41. Cell membrane protects the cytoplasm and the organelles present in the cytoplasm. [2 Gelli ¢ 2. Cell membrane acts as a sable membrane. \L_ + Nutrients are absorbed into the cell through the cell membrane, m the cell are excreted out through the cell membrane, the cell membrane. 7 bese 6. Cell membrane is responsible for the maintenance of shape and size of the cell. U “ jis responsible fon aS : Basic Science Note [First Year) B.Pharma Lecture Note A. Coll rembronie: _~ [General Physiology] ; Ce plosme ene marae protective sheath af the cll body. tis also known a plasms membrane or fluid inside the cell cacy an’ SeParates the flud outside the cell called extracellular uid [ECF] and membrane is composed OF Pree fuid ICE), The cell membrane is a semipermeable membrane. Cell Pie aia (ae [55%], Lipids [40%] and Carbohydrates (5%). The Electron lipid substances. Then other tee layers of cell membrane, The central layer isa lipid layer formed by — The central Hpi layer eee protein lavers formed by proteins. : PhospholipidstandhCholecrect a bislayered structure. Major lipids present on cell membrane are acids. Aminophospho lipids, sphi hospholipids-are the lipid substances containing phosphorus and fateys Serine and phosphatidylinog oe ees phosphatidyl choline, phosphatidy glycerol, phosphatidyl Part of the phospholipid molar cats phosPholipds present in lipid layer of cell membrane, The outer portion. Head portion is theca called the head portion andthe inner portion i called the til (hydrophilic). Tal portion epoch ands soluble in water and has strong affinity for water {hydrophobic}. Two layars of eo, end and is insoluble in water and repelled by water meetin the center of rhe sof Phosphotplds are arranged in such a way that the hydrophobic tail portions BrOaisiccnohens, rane. Similarly cholesterol molecules are arranged in between the Pi * rotein layers cover the two surfaces of the central lipid layer. The protein substances present in vese layers are mostly glycoproteins. - Inte; i oe Sr tranamembrane proteins: They are the proteins that pass through entire thickness of cell embrane from one side to the other side. These proteins are tightly bound with the cell membrane Ex: Cell adhesion proteins and Cell junction proteins. - Peripheral or Peripheral membrane proteins: They are the proteins which are partially embedded in the outer and inner surfaces of the cell membrane and do not penetrate the cell membrane. Peripheral proteins are loosely bound with integral proteins or lipid layer of cell membrane. Ex: Proteins of cytoskeleton . Functions of Proteins in Cell Membrane «_Lntegral proteins provide the structural of the cell membrane. _2-Channel proteins help in the diffusion of water soluble substances like glucose and electrolytes. 3,€arrier proteins help in the transport of substances across the cell membrane by means of active or Passive transport eee proteins serve as the receptor sites for hormones and neurotransmitters. 6 Carrier proteins act as antigens and induce the process of antibody formation. 6 The integral proteins are responsible for attachment’of cells to their neighbors or to basal lamina. {Note: Cell is defined as the structural and functional ut of the living body.} inction of Cell ine: 4. Metabolites and other was! 5. Oxygen enters the cell from the blood and carbon dioxide leaves the cell and enters the blood through 7 od and carbon dioxid«B Pharma Lecture Note E |_ “iv. tt supports for acceleration of gluconeogenesis from fats & degradation of purihe to uric acid, ¥. Itssupports for the formation of myelin protein & bile salts, * Mitochondria: It is a membrane bound cytoplasmic organelle concerned with production of energy. It is @ rod-shaped or oval-shaped structure. It is covered by a bi-layered membrane. The outér membrane is smooth and contains various enzymes such as acetyl-CoA synthetase and glycerol phosphate acetyl transferase. The inner membrane is folded in the form of shelf-like inward projections called cristae and it covers the inner matrix space. Cristae contain many enzymes such as Succinic dehydrogenase, Dihydro- nicotinamide adenine dinucleotide dehydrogenase, Cytochrome oxidase which are involved in Fespiration and synthesis of ATP. Mitochondrion contains its own deoxyribonucleic acid which is responsible for synthesis of various energy forms. Dezeoesate le scars : ‘ochondrion is called the Power house of the cell because it produces the energy required for cellular functions. The energy is produced during the oxidation of digested food particles like proteins, carbohydrates and lipids by the oxidative enzymes in cristae.. . 2 The components of respiratory chain in mitochondrion are responsible for the synthesis of ATP by utilizing the energy by oxidative phosphorylation. 3.1 's for storage of calcium and detoxification of ammonia in liver, ~ # Ribosomes: They are the organelles without membrane. These organelles are granular structures. They are made up of 35% of proteins and 65% of ribonucleic acid. RNA present in ribosomes is called tibosomal RNA. Ribosomes are concerned with protein synthesis in the cell. Ribosomes are called Protein factories because of their role in the synthesis of proteins. Messenger RNA carries the genetic code for Protein synthesis from nucleus to the ribosomes. Ribosomes attached to rough endoplasmic reticulum are invotved in'the synthesis of proteins such as the enzymatic proteins, hormonal proteins, lysosomal Proteins and the proteins of the cell membrane. Free ribosomes are responsible for the synthesis of Proteins in hemoglobin, peroxisome and mitochondria C. Nucleus: It is the most prominent and the largest cellular organelle. Nucleus is present in all the cells in the body except the red blood cells. The cells with nucleus are called eukaryotes and those without nucleus are known as prokaryotes. Presence of nucleus is necessary for cell division, It is mostly spherical jin shape. Nucleus is covered by a membrane called nuclear membrane. Major components of nucleus are nucleoplasm, chromatin and nucleolus. Nuclear membrane is porous in nature. Pores in nuclear membrane helps for exchange of - materials between nucleoplasm and cytoplasm. Nucleoplasm is a highly viscous fluid that forms the “ground substance’ of the nucleus. The nuclear matrix forms the structural framewark for organizing * chromatin. Chromatin is a thread-like material made up of large molecules of DNA. DNA is a double helix which wraps around central core of eight histone molecules to form the fundamiental packing unit of ~ chromatin called nucleosome. Nucleolus is a round granular structure of the nucleus which plays an essential role in the formation of proteins. slats.B.Pharma Lecture Note 5 ‘Transport Mechanism through Cell Membrane: Structure of the cell membrane is well suited for the transport of substances in and ‘out of the cell. Lipids and proteins of cell membrane play an important role in the transport of various substances between ” extracellular fluid (ECF] and intracellular fluid [ICF]. The basic mechanisms which are involved in the cue of substances across the cell membrane areas: 2 1. Passive transport: It is the movement of substances along the cancentration gradient or electrical Bradient. it does not need energy. Passive transport includes diffusion-and-osmosis mechanistn. a : Diffusion mechanism also sub categorizes into simple diffusion and facilitated diffusion * mechanism = - . - ae ~ Simple diffusion: itis a net mavement of molecules from cegion of higher concentration to the region” of lower concentration. Sybstances that can cross cell membrane through De eae ‘xygen, carbon dioxide, alcohol, cholesterol, steroid and hormones, Simple diffusion is a slow process and depends on: : #Concentration of gradient of substances Velocity of kinetic motions ‘Relative solubility of