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79. What are the functions of the Limbic System? Also draw the papez circuit.
(3 marks)
Answer:
Limbic system is a complex system of cortical and subcortical structures that form
a ring around the hilus of the cerebral hemisphere.
Functions Of Limbic System

Piriform cortex and amygdaloid nucleus form the olfactory centers.
Hypothalamus plays an important role in regulation of endocrine secretion and

in regulating the autonomic functions such as heart rate, blood pressure, water
balance and body temperature
Along with the amygdaloid complex, the feeding center and satiety center present
in hypothalamus regulate food intake.
Hypothalamus is responsible for maintaining sexual functions.
Emotional state of human beings is maintained by the hippocampus along with

the hypothalamus.
Hippocampus and Papez circuits play an important role in memory.
Papez Circuit
It is a neural circuit in the brain and plays a role in emotional processing and
memory.
Hippocampus
↓
Fornix
↓
Mammillary Bodies
↓
Anterior Thalamic Nuclei
↓
Cingulate Cortex
↓
Parahippocampal Gyrus
↓
Hippocampus
Reference: Textbook of Medical Physiology, Guyton and Hall, 11th Edition, Page No. 731
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80. What are receptors? Describe the various receptor types as well. (3 marks)
Answers:
Receptors are sensory (afferent) nerve endings that terminate in the periphery as
bare unmyelinated endings in the form of specialized capsulated structures.
Types
A. Exteroceptors
Exteroceptors are the receptors, which give response to stimuli arising from outside
the body and are divided into three groups:
Cutaneous Receptors or Mechanoreceptors

Receptors situated in the skin are called the cutaneous receptors.

Cutaneous receptors are also called mechanoreceptors because of their response

to mechanical stimuli.
Chemoreceptors

Receptors, which give response to chemical stimuli.

Telereceptors

Telereceptors are the receptors that give response to stimuli arising away

from the body.
These receptors are also called the distance receptors.

EXTERORECEPTORS
Cutaneous receptors Chemoreceptors Telereceptors
Sensation Receptor Sensation Receptor Sensation Receptor

Meissner Vision Rods and
Corpuscles Cones in
Touch Taste Taste Buds
and Merkel Retina
Disk
Hearing Hair Cells
Pacinian Olfactory
Pressure Smell in Organ of
Corpuscles Receptors
Corti
Krause end
Cold
bulb
Ruffini end
Warmth
organ
Pain Free Nerve
Ending
(Nociceptor)
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MedEd FARRE: Physiology
B. INTEROCEPTORS
Interoceptors are the receptors, which give response to stimuli arising from within
the body and are of two types:
Visceroceptors: Receptors situated in the viscera are called visceroceptors.

Proprioceptors: Proprioceptors are the receptors, which give response to change in the

position of different parts of the body.
INTEROCEPTORS
Visceroceptors Proprioceptors
Receptors Location Receptors Location
Stretch receptors Heart Muscle Spindle Muscle
Baroreceptors Blood vessels Golgi Tendon Organ Tendon
Chemoreceptors GI tract Pacinian Corpuscles Ligament, Fascia
Urinary vessels,
Osmoreceptors Free Nerve Ending Joint
Brain
Vestibular
Hair cells
Apparatus
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81. (A) Describe the components of basal ganglia. (10 marks)
(B) Write the different connections of basal ganglia.
(C) What are the functions of basal ganglia?
(D) Describe the clinical condition called “Parkinsonism”.
Answer:
Components Of Basal Ganglia
Basal ganglia include three primary components:
Corpus Striatum: Corpus striatum is a mass of gray matter situated at the base of
cerebral hemispheres in close relation to thalamus and it is incompletely divided
into two parts by internal capsule:
i. Caudate nucleus
ii. Lenticular nucleus.
i. Caudate Nucleus
Caudate nucleus is an elongated arched gray mass, lying medial to internal capsule
and has a head portion and a tail portion.
ii. Lenticular Nucleus
Lenticular nucleus is a gray mass, situated lateral to the internal capsule.
A vertical plate of white matter called external medullary lamina, divides lenticular
nucleus into two portions:
a. Outer putamen
b. Inner globus pallidus.
Substantia Nigra
It is situated below the red nucleus. It is made up of large pigmented and small
non pigmented cells. The pigment contains a high quantity of iron.
Subthalamic Nucleus Of Luys
Subthalamic nucleus is situated lateral to red nucleus and dorsal to substantia

nigra.
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Connections Of Basal Ganglia
Direct Pathway: Excitatory pathway & facilitates the intended movement.

+ Cortex
↓ + Glutamine
Striatum←←Dopamine←←Substantia nigra
↓ - GABA
Globus pallidus Interna
+ Thalamus
Indirect Pathway: Inhibitory pathway & inhibits unwanted movement.

- Cortex
↓. + Glutamine
Globus pallidus Externa. ←←←Striatum←←Dopamine ← Substantia nigra
↓ - GABA
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Subthalamic nucleus.→→→→ + Globus pallidus Interna
↓. ↓.
↓ ↓.
Brain stem & Spinal cord. Thalamus
Functions Of Basal Ganglia

Motor Control:
It is primarily associated with motor coordination and control. It helps regulate
the initiation, execution, and cessation of voluntary movements.
It works in conjunction with other motor-related brain regions like the cerebral
cortex and the cerebellum to fine-tune movements and maintain motor stability.
Movement Planning and Execution:
The basal ganglia is involved in the planning and execution of complex, coordinated
movements, including those related to posture, gait, and skilled motor tasks.
Inhibition of Unwanted Movements:
One of the key functions of the basal ganglia is to inhibit or suppress unwanted or
inappropriate movements.
Cognition and Behavior:
Beyond motor control, the basal ganglia has cognitive functions. It plays a role in
decision-making, motivation, and reward-based learning.
Emotion Regulation:
The basal ganglia is involved in regulating emotional responses and expressions.
Dysfunction can lead to mood disorders and emotional dysregulation.
Looping Connections with Other Brain Regions:

The basal ganglia forms complex neural circuits with various regions of the brain,
including the cortex, thalamus, and brainstem.
Parkinsonism:
Also known as “Paralysis Agitans” or “Shaking Palsy.”
Caused by lesions in the basal ganglia.
Pathogenesis:
Results from an imbalance between excitation and inhibition in the basal ganglia.
Mainly caused by the loss of dopaminergic inhibition of the putamen.
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Causes:
Degeneration of dopaminergic fibers from substantia nigra to striatum.
Old age.
Drugs like chlorpromethazine.
MPTP (Methyl phenyl tetrahydropyridine) poisoning.
Clinical Features
Characterized by a triad of akinesia, tremor, and rigidity.
Lack of initiation of movements.
Retardation of movements and loss of automatic, associated movements.
Defect in speech.
Loss of timing and scaling of movements (micrographia).
Rigidity:
Hypertonia in agonistic and antagonistic (mostly proximal) muscles.
Caused by increased discharge of gamma motor neurons due to loss of inhibitory
control.
Two types of rigidity: Cogwheel (intermittent resistance to passive movement) and
Lead pipe (continuous resistance to passive movement).
Posture:
Stupor with a flexion attitude.
Tremor:
Occurs at rest and is absent in sleep.
Characterized by alternate contraction and relaxation of agonists and antagonists

of hands and fingers at a frequency of 6-8 hertz/second.
Festinant Gait:
The body is bent forward.
Characterized by short, quick shuffling steps as if to catch the center of gravity.

Difficulty stopping quickly when pushed forward or backward.
Treatment:
Levodopa: Can cross the blood-brain barrier, unlike dopamine.
Carbidopa: Inhibits decarboxylation of L-dopa in peripheral tissues.
Dopamine agonists (e.g., Bromocriptine).
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82. (A) What is sleep? Also, write about physiological changes during sleep.
(B) What are the types of sleep?
(C) Define electroencephalogram (EEG). Also, explain the normal EEG.
(D) Define Alpha Block.
(E) List some sleeping disorders. (10 marks)
Answer:
Sleep is the natural periodic state of rest for mind and body with closed eyes
characterized by partial or complete loss of consciousness.
Depth of sleep is not constant throughout the sleeping period.
Physiological Changes During Sleep

1. Plasma Volume
Plasma volume decreases by about 10% during sleep.
2. Cardiovascular System
Heart Rate: During sleep, the heart rate reduces. It varies between 45 and 60
beats per minute.
3. Respiratory System
Rate and force of respiration are decreased. Respiration becomes irregular and
Cheyne-Stokes type of periodic breathing may develop.
4. Gastrointestinal Tract
Salivary secretion decreases during sleep. Gastric secretion is not altered or may
be increased slightly.
Contraction of an empty stomach is more vigorous.
5. Excretory System
Formation of urine decreases and specific gravity of urine increases.
6. Sweat Secretion
Sweat secretion increases during sleep.
7. Lacrimal Secretion
Lacrimal secretion decreases during sleep.
8. Muscle Tone
Tone in all the muscles of the body except ocular muscles decreases very much
during sleep. It is called sleep paralysis.
9. Reflexes
Certain reflexes, particularly knee jerks, are abolished.
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Babinski sign becomes positive during deep sleep.
Threshold for most of the reflexes increases.
Pupils are constricted.
10. Brain
Brain is not inactive during sleep.
Electrical activity in the brain varies with stages of sleep.
Types Of Sleep
Sleep is of two types:
Rapid eye movement sleep or REM sleep

Non-rapid eye movement sleep, NREM sleep or non-REM sleep.

Rapid eye movement sleep or REM sleep

Rapid eye movement sleep is the type of sleep associated with rapid conjugate
movements of the eyeballs, which occurs frequently.
It is also called paradoxical sleep because the eyeballs move but the sleep is deep.
Non-rapid eye movement sleep, NREM sleep or non-REM sleep.

Non-rapid eye movement (NREM) sleep is the type of sleep without the movements
of eyeballs.
It is also called slow-wave sleep.
REM SLEEP NREM SLEEP

Rapid eye movement Present Absent
Brain activity More Less
% of total sleep duration 25% 75%
EEG Beta waves Delta waves
Dreams Can be recalled Cannot be recalled
Muscle tone More hypotonia Hypotonia
Threshold for arousal Further elevated Elevated
Pulse, BP, Respiratory rate Increased and irregular Low and regular
Temperature Fluctuating Stable
Neurotransmitter Noradrenaline Serotonin
O2 consumption More Less
Electroencephalogram (Eeg)
Electroencephalogram is a record of summated potentials of the cerebral cortex
recorded from the surface of the scalp.
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Normal Eeg Pattern
Location Frequency Amplitude

