons in the retina besides rods and cones
1) bipolar nerve
2) ganglion cells
3) horizontal cells= one that connect the receptor cell to the other receptor
cells in the outer plexiform layer
4) amacrine cells=connects the ganglion to one another in the inner
plexiform layer. Sometimes it can be inserted between bipolar cells and
ganglion cells. These cells have no axons and their processes make both
pre and post synaptic connections with neighboring neural. And there
considerable overall convergence of receptor on the bipolar cells and the
ganglion cells.
Since the of receptor layer the retina is closely connected to the choroid,
the light rays must pass through the ganglion cells and the bipolar cell
layers in order to reach the rods and cones.
The neural elements of the retina is bounded together by glial cells called
muller cells which is a type of glial cells; this glial cell form the skeleton
network of the nervous system.
At the posterior pole of the eye, there is a yellowish pigmented spot which
is called the macula lutea. This marks the location of the fovea centrallis
which is a thin portion of the retina that has no rods, where the cones are
densely packed, and there are few cells and no blood vessels that overly the
receptors. This is the point of greatest visual acuity.
Neural pathways for vision:
Axons of the ganglion cells will pass caudally or backward s in the Optic
nerve to the optic tract to end in the lateral geniculate body in the thalamus.

The fibers in each nasal hemi retina will deposate in the optic chasm. Know
in the genicuate body, the fibers in the nasal half of one retina and the
temporal half of the other will synapse on the cells whose axons form the
genitocalcaline tract. Passes to the occipital lobe of the cerebral cortex.
*Primary visual receiving area is the visual cortex in the brodmanns area
17 located in the sides of the calcarines fissure.
Each rods and cones are divided into a inner and outer segment that
includes a nuclear region and a synaptic zone.
=Outer zone contains modified cilia and made up of regular stacks of
flattened saccules and disk that is compose of membrane. This saccules and
disk contains the photosensitive pigments, and the inner is segment are
fixed with mitochondria.
In the fovea centralis has no rod. Each fovea has a single bipolar cell that
connects to a single ganglion cell so that each is connected to a single fiber
in the optic nerve.
In other portion of the retina, the rods predominate and there is a good deal
of convergence.
There are about 6 million cones and 120 million rods in each area, but only
1.2 million nerve fibers in each optic nerve.
Rods= sensitive to light thus are receptors to night vision "scotopic vision"
is not capable to resolving details and boundaries of object, or not also
capable of determining the color of the object.
Cones= much higher threshold, much greater acuity, and responsible to
vision in bright light "photopic vision" , and also responsible to color
vision.
duplicity theory = The existence of the 2 kinds of inputs rods and cones

each works maximally in their difference condition of illumination.

Accomodation= process where the curvature of the lens of the eye is
decrease for near vision.
Nearvision or near point= is the nearest point to the eye at which the
object may be brought to clear focus by accommodation.
Near response= when you see a near object, the eye does 3 activities:
1) accommodation
2) constriction of pupil
3) convergence of the near axis
*When is light directed to 1 eye=constriction "pupillary light reflex"
Consensual light reflex= the pupil of the other eye also constrict when the
other eye is lighted.
The optic nerve fibers that carry the impulse initating the pupillary
response also end in the propectal region and the superior foliculi. And the
pathway for the light reflex passes to the pretactal region to the
occulomotor nuclei or they go to Edinger-westphal nuclei bilaterally and
is different to accommodation.
Argyll robertson pupil=abnormally wherein the light reflex are absent but
the accommodation is intact. Due to a destructive lesion to the pectal region
of the brain.

Nodal point= Optical center of the eye which concise to the junction of the
middle and posterior 3rd of the lens. Normally about 15 millimeters from
the retina. Point where light rays from an object will pass without
refraction. All are reflected and brought to focus only in the retina
Common defects in the image forming mechanism:
1) hyperopia- eyeball is shorter than normal so the parallel rays of light
brought to focus behind the retina; corrected by convex lenses to aid the
refracted power of the eye to shortening the focal distance.
2) myopia- the anteroposterior diameter of the eyeball is too long than
normal. Said to be genetic in origin; corrected by biconcave lenses to make