substances Diffusion coefficient of substances in the membrane ~ Facilitated diffusion: Facilitated or carrier-mediated diffusion is the type of diffusion by which the + —water soluble'substances such as Glucose and amino acids are transported through the cell membrane with the help of a carrier pratein. Glucose or amino acid molecules cannot diffuse directly through the cell membranous channels because the diameters of these molecules are larger than the diameter of the cell membranous channels. Therefore they. aly ind with carpacmcotsin which causes conformational change on structure of carrier protein then they can release on ICF. b. Osmosis: It is defined as the movement of water or any other solvent from an area of lower concentration to an asaaof higher concentration of a solute through a semipermeable membrane. The semipermeable me! ae permits the water molecules but not the solutes. Qsmosis depends upon fsmotic pressure, Osmosis across the cell membrane is of two types: eEndosmosis: Mavement of water into the cell © Exosmosis; Movement of water out of the cell, 2. Active transport: f substances against the chemical or electrical or electrochemical gradient. Active transport requires energy which is obtained mainly by breakdown of high unds like adenosine triphosphate (ATP]. Carrier proteins involved in active transport are as: ‘© Uniport: Carrier protein that carries only single substance in a single direction. Ex: Transport of glucose to the erythrocytes. ‘© Symport: Carrier protein that transports two different substances iaghe-same-disection. €x: Transport of Na" and glucose to the intestinal mucosal cells from the gut ‘© Antiport: Carrier protein that transports two different substances in opposite directions, Ex: Chloride- bicarbonates exchange in RBC. Ex: Exchange of CI and HCO; in the erythrocytes * . Primary active transport: It is the type of transport mechanism in which the energy is liberated fre e breakdown of ATP. The substances like sodium, potassium, calcium, hydrogen and chloride are transported across the cell membrane by this method. ¥ Basic Science Note [IB.Pharma.Lecture Note For ‘example: Sodium-Potassium Pump which transports sodium from inside to outside the cell and potassium from outside to inside the cell t i b. Secondary active transport: It is the transport of a substance with sodium ion by means of a common Lots a Bil sodium is transported bya cartier protein then another substance is also Weer 'e same protein simultaneously either in the same direction or in the opposite direction. fore secondary active transport occurs through Sodium Co-transnort or Sodium Counter transport ate is the process by which the substances are transported along with the sodium i protein called as symport. The amino-acids and sugars are transported into the * ny by a Na* co-transport system. ‘ lac mi ere ai ttis the process by which the substances are transported across the cell aoa st soditim ions by carrier protein called antiport. For example, Sodium-hydrogen hvdrogetions ow in which the sodium ions move'from tubular lumen into the tubular cells and the /e from tubular cell into the lumen. 3. Vesicular transport: The vesicular transport is categorized into endocytosis and exocytosis transport mechanism. a. Endocytosis: itis defined as a transport mechanism by which the macromolecules enter the cell Macromolecules [substances with larger molecules] cannot pass through the cell membrane either by active or by passive transport mechanism. —Pinocytosis: It is a process by which macromolecules like bacteria and anti cells. It is also called as cell drinking. = Phagocytosis: It is the process by which particles larger than the macromol Cells. Itis also called as cell eating. Larger bacteria and larger antigens are taken inside the cell by means ‘of phagocytosis. Human body cell such as Neutrophils, Monocytes and the tissue macrophages show phagocytosis. ecules are engulfed into the . Exocytosis: It is the ptocess by which the substances are expelled from the cell. In this process the substances are extrude from cell without passing through the cell membrane. This is the reverse of endocytosis. It is also called as cell vomiting. [Note: Cartier protein of active transport needs energy whereas the corrier protein of facilitated diffusion does not need energy) > Homeostasis: it refers as the maintenance of constant internal environment of the body. Itis the mechanism on which the system reacts in such a way to arrest the change > Negative feedback: yn of change. The common examples for negative feedback mechanism are as: or reverse the directior i, Secretion of thyroxine 4 ji, Maintenance of water balance ili, Maintenance of body temperature Body temperature is a physiological variable controlled by negative feedback which prevents problems due to it becoming too high or too low. When body temperature falls below the present level then stimulus is detected by specialized temperature sensitive nerve endings in the hypothalamus of the brain which form the control center. aise‘unjsseio4 ‘wnipos ‘seouersqns 214032041 “it ‘awAzv3 ‘Seuousoy ‘span ‘spe Axed ‘spe oul ‘2502/9 :saauedsqns 21UeH0 “I : sem! -jyBiam Apog at jo 965s J0 51515009 1 SPINE JeINNSIEANU “ siujoful piny lemouss~ map roseaa {4501 piny reurds0ga189 - _[piny jeauoysaa pu pr TerpTEDTag] PIN sH0%05 - : :se ypns piny seynjaasuedt”A sanssj) anyoauuod asvap Ul pind sau0g ut eu ‘ydusAy pue piny jennsz0nut “| 1uBiem Apog je103 249 Jo 5p JO 4S1SUOD SPINY JE|MIFODCANA “V _ {PINE Apog jo WoRisoao> Jays pd Uys 210W 5 [9N9] Hd UUM “SISOFEMIY ~ ual £2 mojag 51/949] Hd UOUAA 'SISOPIBV ~ ‘aouejeq a5¢q pppe Jo s49pu0siG ZA wsarsis sang ~ "waists Azer) Thaasts Aroyewdsoy - ‘a8 sed se yan: ‘2nuejeq 9seq pve wlewieul yey) swiayshs 29.4) 21 {Jo Ha uyervyews 0} paiznba uo} aseq pue pire ayy uasmiag ones jeuuou oy sdois 5} upovixo jo aseaj24 242 y>ivm 03 amp 1980 ou sayy unoge| jow sasne> a Siow Aajewyjn uous. “svordores y>i2As Bu won2e siys “upo.Ax0 auoilioy 943 Aa ‘anjedau ayy ueys Younwo> $5} 51 PAPI} BAIS vhom e pn ul 13802 WOISAS ax IY UO WwSIUeYpauH 24) aur aseai5u ona ewniou ye aunyessduai Apod ay 35022 Teiajays Jo uonejnuys se vans aumesedivo1 APO.B.Pharma Lecture Note % (Human Histology] histology are tissue preparation, ~ Histology is microscopic study of normal tissueS, Techniques used in ene eGo , staining, counter staining, slide preparation, light microscopy, abe be RGF Tsar tn Lk SPeCiaizeg Tissue: A tissue is defines as group of cells that may.be or may not be ; to perform specific functions outside as well as vari {: Epithelial tissue; This group of tissue form covering of various peti ats with’no intercélluliy internal organs and body spaces inside. The cells are very closely packe rcingsubtohecd ieee ame Substance or matrix between them. The cells are held together by a ceme! Carbohydrate derivatives and usually ie on a basement membrane. Epithelial tissues are F . Secretary, Glandular. and Sensory on function. Epithelial Tissue Nr eer hae oe Keratinised Stratified Simple Epit thelial Tissue Stratified Epithelial Tissue Epithelial Tissue Simple Sqamous_ Epithe! Stratified Cuboidal Epithelial Tissue Epithelial Tissue Simple Columnar Stratified Columanr Epithelial Tissue Epithelial Tissue , Pseudo Stratified Columnar Ciliated Epithelial Tissue Transitional Epithelial Tissue Simple epithelium: it consists of single layer of identical cells. itis usually found on absorptive or Secretary surfaces with a single layer on body surface. very smooth membrane. This type of tissue is present in heart & blood vessels [endothelium], vessels, alveoli of the lungs, bowman capsule in kidneys, 2. Columnar Epithelium Tissue: This is also formed by a single layer of cells which is rectangular in shape & lie on a basement membrane. It is found on lining of Stomach, Gastric glands, Intestinal glands, Gall = bladger, Ureter and Uterine wall. Mucus gland present on this gland is a thick sticky substance secreted by modified columnar cells called goblet cells, secretion, absorption and excretion, 4. Pseudo Stratified Columnar Ciliated Epithelium: This is formed by columnai fine hair-like processes called cilia. The cells are deep b microtubules inside the plasma membrane which are e) cells. This type of tissue is found on lining of uterine tui uterine tubes the cilia propel ova towards the uterus a1 towards the throat. n cells which have many ut don’t reach the free surface. The cilia consist of border of the columnarB.Pharma Lecture Note eine epithelium: stratified epithelia consist of Several layers of cells of various shapes. The upper ‘ayered cells are formed by multiplication of lower layer. Therefore lower layers are called gerthinative layer. The basal cells are only rest on the basement membrane. Its main function is to protect underlying ~ Structures from mechanical wear and tear. 1. Stratified Squamous E , i consists of large fat pon Pithelium: it is composed of a various number of layers of cells. Its upper layer lygonal s " : columnar, squamous cell, However lower layers the cells are either cuboidal or may be subjected to we, ified Epithelium Tissue: This type of tissue is found on wet surfaces of body that due to absence of kerce ar ag tear.sThe upper layer has living cell without keratin whiledower layer wet B. Keratinized Suede = Conjunctiva of eyes, lining of mouth, pharynx, esophagus and vagina. tear. The surface’ Pithelium Tissue: This is found on dry surfaces that are subjected to wear and “yer consists of dead épithelial cells with keratin. This forms a tough, relatively water Proof protective layer that prevents drying of underlying living cells. E.g. skin, hair and nails. 2. Stratified cuboidal epithelium Tissue: Cuboidal cells while germinative layer cor ~ epithelium is found on lining of ducts of It is the type of tissue in which outermost layer consists of sists of either columnar or squamous tissue. This type of Sweat gland, Salivary glands, pancreatic gland, 3. Stratified columnar e} pithelium: It is the type of tissue in which outermost layer consists of columnar cells while germinative | layer consists of either cuboidal tissue. This type of epithelium is found on lining Of ducts of Mammary gland, lining of Vasa differentia, Trachea & Bronchi. 4. Transitional epithelium [Urothelium]: This is composed of several layers of pear-shaped cells. The Cells of its upper surface are dome shaped, middle layers are club shaped and basal layer are cuboidal or rounded. It is present on lining of the urinary bladder and urthary tract. It allows for stretching of wall of urinary bladder when itis filled with urine. nective tissue: Connective tissue is the most abundant tissue in the body. The cells forming “onnective tissues have intercellular substance [matrix] in larger amounts. Fibers which may present in its matrix are semisolid jelly-like consistency or dense and rigid depending upon the position and function of tissue. Its major functions are Binding and structural support, Protection, Transport and Insulation. Type of cells found in connective tissue: > Fibroblasts: Spindle shaped cell which helps to produce collagen and elastic fibers. > Fat cells [Adipocytes]: Bone cklls [Osteocytes]: Cartilage cells [chondrocytes] > Macrophages: Amoeboid polymorphic cell which are actively phagocytic and has role in immunity. > Mast cells: Oval shaped cell which helps to produce granules containing heparin and histamine which are released when the cells are damaged by disease or injury. > Blood cells: RBC, WBC8 Pharma Lecture Note . Connective Tissue . : . id connective Supportive connective Proper connective» Ful ‘dente tissue tissue Bone Cartilage lymph Blood | ~ Loose Connective Tissue sas Dense Connective Tissue . 1 Areolarconnective Adipose connective Fibrous jeonneatye Elastic connective tissue tisssue : > to0se Connective Tissue: 1. Areolar connective tissue: It is found in almost every part of body. The matrix is semisolid It content Fibroblasts, fat cells, mast cells and macrophages widely separated by elastic and collagen fibers..It Provides elasticity and tensile strength. itis found on under the skin, between muscles, supporting blood vessels and nerves and alimentary canal. 2 Adipose tissue: It consists of fat cells [adipocytes] containing large fat globules as in a matrix of areolar tissue. a, White adipose tissue: Single large droplet of fat are present on white adipose. It is present on kidneys and eyes, between muscle fibers and under the skin where it acts as a thermal insulator b. Brown adipose tissue: This is present mainly in newborn. Brown adipose provides 20 times more energy than white adipose. It helps to maintain body temperature. - > Dense Connective Tissue: ° rous connective tissue: This tissue is mainly made up of closely packed bundles of collagen fibers with very little matrix. Fibrocytes are few in number and are found lying in between the bundles of fibers. Its present on ligaments which bind bones together, periosteum and outer protective covering [capsule] of kidneys, lymph nodes, synovial joints and brain. 2, Hlastic connective tissue: Elastic connective tissue is capable of considerable extension and recoil, There are-few cells and the matrix consists mainly of masses of elastic fibers secreted by fibroblasts. Itis found in organs where alteration of shape is required such as on large blood vessel walls. > Supportive Connective Tissue: 1, Cartilage: It is firm dense connective tissue. Its cells are called chondrocytes. They are embedded in matrix reinforced by collagen and elastic fibers. : a.tiyaline cartilage: It appears as a smooth bluish-white tissue. the chondrocytes-arein small groups within cell nests and the matrixis solid and smooth. Its found on articular cartilage, Costal cartilages, Cartilages supporting the larynx, trachea and bronchi. bb. Fibro cartilage: It consists of dense masses of white collagen fibers in a matrix similar to that of ; hyaline cartilage with the cells widely dispersed. It is a tough and slightly flexible tissue. It is found inthe — intervertebral discs, semilunar cartilages within the knee joint, symphysis pubis. ¢. Elastic cartilage: This flexible tissue consists of yellow elastic fibers Wing in @ solid matrix, between the fibers. It is found on Pinna of the ear, the epiglottis,B.Pharma Lecture Note 2. Bone: it is ahard dense connective tissue. Cells [osteocytes] surrounded by a matrix of collagei fibres. Matrix is strengthened by calcium and phosphate. _ 3, Compact bone: There is regular arrangement of cells and matrix. The regular arrangement forms haversian system. It forms very hard structure. It makes shaft of long bones, outer covering af short bones and flat bones. 7 : . -B. Spongy bone: There is irregular arrangement of cells and matrix, Newly forming bone is spongy. They Present on ends of long bone and inner bone of short and flat bones. ft ular Tissue: : 4 kineye may be described as skeletalystriated, striped or voluntary muscle. tis called 3 Shea Cell has ca Faction is under conscious control. The cells are found to be roughly cylindrical in foil Nuclei situated just under the sarcolemma [the cell membrane] of each muscle bands hence the cnc eatalle!t0 one another and they show well-marked transverse'dark and light ce the name striated or striped muscle. Sarcoplasm [cytoplasm of muscle fibers] contains brils which consist of filaments of contractile proteins including actin and myosin, many Inochondria, glycogen and myoglobin [Similar to hemoglobin in red blood cells which stores oxygen within muscle cells). 