Brain Rhythm Characteristics
Recorded (Hz) (µV)
Alpha Rhythm Prominent in Parieto- 8-13 50
EEG. occipital area
Obtained from
awake adults
with closed eyes.
Also known as
Berger rhythm.
Beta Rhythm Obtained when Parietal and 18-30 5-10

eyes are open. frontal regions
Indicates an alert
state
Theta Rhythm Recorded in Parietal and 4-7 10
children. temporal
regions
Occurs in adults in
emotional stress
and disorders.
Delta Rhythm Present during Occipital and 1-4 200
sleep. other regions
Absent in
wakeful adults
but present in
infants.
Presence in
wakeful adults
may indicate
brain lesions.
Alpha Block
It is the phenomenon in which alpha waves are replaced by beta waves (fast,
irregular waves of low amplitude).
Occurrence:
When the eyes are opened
In conscious mental activity and on application of a stimulus
Sleeping Disorders
Insomnia: Insomnia is the inability to sleep or abnormal wakefulness and is the
most common sleep disorder.
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Narcolepsy: It is the sudden attack of uncontrollable sleep.
Sleep Apnea Syndrome is the temporary stoppage of breathing repeatedly during

sleep.
Nightmare: Nightmare is a condition during sleep that is characterized by a sense
of extreme uneasiness or discomfort or by frightful dreams.
Nocturnal Enuresis
Nocturnal enuresis is the involuntary voiding of urine at bed.
It is also called bedwetting.
It is common in children.
Reference: Textbook of Medical Physiology, Guyton and Hall, 11th Edition, Page No. 739,
740, 743
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83. What is the difference between Upper Motor Neuron lesion and Lower Motor
Neuron lesion? (5 marks)
Answer:
Upper motor Lower motor

Effects
neuron lesion neuron lesion
1. Muscle tone Hypertonia Hypotonia
2. Paralysis Spastic type of Flaccid type of
paralysis paralysis
3. Wastage of muscle Wastage of Wastage of
muscle occurs muscle occurs
Clinical observation 4. Superficial reflexes Lost Lost
5. Plantar reflex Abnormal plantar Absent
reflex – Babinski
sign
6. Deep reflexes Exaggerated Lost
7. Clonus Present Absent
8. Electrical activity Normal Absent
9. Muscles affected Groups of muscles Individual
are affected muscles are
Clinical confirmation
affected
10. Fascicular twitch in Absent Present
EMG
Upper Motor Neuron Lesion:
Location: Upper motor neurons are located in the central nervous system (CNS),
primarily in the brain’s motor cortex and the brainstem.
Examples: Stroke, traumatic brain injury, multiple sclerosis etc.
Physiological basis of UMN lesion:

Spasticity: Interruption of corticoreticular fibers causes inhibition of medullary
reticulospinal tract which reduces muscle tone.
Also Facilitates the excitatory reticulospinal pathway from pons. Hence hypertonia
& spasticity.
Exaggeration of deep tendon reflexes: Loss of inhibitory influence causes increased
gamma motor neuron discharge.This increases the sensitivity of the muscle spindle
to stretch.
Loss of superficial reflexes: As efferent pathway is disrupted, superficial reflexes
are lost.
Babinski’s sign (Extensor plantar reflex): Positive
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Lower Motor Neuron Lesion:

Location: Lower motor neurons are located in the peripheral nervous system
(PNS), specifically in the spinal cord and cranial nerve nuclei.
Examples: Spinal cord injuries, peripheral nerve injuries, motor neuron diseases
and certain viral infections affecting the PNS.
Physiological basis of LMN lesion:
Flaccidity: Denervation of muscle abolishes influence of gamma motor neurons
thereby reduces tone
Reflexes: Loss of lower motor neurons disrupts the reflex arc of the stretch reflexes
as well as the superficial reflexes. So both the reflexes are lost
Babinski’s sign: Negative
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84. (A) What are the main causes of nerve degeneration?
(B) Describe the wallerian degeneration. (10 marks)
Answer:
Nerve Degeneration
When a nerve fiber is injured, various changes occur in the nerve fiber and nerve
cell body. All these changes are together called the degenerative changes.
Caused For Nerve Degeneration:
Diabetes: Most common cause of nerve degeneration.
Autoimmune Disorders
Alcohol Abuse
Infections & Trauma
Heredity
Cancers and Tumors
Excessive Pressure or Compression
Neurological Diseases
Aging
Vitamin Deficiencies: Inadequate intake of certain vitamins, such as vitamin B12

and vitamin B6, can result in nerve degeneration. This condition is often referred
to as peripheral neuropathy.
WALLERIAN DEGENERATION
Wallerian degeneration is the pathological change that occurs in the distal cut end
of nerve fiber (axon).
Wallerian degeneration starts within 24 hours of injury.
Early Phase(1st -7th Day):

Functional changes:
Changes in the enzymatic activity (choline acetylase & acetylcholinesterase)

Decrease in the activity of ionic channels

Decrease in the conduction velocity

Failure in the conduction of nerve impulse

Late Phase (8th– 32nd Day):

Neurofibrils disappear
Axis cylinder swells & breaks into fragments
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Debris collects in the axis cylinder place
Myelin sheath slowly disintegrates into fat droplets
Neurilemma remains intact
Schwann cells proliferate rapidly
Macrophages remove debris of axis cylinder
Neurilemmal tube becomes empty (ghost tube)
Schwann cell cytoplasm fills the neurilemmal tube
Changes in cell body:

Starts after 48 hrs of nerve injury
First nissl granules disintegrates into fragments - chromatolysis
Golgi apparatus disintegrates
Cell body swells due to accumulation of fluid and becomes round.
Nucleus is pushed to the periphery.
Changes in the proximal part:

Same degenerative changes as in the distal part (anterograde degeneration)
Regenerative changes in nerve following injury:

Sprouting of a large number of small branches from the cut fibers
Entry of some of these branches into the peripheral stump
Proliferation of Schwann cells & formation of continuous tubes. This bridges the
gap between proximal & distal stumps
The growth of filaments is also guided towards the periphery
When one branch grows in to the periphery, the other branches degenerate
The growth towards denervated fibers is due to some chemical attraction called
neurotropism
Myelin sheath begins to appear in about 15 days and proceeds peripherally
Complete functional recovery takes 3 years.
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85. Briefly explain about Brown Sequard Syndrome. (3 marks)
Answer:
Definition
Brown-Séquard syndrome is a neurological condition that results from damage
to one side of the spinal cord. It’s typically caused by a traumatic injury, such as
a stabbing or gunshot wound, or a tumor compressing the spinal cord.
Cause
Occurs because of the lesion involving one lateral half of the spinal cord.
Features
Ipsilateral (Same-Side) Motor Paralysis:
The side of the body on which the spinal cord is damaged will experience weakness
or paralysis. This is because the motor pathways that control movement are
affected.
Ipsilateral Loss of Vibratory and Position Sense:
The individual may lose the ability to feel vibrations and accurately perceive the
position of their limbs on the same side as the injury. This results from damage to
the dorsal columns of the spinal cord, which transmit sensory information related
to proprioception (limb position) and vibratory sensations.
Contralateral (Opposite-Side) Loss of Pain and Temperature Sensation:
On the side opposite to the injury, there is a loss of pain and temperature sensation.
This occurs because the pathways responsible for transmitting these sensations
cross to the opposite side of the spinal cord shortly after entering it.
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86. (A) What is pain? What are the components of pain?
(B) Explain the pain pathway.
(C) What is referred pain? Give some examples.
(D) Explain how pain is managed in our body. (10 marks)
Answer:
Pain is defined as an unpleasant and emotional experience associated with or
without actual tissue damage.
Pain may be acute or chronic.
Acute pain is a sharp pain of short duration with an easily identified cause.
Chronic pain is the intermittent or constant pain with different intensities. It lasts
for longer periods.
Components Of Pain
Pain sensation has two components:
Fast pain
Fast pain is the first sensation whenever a pain stimulus is applied.
It is experienced as a bright, sharp and localized pain sensation.
Slow pain
Receptors for both the components of pain are the same, i.e. the free nerve
endings. But, afferent nerve fibers are different.
Fast pain sensation is carried by Aδ fibers and slow pain sensation is carried by C
type of nerve fibers.
Pain Pathway
Pain is carried by two pathways: Neospinothalamic & Paleospinothalamic pathway.
Neospinothalamic Tract: (Carries Fast Pain)

1st order neuron: Aδ fibers from receptors to lamina I and V of spinal cord
2nd order neuron:
From dorsal horn of spinal cord

↓
cross to opposite side
↓
ascend in the lateral white column
↓
end in the ventral postero lateral(VPL) & ventral postero medial (VPM) nuclei of
thalamus.
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3rd order neuron: From VPL & VPM nuclei of thalamus to somatosensory cortex
(areas 3, 2 & 1) of post central gyrus.
Paleospinothalamic Tract: (Carries Slow Pain)
1st order neuron: C Fibers from receptors to lamina IV and V of spinal cord
2nd order neuron:
From dorsal horn of spinal cord

↓
cross to opposite side
↓
ascend in the lateral white column
↓
end in intralaminar & midline nuclei of thalamus
3rd order neuron: Arise from intralaminar & midline nuclei of thalamus & reach
the entire cerebral Cortex.
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Special features:
Neospinothalamic tract: concerned with localization and interpretation of quality
of pain
Paleospinothalamic tract: concerned with perception of pain, arousal and alertness
Referred Pain
Visceral pain instead of being felt at the site of the viscera is frequently felt at some
distance, on somatic structures. This is called referred pain.
Examples:
Appendicitis pain at the umbilicus

Cardiac pain at the inner aspect of left arm

Cholecystitis at the tip of the shoulder.

Theories of referred pain: (Mechanism of referred pain):

1. Convergence theory: Fibers carrying pain- both from the viscus & the corresponding
dermatome (somatic structures) converge on the same pathway to the cortex
2. Facilitation theory: The visceral pain produces a subliminal fringe effect on the
Substantia Gelatinosa Rolando [SGR] cells which receive somatic pain nerves.
Modulation of Pain
Analgesia [inhibition of pain] is done by three methods:
Gate control theory

Endogenous pain relief from PAG(Peri Aqueductal Grey matter) & NRM

By release of Endogenous opioid peptides (Enkephalins & Endorphins)

Gate Control Theory Of Pain

The posterior or dorsal horn acts as a Gate for pain
Pain impulses in the spinal cord can be modified or gated by other afferent
impulses [touch, pressure vibration] that enter the spinal cord
Large myelinated A fibers interact with small unmyelinated C fibers via inhibitory
cells of the Substantia gelatinosa of the spinal cord
Stimulation of C fibers inhibits SG cells & favors passage of impulses along the
pathway of pain in the spinal cord.
Stimulation of large ‘A’ fibers increases SG activity & block impulse transmission
to nerve cells concerned with pain- (inhibit transmission of pain from the ‘C’
fibers to Spinothalamic tract- presynaptic inhibition)
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Endogenous Pain Relief From Pag/Central Pain Suppression Mechanism
Descending pathways arise from Periaqueductal gray matter [surrounding

aqueduct of Sylvius] [release Encephalin]
↓
Descend & connect with Nucleus raphe magnus of medulla
↓
release of Serotonin
↓
posterior horn cells of spinal cord
↓
inhibits the release of substance “P” from the pain fibers
Opioid Peptides:
Enkephalins: Met enkephalins, Leu enkephalins
Endorphins: Beta endorphins, & Dynorphins
Present in PAG (peri aqueductal gray matter), NRM (nucleus raphae magnus),
periventricular areas, posterior horn cells, GITract & Hypothalamus
Endogenous morphine - ENDORPHIN
Two sites of action:

Terminals of pain fibers (receptors) & decrease the response of the receptors to
nociceptive stimuli
At spinal level – binds to opioid receptors & decreases the release of substance P
Reference: Textbook of Medical Physiology, Guyton and Hall, 11th Edition, Page No. 598-
603
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87. (A) What are the nuclei of hypothalamus? (10 marks)
(B) Describe in detail about the functions of hypothalamus.
Answer:
Nuclei Of Hypothalamus
Nuclei of hypothalamus are divided into three groups:
Anterior or preoptic group

Middle or tuberal group

Posterior or mamillary group

Anterior or Preoptic Middle or tuberal Posterior or mamillary

group group group
Preoptic nucleus Dorsomedial nucleus Posterior nucleus
Paraventricular nucleus Ventromedial nucleus Mamillary body
Anterior nucleus Lateral nucleus

Supraoptic nucleus Arcuate (tuberal) nucleus
Suprachiasmatic nucleus
Functions Of Hypothalamus
Secretion of Posterior Pituitary Hormones
Hypothalamus is the site of secretion for the posterior pituitary hormones.
Antidiuretic hormone (ADH) and oxytocin are secreted by supraoptic and
paraventricular nuclei.
Control of Anterior Pituitary
Hypothalamus controls the secretions of anterior pituitary gland by secreting
releasing hormones and inhibitory hormones. It secretes seven hormones.
Control of Adrenal Cortex
Anterior pituitary regulates adrenal cortex by secreting adrenocorticotropic
hormone (ACTH).
Control of Adrenal Medulla
Dorsomedial and posterior hypothalamic nuclei are excited by emotional stimuli.
These hypothalamic nuclei, in turn, send impulses to adrenal medulla through

sympathetic fibers and cause release of catecholamines, which are essential to cope
up with emotional stress.
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Regulation of Autonomic Nervous System

Hypothalamus controls autonomic nervous system (ANS).
Sympathetic division of ANS is regulated by posterior and lateral nuclei of
hypothalamus.
Regulation of Heart Rate
Hypothalamus regulates heart rate through the vasomotor center in the medulla
oblongata.
Stimulation of the posterior and lateral nuclei of the hypothalamus increases the
heart rate. Stimulation of preoptic and anterior nuclei decreases the heart rate.
Regulation of Blood Pressure
Hypothalamus regulates the blood pressure by acting on the vasomotor center.
Stimulation of posterior and lateral hypothalamic nuclei increases arterial blood

pressure and stimulation of the preoptic area decreases the blood pressure.
Regulation of Body Temperature
Body temperature is regulated by hypothalamus.
Hypothalamus has two centers which regulate the body temperature:

(1) Heat loss center that is present in preoptic nucleus of anterior hypothalamus
- Sweating and vasodilatation
(2) Heat gain center that is situated in the posterior hypothalamic nucleus -
Shivering & vasoconstriction
Regulation of Hunger and Food Intake

Food intake is regulated by two centers present in hypothalamus:
Feeding center

Satiety center.

Ventromedial Nucleus
(Satiety center)
↓
Inhibits feeding center
↓
↑Food intake
Lateral Nucleus
(Feeding Center)
↓
Hunger
↓
↓food intake
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Regulation Of Water Balance

Hypothalamus regulates water content of the body by two mechanisms:
Thirst mechanism

Antidiuretic hormone (ADH) mechanism.

Tonicity of body fluid

↓
Osmoreceptors
↓
Thirst center
↓
↑Water intake
ECF volume
↓
Baroreceptors
↓
Thirst center
↓
↑Water intake
Regulation Of Sleep And Wakefulness

Mamillary body in the posterior hypothalamus is considered as the wakefulness
center.
Stimulation of mamillary body causes wakefulness and its lesion leads to sleep.
Stimulation of anterior hypothalamus also leads to sleep.
Role In Behavior And Emotional Changes

The behavior of animals and human beings is mostly affected by two responding
systems in hypothalamus and other structures of limbic system.
These two systems act opposite to one another.
Hypothalamus has two centers for behaviorial and emotional changes.
They are:
(1) Reward center: Ventromedial nucleus
(2) Punishment center: Posterior & lateral nucleus
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Regulation of Sexual Function

It regulates the sexual functions by secreting gonadotropinreleasing hormones.
Arcuate and posterior hypothalamic nuclei are involved in the regulation of sexual
functions.
Role In Circadian Rhythm

Hypothalamus play a role in influencing the changes in body functions tuned to
the day and night cycle
Retina
↓
Optic tract
↓
Suprachiasmatic nucleus of hypothalamus
↓
Pineal gland
↓
Melatonin
↓
Day & night variations
Role in Stress:
It helps to protect the body from damaging effects of stress.
Stress
↓
Cerebral cortex & Limbic system
↓
Hypothalamus
↓
Adrenal cortex
↓
Glucocorticoids
Reference: Textbook of Medical physiology, Guyton and Hall, 11th edition, Page No.
732, 733
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88. (A) What are the parts of the cerebellum? (10 marks)
(B) Name the divisions of cerebellum.
(C) Describe the functional divisions of cerebellum.
(D) Write the functions of cerebellum.
(E) Briefly describe the cerebellar lesions.
Answer:
(A) Parts Of Cerebellum