the parallel rays of light diverge before they enter the eye
3) astigmatism- curvature of the cornea is not uniform. Part of the retinal
image is blurred; corrected by cylindrical lenses that are place to equalize
the reflection to all meridians
4) presbyopi- lost of accommodation, reading and close work is difficult,=
occurs in 40 to 45 years old.
Photoreceptors mechanism:
=The potential changes that initiate the action potential in the retina are
generated by the action of light in the photosensitive in the rods and cones.
When light is absorbed in substances, their structure changes and this
change will trigger a sequence of events that initiate the neural activity or
action potential.
=The receptors are local, graded, only in the ganglion cells that follow the
all or none law.
=The response is hyper polarizing or depolarizing, while the response of
the bipolar cells are either hyperpolarizing or depolarizing. whereas the
amacrine cell produce depolarizing potential and spikes that may act as
generator potentials for the Propagated spikes that are produce in the
ganglion cells.
The cones= receptors have sharp onset and offset of action potential.
The rods= has slow offset of action potential.
The sodium channels in the outer segments of the rods and cones are open
during dark. So the current will flow from inner to outer segment. current
also flow in the synaptic endings of the photo receptors. The NA/k
exchange pumps, the inner segment will maintain the ionic equilibrium.
When the light strike the outer segment some of the NA channels are close,
and the result is hyperpolarization receptor potential.
The hyperpolarization will decrease the release of synaptic transmitters and
will generate a signal that leads to action potential of the ganglion cells.
The action potential are transmitted to brain and steady release of
transmitter in the dark and the hyper polarization inducethe light reduces
the transmitter release. These photosensitive compounds in the eye are:
1)opsin
2)retinene 1= is the aldehyde of vitamin A. They are also called retinols.
The photosensitive pigments in the rods are called rhodopsin= has peak
sensitive to light with a wave length of 105 nanometers.

The light energy activates rhodopsin and triggers the formation of series of
intermediates. One of this is Metarhodopsin II which appears to be the
key compound in initiating the closure of the NA channel in the rods.
Bleaching - The final step is the separtion of the retinine 1 from the opsin.
Some of the rhodopsin is regenerated directly while some of the retinene
1is reduced by alcohol dehydrogenase. It will be reduced to vitamin A1.
And this intern reacts to the exotocin to form rhodopsin again.
Linkage between rhopodsin and NA channel exceed. When there is
activation of rhodopsin this will activate transducin which a G protein that
is also is called G1. This will bind the And activates the
phospodiastibase that catalyzes the cyclic GNP to 5 GNP.
3 types of cones= these receptors sub serve color vision, and they respond
maximally to light at wave length 440-535-565 nanometer wavelength.
Each of these cones contains retinene 1 and opsin. The opsin resembles
rhodopsin,
Light activates retinine 1 and then activates G2; g2 activates
phosphodiasterase which catalyzes the convertion of cyclic GNP to cyclic
GNP. This results to closure of the NA channel between the extra cellular
fluid and the cones cytoplasm.
There will be a rise of the intracellular sodium and hyper polarization of the
cone; Outer segment will takes place.
There is a congenital defect in the cones and rods opsins that leads to
condtiion where the pigment acumulate in the retina and eventual
blindness. This is the end result of different inherited genetic defects Called
retinitis pigmentosa
Synaptic mediators in the retina are:
-somatostatin
-TRH
-RH
-Enkephalins
-CCK
-BIP
-glucagon
-neurotensin
-acetylcholine
-dopamine
-serotonin

-glycine
-glutamate
-GABA
-substance P
-B endorphins
The amacrine cell, is the only cell that secrete acetylcholine in the retina
Peptides are found in different population of amacrine cells.
Process of image formation involves formation of 3 images
1)1st by the action of light in the photosensitive receptors
2)2nd in the bipolar cell= the signal is altered by the horizontal cell
3) 3rd in the ganglion cell= altered by amacrine cells
*the 3rd image that will reach the occipital cortex.
ERG "electroretinography"
=recording of the electrical of the eye.
Turning off the light elicits an A and B type of waves also C waves which
so slow with short stimuli, the pea koccurs after the end of the stimulus.
The ganglion cells, their axons projects a detailed special representation of
the retina on the lateral geneculate body. Each geneculate bodies consist of
6 well defined layers.
Layer 3 to 6 has small cell called parvocellular
Layers 1 and 2 cells called magnocellula;
These are the layers of cell in the geneculate body
In each side, layer 1,4, 6 receive inputs in the contralateral eye. Where as
2,3,5 received input in the ipsilateral eye.
2 types of ganglion cell:
1) large ganglion cells " Y cells"= add responses from different kinds
of cones, so they are concerned with movements and stereo gnosis.
=goes to the magnocellular.
2) Small ganglion cells "x cells"= they subtract input from 1 type of
cone to another, so they are responsible for color vision.
=Will project to the barcocellular layer.
Visual cortex has 3 layers:
=axons from lateral veniculate neuron= ending in yyramidal cells in layer
4, and layer 4-C. cell from layer 4-C inturn will project to layer 4B and
layer 2 and 3.
Layer 2 and 3contain cluster of cell about 0.2 nanometer in daiamter, and
contains high concentration of mitochondrial cenzyme called cytochrome
oxidase. These clusters are Called blobs.