2. Smooth muscle: It is also called non-striated or involuntary muscle, itis not under conscious control. ft found in the walls of hollow organs such as blood vessels, ureters, Urinary bladder, Alimentary tract, Uterus. The cells are seen to be Spindle shaped with only one central nucleus. There is no distinct sarcolemma but a very fine membrane surrounds each fiber. 3. Cardiac muscle: This muscle is found exclusively in the wall of the heart. It is not under conscious control but when viewed under a microscope cross-stripes characteristic of voluntary muscle can be seen. Each fiber has a rfucleus and one or more branches. The intercalated discs can be seen as lines which are thicker and darker than the ordinary cross-stripes. The end-to-end continuity of cardiac muscle cells has significance in relation to the way the heart contracts as a single unit. A wave of contraction spreads from cell to cell across the inter- calated discs. So cells do not need to be stimulated individually and excitation occurs very rapidly. IV. Nervous tissue: * Excitable celis: Neurons are excitable cells which can initiate, receive and transmit impulses. Neurons undertake communication and signal transmission in nervous system. Neurons are myelinated or non myelinated * Non-excitable cells: These support the neurons and are also known as glial’cells, 1. Astrocytes: Form the blood brain barrier, support to neurons 2. Oligodendrocytes: Form myelin in the CNS 3. Schwann cells: Form myelin in the PNS 4, Microglia: Macrophages in the nervous system 10B.Pharma Lecture Note 1 " [Digestive system] The oral cavity is lined throughout with mucous membrane consisting of stra mn “Containing small mucus-Secreting glands, The part of the mouth between the gums and the Cheeks isthe vestibule and the remainder of the cavity is the oral cavity. The anterior hard palate and posterior sof) Palate forins the roof of mouth. The anterior hard palate is formed by maxilla and palatine bones, The Soft palate Is muscular and smooth and support for swallowing. The uvula is small conical mustular flay | ~ which iscovered with mucous membrane and hangs down from the middle of free border of soft palate Mouth consists of tongue and teeth: _|_—rengue: The tongue is a voluntary muscular structure that occupies floor of mouth. It is.attached by the freruun to the floor of of mouth. The tongue plays an important part in Chewing [mastication], |], Swallowing. | [deglutition}, Sp Speech and Taste. The superior surface consists of stratified squamous epithelium with numerous papillae. > Vallate papillae: These are larger in size and situated on the base of oral ‘Sour Side Bart of tongue > Filliform papillae: These are smallest and more on number and situated on the center and upper region of tongue > Fungiform papillae: These are smaller than vallate and less numerous than filliform. These are lies on margin and tip on tongue. | Bitter Back Salt & Sweet | Tip Teeth: The teeth are embedded in the alveoli or sockets of alveolar ridges of mandible and maxilla. There are two sets of teeth as Temporary or deciduous teeth and Permanent teeth. There are 20 temporary teeth, | 10 in each jaw. They begin to erupt when the child is about 6 months old and should be fulfill within 24. fone There are 32 permanent teeth, 16 in each jaw. Permanent teeth begin to replace the deciduous teethin the 6" year of age and should be fulfill within 21” year. incisors and canine teeth are the cutting teeth and are used for biting off pieces of food whereas premolar and molar teeth with broad & flat surfaces are used for grinding or chewing of food. Structure of teeth: > Crown: It is an exposed part of tooth. It is covered with hardest substance called enamel produced Eh ameloblast cell within the dentine layer below it. > Neck: It is a short part embedded on upper gums. > Root: This part is embedded in bony jaw that holds the tooth. Root is covered by protective and supportive hard layer known as cement produced by cementoblasts, Internally root has narrow pull cavity which is filled with nerve fibres, odontoblasts and blood vessels which deliver oxygen and n to tooth for its growth. \ 2 ct pm Mi [16x2=32] Temporary Teeth: 12 c! pm® mzB.Pharma Lecture Note mucous membrarle. Its outermost Pharynx or throat is situated behind the soft palate and lined with layer consists of a number of involuntary constrictor muscles which are involved in. swallowing: 1 (§ divided into three parts such as Nasopharynx, Oropharynx and Laryngopharyax. * ed _2* Nasopharynx: It is upper part of pharynx, It communicates with nasal aperture through internal nostril _ and with garthrough Eustachian tube. It éxtends up to soft palate. On posterior wall of it there are t extends up to soft palate ‘Pharyngeal tonsils consisting of lymphoid tissue. “Tiirects air downwards during inhalation and upward exhalati Fe. Pedeabuies . a % Oropharynx: |tis middle part of pharynx. It serves as common passage for air traveling from nose to ‘trachea and food traveling from oral cavity to oesophagus. Therefore it consider as common passage tO both respiratory and digestive systems. it extends from level of soft palate to level of Cs. In lateral wall of aye there are palatine tonsits, 5 Laryngopharynx: It is lower part of pharynx. t consists of two opening as.air opening [Glottis] and food opening [Gullets}. Both the openings are separated by a flap of elastic cartilage known as gpiglattis which covers the glottis and does not allow entering food on trachea. It extends from the,level of Cs to Ce. It acts as the passageway for digestive system. Function of Pharym i, It helps to transfer food from mouth to esophagus. ‘i, It helps to warm, moisten and filter the air. ii There are olfactory ngrve-eadings for the sensation of taste in the epithelium of the oral and — pharyngeal parts.— y iv. The auditory tube extending from nasopharynx to each middle ear allows’air to enter middle ear. V. The pharynx functions in speech by acting as a resonatifig chamber for sound ascending from the larynx. Esophagus [Foodpipe] Esophagus lies in the median plane in the thorax in front of the vertebral column behind the trachea and heart. It continuous with the pharynx above and just below the diaphragm it joins the stomach. It passes between muscle fibers of diaphragm at the level of Tio. Upper cricopharyngeal sphincter prevents air passing into the esophagus during inspiration and the gspiration of esophageal contents. Lower esophageal sphincter prevents the reflux of gastric acid contents into esophagus. tt is lined by non- keratinized stratified squamous epithelium. Its superior muscular layer consists of skeletal muscle where whereas middle muscular layer consists of both skeletal and smooth muscle and inferior muscular layer consist of smooth muscle. stontach: 4 is curved and J-shaped wide elastic sac situated below the diaphragm o} it-contiguous with esophagus at the cardiac sphingter and with the ‘sphincture allows the food to move towards stomach while pylori backflow of food into stomach. It consists of Lesser and Greater curvature.B.Pharma Lecture Note . eater curv ture i les on right side ofthe stomach just before pyloric sphiicter eles ne ‘when the stomach contains food the sphincter is closed. When the stomach is empty the mUCOUE Membrane lining is thrown into longitudinal folds which are known as Rugae- : ‘Structures of stomach wall: 1. Outer serous layer: Iti formed by peritoneum. eT 2. Muscular layer: It is made of mainly three layers of fibers such as inher oblique, middle circu and outer. longitudinal layer... . ~ 3. Submucus layer: It is formed by areolar tissu sie blood vesueB lymph vessels and ese nen pl me 4. inner mucus layer; This layer i us secret where gestic cals such as Parietal-cells, Chief cell and Mucus cells are situated. Parts of stomach: > Cardiac region: It is an upper part of stomach where esophagus open. Its opening 's guarded by ” cardiac sphincter. >-Fundus: itis small dome shaped structure which