1. Vermis
Worm-like central body
Formed by nine parts
Superior Vermis Inferior Vermis

1. Lingula 6. Tuber
2. Central lobe 7. Pyramid
3. Culmen 8. Uvula
4. Lobulus simplex 9. Nodulus

5. Declive
2. Cerebellar Hemispheres
Each hemisphere has two portions:
1. Lobulus ansiformis or ansiform lobe, which is the larger portion of cerebellar

hemisphere.
2. Lobulus paramedianus or paramedian lobe, which is the smaller portion of
cerebellar hemisphere.
(B) Divisions Of Cerebellum
Anatomical Divisions Phylogenetic Divisions Physiological Divisions

Anterior lobe Paleocerebellum Vestibulocerebellum
Posterior lobe Neocerebellum Spinocerebellum
Flocculonodular lobe. Corticocerebellum
(C) Functional Divisions Of Cerebellum

Vestibulocerebellum (Archicerebellum)
connected with the vestibular apparatus
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phylogenetically oldest part of cerebellum
regulates tone, posture and equilibrium by receiving impulses from vestibular

apparatus.
Spinocerebellum (Paleocerebellum)
connected with spinal cord
forms the major receiving area of cerebellum for sensory inputs
regulates tone, posture and equilibrium by receiving sensory impulses from tactile
receptors, proprioceptors, visual receptors and auditory receptors.
Corticocerebellum (Neocerebellum
largest part of cerebellum.
connected with the cerebral cortex.
phylogenetically newer part of cerebellum
concerned with planning, programming and coordination of skilled movements.
(D) Functions Of Cerebellum

(1) Control of body posture & equilibrium (Vestibulocerebellum & Spinocerebellum)
(2) Control of Gaze (Movements of eyeballs) – Vestibulocerebellum
Controls eye movements and coordinates with head through medial longitudinal
fasciculus.
(3) Control of muscle tone & Stretch reflex (Spinocerebellum)

Facilitates γ motor neurons in the spinal cord

(4) Control of voluntary movements (Neocerebellum)

Regulates time, rate, range(extent), force and direction of muscular activity.

Controls coordination of movements, but does not initiate movements

Influences the activity of agonists, antagonists & synergistic muscles

Planning and programming of voluntary movements

Smooth transition of movements

Learning of motor skills

(E) Cerebellar Lesions
Ataxia Impaired coordination of movements

Atonia Deficiency of usual and expected tone of muscle
Asynergia Lack of coordination between protogonistics, antagonists

synergists muscles
233
Asthenia Slow movements

Dysmetria Errors in the rate, range, force and direction of movements
Dysdiadochokinesia Inability to perform rapid, alternate movements(supination
& pronation of hands)
Decomposition Movements occurring in stages
Drunken Gait Walks in a zigzag line
Scanning speech Long pauses between syllables and words with loss of melody
in speech production
Intention tremor Oscillatory movements of hands during movements/ tremor
that develops during movement
Nystagmus Jerky movements of eyes
Reference: Textbook of Medical Physiology, Guyton and Hall, 11th Edition, Page No. 698-
706
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Neural
89. (A) What is reflex? (10 marks)
(B) Define reflex arc with the help of a diagram.
(C) Classify reflex based on different factors.
(D) Write a short note on withdrawal reflex.
(E) Briefly describe stretch reflex and inverse stretch reflex.
Answer:
Reflex activity is the response to a peripheral nervous stimulation that occurs
without our consciousness. It is a type of protective mechanism and it protects the
body from irreparable damages.
Reflex arc is the anatomical nervous pathway for reflex action. A simple reflex arc
includes five components:
Receptor - Receptor is the end organ, which receives the stimulus.

Afferent Nerve(sensory neuron) - Afferent or sensory nerve transmits sensory

impulses from the receptor to center.
Center - Center receives the sensory impulses and in turn, it generates appropriate

motor impulses. Center is located in the brain or spinal cord.
Efferent Nerve (motor neuron) - Efferent or motor nerve transmits motor

impulses from the center to the effector organ.
Effector Organ (muscle) - Effector organ is the structure such as muscle or gland

where the activity occurs in response to stimulus.
Afferent and efferent nerve fibers may be connected directly to the center. In
some places, one or more neurons are interposed between these nerve fibers and
the center. Such neurons are called connector neurons or internuncial neurons or
interneurons or relay neurons.
235
(C) Classification Of Reflexes
Methods Types Of Reflex

Depending upon whether inborn Inborn Reflexes or Unconditioned Reflexes
or acquired
Acquired Reflexes or Conditioned Reflexes
Depending upon situation – Cerebellar Reflexes

anatomical classification
Cortical Reflexes
Midbrain Reflexes
Bulbar or Medullary Reflexes
Spinal Reflexes
Depending upon purpose – Protective Reflexes or Flexor Reflexes
physiological classification Antigravity Reflexes or Extensor Reflexes
Depending upon number of Monosynaptic Reflexes
synapse Polysynaptic Reflexes
Depending upon whether visceral Somatic Reflexes
or somatic Visceral or Autonomic Reflexes
Depending upon clinical basis Superficial reflexes
Visceral reflexes
Pathological reflexes.
Deep reflexes
(D) Withdrawal Reflex

Refers to the withdrawal of body parts by flexion of limbs when a painful (noxious)
stimulus is applied.
It is a polysynaptic reflex.
Receptors: Nociceptors
Afferent Limb: Type III & IV somatic afferents
Center: Spinal Cord
Efferent fibers: Somatomotor neuron supplying the flexor muscles of the same side
and extensor muscles of opposite side.
Response:
Mild stimulus- flexion of limb of same side and extension of limb of opposite side.
Stronger stimulus- response in all four limbs.
(Reason: a) Irradiation of impulse, b) Recruitment of more motor units)
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Neural
Special features:
Withdrawal reflex is a protective reflex (protects the tissue from damage)
Shows local sign ie., response depends upon the location of the stimulus
Stronger stimulus causes wide spread and prolonged response
(E) Stretch Reflex