Interblob regions- areas between blobs

Primary visual cortex= located in brodmanns area 18
Color vision:
Characteristics of color:
1) Hue
2) Intensity
3) Saturation= degree of freedom from dilution with white
For any color, there is complementary color, that when it is mix it will
produce white. Black is produce when absence of light but is also a positive
sensation because Blind eye dont see black, it sees nothing. The sensation
of white
Primary color.
=Red,blue,yellow
The color perceives depend in the other color present in the visual field.
Example:
=a red color is seen as red when the background is illuminated with blue or
green; but pink or white if the illumination is red.
Young-helmholtz theory- there are 3 different kinds of cones and each of
this containing different photo pigment and they are maxilly sensitive to the
1 of the 3 primary colors. With the sensation of any given color being
determined by the relative frequency of the impulses from each of this cone
system.
The genes of human rhodopsin is in chromosome 3
The blue sensitive cones is on chromosome 7
The other 2 cone pigments are encoded in the genes that are arranged in
tandem on the A arm of X chromosome.
Color blindness
Routine test
1) Yarn-matching test= match the color of the yarns
2) Ishihara charts= chart that has number, different colors, and
backgrounds
Suffixes:
1) anomaly- means weakness of color vision
2) anoxia- means color blind

Prefixes:
1) Prot- defficinet in red
2) Deuter-defficient in green
3) Tri- defficient in blue
Trichromat= person who is normal or he is a protanomaly, deotanomaly,
trinanomaly. They all have 3 cone system but 1 of them maybe weak.
Dichromats= only 2 cone system.
Monochromats= only 1 cone system, or sometimes absent of all.
If person spends considerable length of time in a brightly lighted place then
go to the dim lighted environment, the retina will slowly becomes sensitive
to light as the individual becomes acoustic to the dark. This decline to the
visual threshold is called dark adaptation. Nearly maximal about 20
minutes.
Person goes from Dim to light environment, eyes adapts and visual
threshold rises called Light adaptation. Nearly maximal about 5 minutes.
Faster than dark adaptation.
If a patient is deficient in vitamin A, he can have:
=Nyctalopia "night blindness"- most common
Vitamin B Complex also necessary.
=Nicotinamide plays in the interconvertion of retinene and vitamin A in the
rhodopsin cycle.
*In normal visual, we need the vitamin A and B complex.
When you try to stare fixedly to a stationary object then makes continuous
jerky movements, the eye will tend to fix in that object by rapid motion
called physiologic nystagmus
Visual acuity= degree of details and contour of image is perceived. How
clear you see the object
Visual threshold= minimal amount of light that elicits the sensation of
light
Minimum separable= shortest distance by which 2 lines can be separated
but still can be perceive as 2 lines.
Snellen letter chart= determines visual acuity. Viewed to a distance of 20
feet

Critical fusion frequency- rate wherein the stimuli are presented and still
perceive as separate stimuli.
*The stimuli presented at higher rate than the critical fusion frequency are
perceived as continuous stimulus. There must be 32 pictures that passes
to your eye in 1 second in order to see it as continuous
Visual fields- area that the eye see
The peripheral portions of the visual field is measured by Perimeter by a
process called perimetry
The central visual field is mapped by tangent visual screen.
Objective scotomas= if the blind spots in the visual field is due to disease.
Scotoma= there are area in the visual field that is blind.
Binocular vision= the impulse sent up in the 2 retinas by the light rays
from an object are fused at the cortical level in to a single image by a
process called fusion.
Corresponding points = Points in the retina which image must fall if its
too be seen binocularly as a single object.
Diplopia= if 1 eye is gently push out of the line while starring fixedly to an
object in the center of the visual field.