is elevated above the level of esophageal opening, > Body: It is largest part of stomach forming 75% to 80% of whole stomach which lies on middle part of , stomach. It extends from just below the fundus to pyloric region. > Pyloric region: It is a lowermost part of stomach where duodenum opens. Its opening is guarded by pyloric sphincter. fyndons of stomach: [. Mechanical Function: ‘ = Itacts as reservior of food. -It heI§6 in proper mixing of food with digestive juice and also helps to propel food into the duodenum. ‘Absorptive function: It helps to absorb Glucose, Saliva, Alcohol, certain drugs and Vitamin By2. iii Digestive Function: Stomach produces various digestive enzymes such as Salivary amylase, Pepsin, Renin and Gastric lipase for proper digestion of carbohydrates, Proteins and Fats. s Salivary amylase: It helps to convert starch to maltose. z - Pepsin: It helps to convert protein to proteoses and peptones. - Rennin: It helps for coagulation of milk. ic lipase: It helps to convert fats into fatty acid and glycerol. " { Secretory Functions: Zi ‘Stomach secrets Gastrin hormone and Intrinsic : cagvif itis secrete by pyloric region of stomach ate helps to stimulates gastric glands to release gastric juice. Gee waits Dae tric IntrinsjeSctor: It is secreted by parietal cell of stomach and helps for absorption of vitamin B: which is essential for maturation of RBC.oat. RE a as oe: ee seo a , Sy B.Pharma Lecture Note ‘Small ine: this tingest part of alienantary cana. continu the large intestine at the ileocaecal valve. Chemical digestion. absorption of nutrients takes place in small intest hepatopancreatic duct > Deodena' receives bile from gall bladder and pancreas through Common hepatopant or Ampulla of Vater which is guarded by Sphincter of ee wall of duodenum contains Crypts of Leiberkuhn which helps to secret secretin hormone and BGn ‘Majgr,duodenal papilla lies on the opening.of pancreatic duct into duodenum. =. ss > Jejunum: It is middle part’of small intestine which helps to conduct food from duodenum to ileum > Hleum: It is longest and highly coiled part of intestine. Its inner surface possesses columnar cells or enterocytes with thin walled fingers ike projections called villi which helps to increase surface area for absorption. Goblet cells that secrete mucus are present in between the enterocytes. These vill are highty riched with blood capillaries or lymph capillaries which are commonly called as lacteals. wus with stomach at the pyloric sphincter and leads into of food is completed and most of the nner's glands which helps to secret mucus. its mucous membrane consists of Payer's Patches which helps to destroy micro-organism present on intestine. Surface area of the small intestine mucosa is greatly increased by permanent circular folds called as villi or microvilli, Permanent circular folds promote mixing of chyme. The intestinal glands are tubular glands situated below the surface between the villi, Large intestine: It begins at the caecum in the right iliac fossa and terminates at the ré deep in the pelvis. Its lumen is larger than that of the small intestine. m and anal canal which are > caecum: It is a first part of the colon which continuous with the ascending colon superiorly. The vermiform appendix is a fine tube which leads from the caecum and it contains more lymphoid tissue. > Ascending colon. This passes upwards from the caecum to the level of liver where it curves acutely to the left at the hepatic flexure to become the transverse colon. > Transverse colon: This is a loop of colon which extends across the abdominal cavity in front of the duodenum and the stomach to the area of the spleen where it forms the splenic flexure and curves acutely downwards to become the descending colon. > Descending colon: This passes down to left side of abdominal cavity then curves towards the midline and it enters to the pelvis region for formation of sigmoid colon. > 'Sigmoid colon: It is an S-shaped curve in the pelvis which continues downwards to become the rectum. : > Rectum: it leads from the sigmoid colon and terminates in the anal cal > Anal canal: It consists of internal sphincter and external sphincter, smooth muscle fibers is under the control of the ANS and the external ‘muscle is under voluntary control. <Setests - ue i called as panct | : ne portion of pancreas and secret enzymes called pancreatic juice. itis poured into di i is control by Sphincter of Oddi also contain Wirsung dug through hepato- pancreatic duct whicl Duct of santoriti. ©» i : : ~ PrEndocrine Gland : Pancreas also possess islets of Langerhans which are endocrine on function an __ Secret hormones like Glucagon by alpha cells; Insulin by beta cell and Somatostatin by Delta cell, {. Itsecrets pancreatic juice with a various pancreatic enzymes such ‘| Amylase: it helps to convert carbohydrates to glucose. “ ~Trypsin.and Chymotrypsin: Ithelps to converts protein into amino.acids. ~ Lipase: it hydrolyses fats into fatty acids and glycerols. ~ Nuclease: It helps to convert nucleic acids into nucleatides. |. Italso helps to secret various pancreatic hormones such as: Insulin: It is secret by B cell which helps for Glycogenesis [Convert Glucose to Glycogen). ~ Glucagen: It is secret by a cell which helps for Glycogenolysis [Convert Glycogen to Glucose]. ~Somatostapin: It is secret by 5 cell which helps to Control secretion on Insyjig.and Glucagen. ~ Pancreatic peptide: It is secret by F cell which helps to secret pancreatic enzymes. ili, It helps to form hepato pancreatic duct with bile duct. Liver: It is largest gland in the body. Its situated below diaphragm on right side of abdominal side. The lveris_ enclased in a thin inelastic capsule and covered by a layer of peritoneum. Human liver consists of four lobes as Right central lobe, Caudate lobe , Quadrate lobe and Left central lobe. The liver is composed of several units called as lobules. Each lobule is cylindrical with central vei midddle of lobules. Blood flow from branches of portal vein pass through sinusoids and drain into ¢ Vein. The sinusoids are lined with parenchymal cells called hepatocytes. Similarly bile canaliculi whieh present on rows of hepatocytes drain into intralobular ducts to form hepatic ducts. The left and right hepatic ducts form common hepatic ducts. The cyst duct from gall bladder joins hepatic duct forming ‘common bile duct. The common bile duct then passes downward to pancreatic duct to form a Hepatopancreatic duct {Ampulla of vater] which opens at duodenum. The Ampulla of vater is gua sphincter of Oddi. Histologically, liver consist of many hexagonal hepatic lobules which are separated from each other! thin layer of connective tissue called as Glisson's capsule. There are angular intervals filled with . connective tissue along periphery of each hepatic lobule which are called as portal canals.ies h 6. ‘It supports for formation of RBC on embryo [Haemopoisis]. 7. It produces blood protein such as prothrombin and fibrinogen which assist for blood clotting. " 8. It supports to secret heparin which is an-anti -oagulant. 9.It converts old and damaged haemoglobin into bile pigments such as billirubin and billiverdin. 10. It-can stores glycogen, fats, vitamin A, D, E, K, Biz, bile, blood, iron, copper and potassium. Gall Bladder: © itis a pea aipead sac attached to the posterior surface of the liver. It has a fundus, body and a neck which is continuous with the cystic duct. The cystic artery supplies.blood to the galt bladder. These are located in mouth cavity, These secreted saliva. Trex qn 3me@e ports, Parotid glands [1 Pair on No.]: These are largest glands which are situated ts acoustic meatus. Their ducts open into the mouth at the level of the second ‘upper molar tooth. The duct of parotid gland is called as Stenson's du loa - Submandibular glands [1 Pair on No.