The stretch reflex is a rapid and involuntary muscle response to a sudden stretch
or lengthening of a muscle. It plays a crucial role in maintaining posture, balance,
and coordinating muscle movements.
237
Pathway
Stretch Stimulus → Muscle Spindle Activation → Spinal Cord Processing → Motor
Neuron Response → Muscle Contraction
Inverse Strech Reflex

Refers to relaxation of muscle in response to a strong stretch.
Also called as lengthening reaction or clasp knife reflex.
Receptors: Golgi tendon organ
Afferent fibers: Group Ib fibers
Center: Corresponding spinal segment
Efferent fibers: α motor neuron to the corresponding muscle
Response: Inhibition of α motor neuron by the inhibitory interneuron and relaxation
of the corresponding muscle.
Functions
Monitors the force generated in the muscle
monitors muscle tension and prevents rupture of muscle
along with stretch reflex maintains optimal motor responses for postural
adjustments.
Reference: Textbook of Medical Physiology, Guyton and Hall, 11th Edition, Page No. 676, 678

238
Neural
90. Briefly describe the types and mechanism of memory. (3 marks)
Answer:
Definition of Memory
Refers to the ability to recall past events at a conscious or a subconscious level.
Types
Short term memory: recalling within a few minutes or few days (e.g) recalling a
phone number to dial immediately after memorizing it.
Long term memory: (remote memory) recalling the stored information even after
few days or few years (e.g) remembering about the picnic enjoyed.
Mechanism
Mechanism of short term memory
1. Post tetanic potentiation or facilitation: When an excitatory presynaptic neuron

is stimulated for a brief period by a tetanizing current, the synapse becomes
more excitable after stoppage of stimulus.This is due to accumulation of Calcium
in presynaptic nerve endings.
2. Reverberatory circuit theory: Reverberation of impulses between cerebral cortex

brainstem and subcortical nuclei through reverberating circuits.
3. Presynaptic facilitation: The presynaptic neuron is facilitated for a long time by

neurons that lie on presynaptic terminals. Neurotransmitter involved is serotonin.
Mechanism of long term memory
Physiological changes
Changes in the gene expression in postsynaption neuron in the synthesis and

release of excitatory neurotransmitter
Changes in the response of receptors in the post synaptic membrance

Anatomical changes
Changes in the member & shapes of dendritic spines

Changes in number & size of synapses thickening of cortex

Formation of new synaptic connections

Chemical changes
increase in RNA, protein & neurotransmitter synthesis

239
Conversion of recent (short term) memory into long term memory
Recent memory initiates chemical, physical and structural changes in the synapses
that are responsible for permanent memory
Hippocampus is the area mainly responsible for recent memory and its conversion
in permanent memory
Conversion will be lost in case of brain injury and electric shock
Reference: Textbook of Medical Physiology, Guyton and Hall, 11th Edition, Page No. 724,
725

240
Neural
91. (A) What is Aphasia?What are its causes? Also describe its types in brief.
(B) Write some abnormalities of memory. (5 marks)
Answer:
(A) Definition Of Aphasia

Aphasia is defined as the loss or impairment of speech due to brain damage.
Aphasia is not due to paralysis of muscles of articulation. It is due to damage to

speech centers.
Damage of speech centers impairs the expression and understanding of spoken
words. It also affects reading and writing.
Causes of Aphasia
Mainly, aphasia occurs due to damage of one or more speech centers, which are
situated in the cerebral cortex.
Damage of speech centers occurs due to:
Stroke

Head injury

Severe blow to head

Cerebral tumors

Brain infections

Degenerative diseases.

Types Of Aphasia
Type of Aphasia Lesion Site Main Features

Fluent Aphasia Wernicke’s area (Area 22) Excessive talk with full
Sensory or Wernicke’s of Jargons & Neologisms
Speak well, good auditory
Conduction aphasia Areas 40, 41 & 42 (in and comprehension but can
around auditory cortex) not put parts of words
together
Non - fluent Aphasia Broca’s area (Area 44) Slow speech, words are
Motor/Broca’s aphasia hard to come by, limited
to two or three words to
express the whole range
of meaning and emotion.
241
Global Aphasia Angular gyrus Normal speech

Normally understand the
auditory information
Difficulty in understanding
the written language or
pictures
Anomic Aphasia Both Wernicke’s and Broca’s Scanty, non fluent speech
area
(B) Abnormalities Of Memory
AMNESIA - Loss of memory is known as amnesia.

Amnesia is classified into two types:
Anterograde amnesia: Failure to establish new long-term memories. It occurs

because of lesion in hippocampus.
Retrograde amnesia: Failure to recall past remote long-term memory. It occurs

in temporal lobe syndrome.
Dementia
Dementia is the progressive deterioration of intellect, emotional control, social
behavior and motivation associated with loss of memory.
Usually, it occurs above the age of 65 years.
Most common cause of dementia is Alzheimer disease.
Alzheimer’s Disease
Alzheimer disease is a progressive neurodegenerative disease.
It is due to degeneration, loss of function and death of neurons in many parts of
the brain, particularly cerebral hemispheres, hippocampus and pons.
Synthesis of acetylcholine decreases due to lack of enzyme choline acetyltransferase.
Dementia is the common feature of this disease.
Reference: Textbook of Medical physiology, Guyton and Hall, 11th edition, Page No. 720, 725

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Functions Of Limbic System

Hypothalamus plays an important role in regulation of endocrine secretion and

Emotional state of human beings is maintained by the hippocampus along with

Receptors situated in the skin are called the cutaneous receptors.