}: These are medium sized glands which are lie at angle of the jaw Their ducts open on the floor of the mouth on each side of the frenulum of the tongue. The duct of submandibular gland is called as Wharton's duct . ~ Sublingual glands [1 Pair on No.]: These glands lie under the mucous membrane of the floor of the mouth in front of the submandibular glands. They have numerous small ducts that open into the floor of - the mouth, The duct of sublingual gland is called as Duct of Rivinus. _ Saliva Dee viceperand cricuriess fluid which is secreted by Maltose ii, Digestion of carbohydrate on stomach: Salivary amylase is inactivated due to high acidity on stomach due to which degradation of starch is Stopped, Therefore digestion of carbohydrate is not occur on stomach. iii, Digestion of carbohydrates on duodenum: Carbohydrates are finally digested in duodenum by following carbohydrate hydrolysing enzymes; * pmylase:t convert carbohydrates into Glucose. 7 Gyerase: Jt digests sucrose into Glucose and Fructose. Ziyaltase: It converts maltose.into glucose... Pp iose: it digests Lactose into Glucose and Galactose, ‘most complex food materials in diet. The digestion of proteins starts from stomach and ends- _atduodenum. 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Tear tracts pass ackvariat synapse with thalamus. From there the nerve fibers proceed Lacpvatds and medially ast ~ terminate inthe visual area of the cerebral cortexin the occipital lobes of the cereb vad > accommodation {fis the adjustment of eye to see either near or distant objects clearly. It process by which light rays from near objects or distant objects are brought to ‘a focus 0 of retina. Pathvay fc for Scomnoseton rates: 1. Afferenit Pathway: Visual impulses from retina pass throug! “tract, lateral geniculate body and optic radiation to visual cortex of occipital lobe. From-here a fibers carry the impulses to frontal lobe. The center for afferent pathway. lies in frontal eye field w situated in the frontal lobe of cerebral cortex. : the optic nerve, optic chiasma, 2. Efferent Pathway: E i a. Efferent fibers to ciliary muscle and sphincter pupillae: From frontal eye fi field, the corticonuclear fibers pass through internal capsule to the Edinger-Westphal nucleus of third cranial nerve. From here; the preganglionic fibers pass through the third cranial nerve to ciliary ganglion. WI ile postganglionic fibers from ciliary ganglion pass through the short ciliary nerves and supply the ciliary muscle.and tl constrictor pupillae: b. Efferent fibers to medial rectus: Some of the fibers from frontal eye field terminate in the somatic motor nucleus of third cranial nerve. The fibers from motor nucleus supply to medial rectus. [Human Ear] ~ The ear has 2 function of hearing and maintaining equilibrium of the body.Itis also called phonore organ. It is supplied’by the 8"” cranial nerve [Vestibulocochlear nerve]. phere of Ear: External Ear i. Auricle {PinnaJ: It is supported with elastic cartilage which is covered by skin and is moved by al muscles. ii External Acoustic Meatus [Auditory canal}: This tube is supported by cartilage in its external pa by bone in its interior part. Its outer hairy part prevents entry of dust particles. Its inner part contai wax or ceruminous glands which helps to lubricate ear-drum and prevents the foreign bodies. B. Middle Ear: It consists of an air filled chamber called as tympanic cavity which is connected to p by a'Eustachian or Auditory tube. The Eustachian tube helps to keep air pressure equat on both tympanicmembrane. - a Tympanic membrane or Eardrum is thin, oval, membranous, bluish-grey and stretchable capable of vibrating. The middle ear is connected with internal ear by Fenestra ovalis (Oval Fenestra rotunda [Round window] Tympanic cavity consists of three bony ossicles called ai which are as: - Malleus: Hammer-shaped attached with ear drum.‘Anvil shaped lies between malleus and stapes. ~Stapes: Stirrup shaped attached with fenestra ovalis. - ad hina ere ¢- Internal Ear: itis a delicate membranous part called as membranous labyrinth, Its enclosed Im li labyrinth of auditory floating in perilymph. Its cavity is filled with endolymph. - ~ xara {. Vestibule: itis a central sac of membranous labyrinth composed of utriculus and sacculus. spot or macula is present in both utriculus and sacculus. Macula consists of otolith membrane: ‘ fi, Semitunar canals: There are mainly Anterior, Posterior and Lateral Semicircular canal, Each yg semicircular canal consists of ampulla which consists of sensory spot known as crista, ~_. ee ii, Cochtea: Cochlea is the main hearing organ. tis spirally coiled arising from sacculus. It is connected with sacculus by a small duct called as Dilctus reunites. It consists of three fluid chambers as: a - Upper scala vestibule: It is Connected with tympanic cavity through Oval window (Fenestra ovalis)- filled with perilymph. . ad ~ Lower scala tympani: It is connected with tympanic cavity through Round window [Fenestra rotunda). Itis filled with perilymph. ‘ + Middle scala media: It is most important canal of cochlea. Its filled with endolymph. It communicates at the tips of cochlea through helicotrema. : i The scala media has an upper membrane called as Reissner's membrane and lower membrane is called as basilar membrane. The basiler membrane has Organ of corti within Hair cells, Dieter's cells and Cells of Hensen. The tectorial membrane ‘overhangs the sensory hair in the scala media. Organ of corti Present on scala media of cochlea re s and conducts sound stimulus. Mechanism For hearing: ~ Sound waves in air are collected by pinna. ~ The external auditory meatus directs these waves to the tympanic membrane which then vibrates. ~The vibrations are transmitted by Malleus, incus and stapes to the membrane covering fenestra ovalis. ~ From inner surface of this membrane, vibrations are transmitted to organ of corti through perilymph and endolymph ~ From organ of corti, impulses are carried to brain stem through cochlear portion of 8™ cranial nerves. ~ The fibers are then carried to auditory centre of brain which is present in temporal lobe of the opposite side. ‘Mechanism for Balance Movement of head or alteration in its position produces movement of endolymph present in the ircular canals. The movement of endolymph stimulates nerve endings in ampullae. The impulses are carried to brain through vestibular portion of 8" cranial nerve. These impulses produce sensations * which make us conscious about position of the head. If the position of head is disoriented, we can then Adjust it so as to maintain balance and equilibrium. zifferent drugs, @rizene, Chloroform, act aha : Bacterial infection agent: Vitamin deficiency, protein energy malnutrition, ‘eHyper-sensative reaction: Allergy ‘i, Morphological Changes During Necrosis: ‘¢Swelling of cell and loss of cellular structure. Break down of cell membrane. © Denaturation of the cytoplasmic proteins. ‘ Break down of cellular organelle like mitochondria, ribosome, ER. Le © Pyknosis [Condense nucleus] and Karyolysis [Break down of nucleus] : as oe a . > Types of Necrosis: ‘@. Coagulative necrosis: It is a type of accidental cell death typically caused by ischemia or infarctio ‘macroscopic appearance of an area of this necrosis is pale segment of tissue presenting against well vascularized tissue and dry on cut. Similarly microscopic anatomy shows lighter staining tissue c ‘no nuclei with very little structural damage giving an appearance of Ghost Cells. b, Caseation Necrosis: It is a form of cell death in which tissue maintains a cheese like appearance. dead tissue appears as a soft and white proteinaceous dead cell fnass. It mainly occurs due to Tuberculosis infection and bacterial agents, itis characterized by acellular pink areas of necrosis surrounded by Granulomatous Inflammatory process. ¢. Liquefactive Necrosis or Colliquative Necrosis: It is a type of necrosis which results in transmissio ~ tissue from liquid to viscous form. It is cause mainly by fungal and bacterial infection. Its occurrence sit 's Brain. During this type of necrosis, tissue become liquidy and creamy yellow [Pus] on macroscopic study while Lots of neutrophils and cell debris are seen on its microscopié Study. d. Fat necrosis: It isa form of necrosis characterized by action upon fat by digestive enzymes. In fat necrosis lipase release fatty acid from triglycerides. Then fatty acids.react with calcium to form soay These soaps appear as white chalky deposits, It is usually associated with trauma of pancreas or Pancreatitis. It also occurs on breast, salivary glands and neonate after traumatic delivery, There is shadowy appearance of dead fat cells on microscopic study. . Gangrene or Putrefaction Necrosis: It isa type of necrosis caused by insufficient blood supp affected tissues which result cell death. Diabetics and long term smoking increase the risk suff _from gangrene. Dry gangrene is form of coagulative necrosis which develops in} mic ad_ vessels. pe hetelftioasheies Aa arc te © ight microscopy due to the eosinophilic appearance. It is cause 2. Apoptosis: itis single cell death. itis a phys loge process seeo on embry : foetus, Endometrium during Menstruation and Alcoholic liver disease. et re inflammation: It is a vascular resporise to injury. It is causes by Infection, Trauma, Physical be thermal extremes or from ionizing radiation, Chemical injury, Immunologic injury and from cell death. a a. Acute Inflammation: Its duration is short which may occur within seconds, minutes, hour ora Causative agent is tissue injury and bacterial infection. The major cells involved in dufing this = : ie In are Neutrophils, Basophils and eosinophils. ae a sp > Major events occur on Acute Inflammation: increase on vascular caliber which leads to increase blood flow on tissue. ; ‘© Increase on vascular permeability which leads to transudation of plasma on tissue. © Margination and Immigration of blood celll especially Neutrophils: Note: Transudate is plasma product which has specific gravity less than 1.02. Similarly exudate is plasma product which has specific gravity more than 1.02. Motile blood cell especially neutrophils and monocytes are collected near blood vessel wall during Margination. While motile blood cell comes out of blood vessel and collect at injured site during Immigration by the stimulation by chemotactic factors such as: ~ chemokines.and complement peptide: : “ > Outcome of acute inflammation: #Abscess formation. Healing by fibrosis and scar formation. # Leads to chronic inflammation. # Regeneration of new cell. > Gross Changes: Edema [Swelling of tissues caused by capilliary blood vessel passing out water into th surrounding tissues}, Redness due to dilation of blood vessels, Abscess Auscess[Colleciong of pus formed by ~ tissue injury] formation, Loss of inflamed part function and Cardinal sign. AR > Microscopic Changes: Congested blood vessel, Transudate and exudate and Pus Formation P £ b. Chronic Inflammation: its duration is prolonged which may takes month or weeks and cause due to repeated acute inflammation, prolong exposure to tissue injury and acute immune disease, © > Non Granulomatous Inflammation: I s the continuation of a partially successful acute i and cause bacterial infection. There is non-structural unorganized diffuse infiltration of ti [Perineuriomas] PMN and Round cells on this type of inflammation. This type of inflam mediated by the interaction of monocytes~macrophages with lymphocytes,4 ‘of Langhans giant cel and Lymphocytes as epithelioid cells. . b. Venous thrombosis: tis also called Thrombophlebiti > Fate of Thrombus: a “ eBlood vessel and arterial occlusion - “PLeDissolution of fibrinolytic activity \—~eEmbolism ‘¢ Mechanical damage of endo soft Granuloma: It is cause by caseous necrosis is especially in aac surrounded wit! ij. Hard Granuloma: It is mainly cause.by Leprosy, Fungal infection and Foreign boat action. rombosis: It.is the formation of blood clot inside blood vessel obstructing flow of blood tl circulatory system: When thrombus is significantly large enough to reduce blood flow to a tissue, ' can occur and metabolic:products such as lactic acid can metabolite. Platelets, deposition on vi surface is the initial and essential stage of thrombosis. Thrombus is a solid mass consisting of p [Thormbocytes) and fibrin in which red and white cells are trapped. > Major causative factor for thrombosis: Endothelial Injury of blood vessel: Vascular injury.exposes to the sub-endothelial connective tisst thrombogenic and play an important role in initiating haemostasis as well as thrombosis. It may be ¢ due to hypertension, atherosclerosis, autoimmune disorder, inflammation, hyperlipidemia, trauma. Altered blood flow: It is cause due to venous stasis which leads to heart failure and due to atrial fibrillation which leads to thromboembolism. Stasis may lead to disrupt laminar flow and bring platel into contact with the endothelium. iS ‘eHypercoagulability: It is defined as any alteration of the coagulation pathways that predisposes to thrombosis. itis cause due to hereditary factor or autoimmune disorder, tissue damage, Tumour, - bacterial infection, smoking, > Types of Thrombus: ‘a. Cardiac or Arterial thrombosis: It is also called mural thrombosis. These thrombi are formed in of active blood flow such as atrium of heart and different heart diseases as well as within different artery. It is grey white on color and laminated. It is formed on retrogressive direction of blood flow. major cause of arterial occlusion is atrial fibrillation which cause blood stasis and create thrombus. aerial fib These thrombi are formed in areas of less active blood flow such as veins of lower extremities especially on leg vein. It occurs during Surgery, Trauma, Imabilty of limbs, Thromboembolism, Thombophila, Smoking. Itis formed on direction of blood flow. Itis red on color and occludes a blood vessel. ‘Organization & recanalization of pharucted blood vessel kfr a ee 'tis a lodging of an.embolus which may be blood clot, fat globule, ; ‘teria fh the blood steam, This causes Blockage in a blood vessel, 99% of emboll oEcUur ‘thrombosis while 1% of it is form from fat bubble, 8s bubble and foreign bodies. z ” >Types of embolism: ** 280 os el aE tai 2s a. — embolism: It is cause by infarction and tissue death dae to blockage of blood supply. It is | originated from mural thrombosis. It occurs during different heart and arterial diseases like neacetaliie Zi hypertension, diabetes, stroke, myocardial infarction. it may seen on brain, liver, spleen. on i b. Pulmonary embolism: it is called as pulmonary embolism because it mainly occurs on lungseIGOHSiie from the venous thrombus. It occludes pulmonary blood vessel. The most common site for origin of | pulmonary emboli is femoral veins. ¢: Fat embolism: it is originate from injury to fatty area such as breast and thigh. : ji d. Air embolism: Its cause by present of gas bubble on vascular system. tt may cause during:Bjood Transfusion, Intravenous drip or injury to lung. . e. Amniotic Fluid Em! hese emboli are caused by escape of amniotic fluid into the maternal circulation. They can cause materpal death. ro eisierpalidesth. S. Infarction: itis define as tissue death [Necrosis] caused by lack of oxygen due to obstruction of tissue blood supply. tis irreversible condition. itis cause by occfusion on artery, vein testis and ovary, edema, thrombolism, vasospasm, tumour. x > Factors affecting Infarcti . 