Cutaneous receptors are also called mechanoreceptors because of their response

Receptors, which give response to chemical stimuli.

Cutaneous receptors Chemoreceptors Telereceptors

Sensation Receptor Sensation Receptor Sensation Receptor

81. (A) Describe the components of basal ganglia. (10 marks)

(B) Write the different connections of basal ganglia.

(C) What are the functions of basal ganglia?

(D) Describe the clinical condition called “Parkinsonism”.

Components Of Basal Ganglia

Basal ganglia include three primary components:

ii. Lenticular nucleus.

ii. Lenticular Nucleus

Lenticular nucleus is a gray mass, situated lateral to the internal capsule.

b. Inner globus pallidus.

Subthalamic Nucleus Of Luys

Subthalamic nucleus is situated lateral to red nucleus and dorsal to substantia

Connections Of Basal Ganglia

Direct Pathway: Excitatory pathway & facilitates the intended movement.

Globus pallidus Interna

Indirect Pathway: Inhibitory pathway & inhibits unwanted movement.

Globus pallidus Externa. ←←←Striatum←←Dopamine ← Substantia nigra

Subthalamic nucleus.→→→→ + Globus pallidus Interna

Brain stem & Spinal cord. Thalamus

Functions Of Basal Ganglia

Dysfunction can lead to mood disorders and emotional dysregulation.

Looping Connections with Other Brain Regions:

Caused by lesions in the basal ganglia.

Mainly caused by the loss of dopaminergic inhibition of the putamen.

Drugs like chlorpromethazine.

MPTP (Methyl phenyl tetrahydropyridine) poisoning.

Lack of initiation of movements.

Retardation of movements and loss of automatic, associated movements.

Loss of timing and scaling of movements (micrographia).

Characterized by alternate contraction and relaxation of agonists and antagonists

Characterized by short, quick shuffling steps as if to catch the center of gravity.

(B) What are the types of sleep?

(C) Define electroencephalogram (EEG). Also, explain the normal EEG.

(D) Define Alpha Block.

(E) List some sleeping disorders. (10 marks)

Physiological Changes During Sleep

Babinski sign becomes positive during deep sleep.

Threshold for most of the reflexes increases.

Pupils are constricted.

Electrical activity in the brain varies with stages of sleep.

Rapid eye movement sleep or REM sleep

Non-rapid eye movement sleep, NREM sleep or non-REM sleep.

Rapid eye movement sleep or REM sleep

Non-rapid eye movement sleep, NREM sleep or non-REM sleep.

REM SLEEP NREM SLEEP

O2 consumption More Less

Normal Eeg Pattern

Location Frequency Amplitude

Beta Rhythm Obtained when Parietal and 18-30 5-10

Hypothalamus plays an important role in regulation of endocrine secretion and

Emotional state of human beings is maintained by the hippocampus along with

81. (A) Describe the components of basal ganglia. (10 marks)

Basal ganglia include three primary components:

Lenticular nucleus is a gray mass, situated lateral to the internal capsule.

Subthalamic nucleus is situated lateral to red nucleus and dorsal to substantia

Dysfunction can lead to mood disorders and emotional dysregulation.

Caused by lesions in the basal ganglia.

Mainly caused by the loss of dopaminergic inhibition of the putamen.

Drugs like chlorpromethazine.

MPTP (Methyl phenyl tetrahydropyridine) poisoning.

Lack of initiation of movements.

Retardation of movements and loss of automatic, associated movements.

Loss of timing and scaling of movements (micrographia).

Characterized by alternate contraction and relaxation of agonists and antagonists

Characterized by short, quick shuffling steps as if to catch the center of gravity.

(E) List some sleeping disorders. (10 marks)

Babinski sign becomes positive during deep sleep.

Threshold for most of the reflexes increases.

Pupils are constricted.

Electrical activity in the brain varies with stages of sleep.

Beta Rhythm Obtained when Parietal and 18-30 5-10

In conscious mental activity and on application of a stimulus

Narcolepsy: It is the sudden attack of uncontrollable sleep.

Sleep Apnea Syndrome is the temporary stoppage of breathing repeatedly during

It is also called bedwetting.

It is common in children.

(B) Describe the wallerian degeneration. (10 marks)

Infections & Trauma

Cancers and Tumors

Excessive Pressure or Compression

Vitamin Deficiencies: Inadequate intake of certain vitamins, such as vitamin B12

Axis cylinder swells & breaks into fragments

Debris collects in the axis cylinder place

Myelin sheath slowly disintegrates into fat droplets

Neurilemma remains intact

Schwann cells proliferate rapidly

Macrophages remove debris of axis cylinder

Neurilemmal tube becomes empty (ghost tube)

Schwann cell cytoplasm fills the neurilemmal tube

First nissl granules disintegrates into fragments - chromatolysis

Golgi apparatus disintegrates

Cell body swells due to accumulation of fluid and becomes round.

Nucleus is pushed to the periphery.

Entry of some of these branches into the peripheral stump

Complete functional recovery takes 3 years.

85. Briefly explain about Brown Sequard Syndrome. (3 marks)

(D) Explain how pain is managed in our body. (10 marks)

It is experienced as a bright, sharp and localized pain sensation.

2nd order neuron:

2nd order neuron:

Endorphins: Beta endorphins, & Dynorphins

87. (A) What are the nuclei of hypothalamus? (10 marks)

These hypothalamic nuclei, in turn, send impulses to adrenal medulla through