1, Anatomical pattern of blood supply: ® End arterial blood supply on body organ such as kidney accelerates infarction, Double blood supply retards infarction. Lung: Pulmonary and Bronchial’blood vessel.” i Liver: Hepatic and portal blood vessel, 2. Types of tissue involved: Nervous Tissue: Infarct quickly. ' ‘*Fibroblast, Skin, Muscles: Infarct slowly 3. Oxygen content on blood as on anemia accelerates infarction, : : 4. Rate of development of occlusion of blood vessel also influence infarction rate. > Types of Infarction: ' Hemorrhagic infarction: it is red on color. itis due t ‘© venous occlusion. it mainly ‘vary, smalll intestine. The occlusion contains 3 ‘More RBC and fibrin strands. due to arterial occlusion. it occu teauses ischemicnecrosis, vasoconstriction and irreversible gangrene.Suoneynu 2u38 wo ansas axe s:20UeD asf, ule eworseigounay se yons ss20ue> aus: t = aids ues sown ueueAg 2x3 a2eds prouy2ezeans ‘ayy Bunexiavad yanou sinav0 ued saaineD Apoq OW anon ana} owoud'spuig uo jo sucyduns pue vB 24, ysuasiedhy se wo) ms ee ‘Ayoysuasiody se sie sy uota ee “apie puny vo J stoi voappa4 POIEUNONS- oj 0328) yous wos ynsa2 hew Y‘pIO I jessan poo jo worse] 5H -Auyusou ip uy hyenas ssauys pue no! 24, eye pur Ja} oy yBiom ‘0 18 pooja uo Uae AHdeveloping country such as Nepal and rare on developing cou! rent and smokers. common on AIDS patient, Children, Immunosuppressant pati ; ‘e marrow. BCG vaccination can |. Extracellular T.B: It is usually seen on.skin, bone, meninges, bon prevention from extracellular T.B: " . : “Il, Pulmonary T.B: It is the tuberculosis of lung. > Types of Pulmonary Tuberculosis: ‘i a. Primary Pulmonaty T.B: Its seen on young children who are exposed to T.B. bacilli for first time. Th most common site involved for primary complex 6r Ghion's complex are lungs and hilar lymph nodes. “also occurs on cervical lymph nodes, tonsils and mesenteric lymph nodes. The lesions of primary pulmonary T.8. involve Tuberculous granulomas with peripheral fibrosis and Extensive caseation necrosis: within center of granulomas, The lesions are commonly healed by fibrosis but sometimes they undergo calcification and ossification. b. Secondary Pulmonary T:B: It is seen on adult and old age person who has been previously infected or sensitized by T.B bacilli. It can be cause due to activation of dormant bacilli in previous lesion. The lesions of secondary pulmonary T.B involve cavitation of lung and pleural effusion. It mainly occurs on lungs, lymph nodes, pharynx, larynx, small intestine, skin. It occurs by lymphohaematogenous spread of infection from primary complex to apex of affected lung where oxygen tension is high and favorable for proper growth of aerobic tubercle bacilli. ¢. Miliary T.B: It affects immunosuppressant person who has not received BCG vaccination. The spread may occur to systemic or isolated organ within extra pulmonary sites such as liver, spleen, brai meninges, genitourinary tract and bone marrow. The military lesions are millet seed shaped within tubercles with minute areas of caseation necrosis. > Gross Feature of Lesions on Pulmonary T.B: ~ Gray white cheesy material on affected areas =Consolidation and cavitation of lung. ~Calcification and ossification of lesions. ‘ > Microscopic Feature of Pulmonary T.B: 1.B granuloma within central caseation necrosis surround by lymphocytes, epithelium cells and | type of giant cells.% * aa 8.Pharma Lecture Note @ | > Clinical Features of Pulmonary T, |, Rise‘of temperature on evening time. Vi-Septic shock Ml. Coughing which continues for'several days. _ VIL Difficult for breathing, Ml, Haemophysis [Blood in sputum), Vill. lymphadenopathy [Enlargement of lymph). IV. 4est pain Venous thromboembolism. ve We, ‘it loss and Loss of appetite. ~ X. Pneumothorax »Diagno. of Pulmonary - 2. Chest X-ray: Chest X-ray is performed tg kngw gross features of lesion such as consolidation, Cavitation, calcification and ossification of lesions, aE Ss PR ela t, b. Blood test: os Anemia [Decrease on Hb%] Increase on total WBC count ~ Increase on DLC (Differtial Leucocyte Count] and Lymphocyte number Decrease on ESR [Erythrocyte Sedimentation Rate] ©. Sputum test for AFB and culture of AFB 4. Montovx test [Shin test} or Tuberculin test whi is seen as posative on 7.8 patient. Op. COPD [Chronic Obstructive Pulmonary Disease]: ‘COPD is an diffuse pulmonary disease which is characterized by increase on resistance on air flow. It includes: » Chronic bronchitis: ' | » Site: Bronchus of lung. : | Pathological Change: Air flow and bronchus dilatation Causes: Persistence bacterial infection Clinical features: Fever, Cough, Purulent sputum, Fibrosis of air ways > Bronchiectasis: Site: Bronchus of lung Pathological Change: Air flow and bronchus dilatation Causes: Severe persistence bacterial infection Clinical features. Fever, Cough, Purulent sputum 1 Change: Inflammation and obstruction of bronchioles z pollution and tobacco smoking Clinical features: Cough and dyspnea [Breathlessness‘secondary hypertension are as: i, Renal factors such as Renal failure and Glomerulonephritis. ralowascut ctor i. Cardiovascular factors such as arteriosclerosis, Atherosclerosis and Angina pet "Neurogenic factors such as CNS abnormali ress. , ae cust ” iv. Endocrine factors such as Thyrotoxicosis [increase on Ts hormone], Increase © on adienal | secretion, Cu: disease, Diabetes mellitus and Pheochromocytoma (Adi - > Clinical features: _ . i. Dizziness t = iii, Insomnia [Sleeplessness} ii Ralpitation {Feeling of heart beat) py ‘Iv. Change on vision Diagnosis v. Examination of blood pressure Nw 19. Arteriosclerosis: i. It is thickening of arterial wall and loss of elasticity of arterial wall. It is disease of elderly person. Its responsible for hypertension in od age jerosclerosis: Atherosclerosis is a deposition of cholesterol ie. lipid or fat with a formation. of yellow flague of fat in the tunica intima layer of arterial wall. It mainly occurs on large elastic arteries such as Aorta and also on medium sized muscular arteries such as Coronary Artery [Artery of Heart], cerebral artery [Arter ‘of brain] and Artery of lower limb. > Risk factors for Arteriosclerosis: i. Family history of Hypertension ii, Alcoholic person iv. Obese and diabetes person Cigarette sriioking v. Increase serum cholesterol level vi: Genetic abnormalities viii, Mental stress vii. Hyper: -lipidemia >- Gross appearance: Appearance of yellow plaque due to the deposition of a > Microscopic Appearance: |, Proliferation of smooth muscle cell » ila Il. Deposition of dense fiber collagenous tissue ‘ III. Appearance of foamy macrophages [Lipid laden macrophages}‘cardiac mu: an rn omnes ‘3 Pete pact! Paroxysmal chest pain ._ li. Myocardial Infraction: Heart failure. iii, Chronic ischemic heart disease iv. Sudden cardiac death > Causes of Ischemic heart disease: i, Various diseases related to coronary blood vessels such as Arteriosclerosis, Atherosclerosis Vasospasm, Shock and Hypertension ‘ ii, Myocardial diseases such as Cardiomegaly [Increase on size of heart}, Anemia [Decrease on Hb level] and Tachycardia (Increase on heart beat}. ili. Carbon monoxide poisoning as on smokers iv. Cyanotic heart disease due to lung cancer > Clinical feature of Ischemic heart disease: ve i. Chest pain v. Nausea ii. Dyspnea [Breathlessness] vi. Arrhythmia [Irregular heart beat] iii. Cardiogenic shock . $ vii, Pericardial effusion iv. Mural thrombus and embolism > Diagnoses: Lecce Test over seruss enzymes such as Creatinine phosphokinase and Lactate Dehydrogenase ay 22. pheumatic heart disease: Rheumatic heart disease is chronic immunological heart disease which invol Cuspid valve and tricuspid valve of heart. It is associated with joint pain and subcutaneous nodules, > Pathophysiology: It is caused by fi streptococcus haemolyticus, Antibody developed against en action is called ASO [Anti streptolysin 0}. Ag-Ab complex forms during rheumatic heart dis vegetation within blood cells and deposes in mitral and tricuspid valve due to which ster heart valves} is cause. 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