Physiology practical _ BDS level 4 _ Diseases and general review _ ISNC side note:(slide 19 has one exception of a biogenic amine with different Receptor location)

1. Physiology practical
Level 4 _ Diseases
Written by: Olla S. BaEissa

2. • Clinical disease/disorder : Dwarfism
• • Reason: deficiency of GH secretion during childhood
• • Gland: Anterior pituitary.
• • Features: (For my Info)
• – Physical parts of the body develop inappropriate proportion to one another
• - the rate of development is greatly decreased.
• GRH deficiency _ GH deficiency _ ↓ IGF-I or other causes

3. • Clinical disease/disorder: Gigantism
• • Reason: Increased production of GH during adolescence
(or) Increased production of GH before epiphyseal closure
• • Gland: Anterior pituitary.
• • Features:
• Tumors of somatotrophs
• Patients grow – 8 feet
• Tall stature
• Gynacomastia

4. • Clinical disease/disorder: Acromegaly
• • Reason: Increased secretion of GH after adolosence.
• • Gland: Anterior pituitary.
• • Features:
• Enlargement in the bones of the hands and feet ,
• frontal and facial bones (acromegalic facies)
• lower jaw protrudes forward (prognathism)
• Changes in the vertebrae cause a hunched back (kyphosis)
• visual field changes (Bi-temporal hemianopia)
• nose increases to as much as twice normal size
• Increased body hair (hirsutism)

5. • Clinical disease/disorder: Goiter
• • definition: Any enlargement of thyroid gland, occurs in a gland that is producing too much hormone or too little
hormone (hyperthyroidism), (hypothyroidism)
• • Reason: is an increase in thyroid stimulating hormone (TSH) in response
to a defect in normal hormone synthesis within the thyroid gland.
• • Gland: Thyroid gland.
• • Features:
• • not in case of the normal amount of hormone (euthyroidism).
• • Thyroid gland grows abnormally.
• • commonly develops as a result of iodine deficiency or inflammation of the thyroid gland

6. • Clinical disease/disorder: Graves’ disease
• • definition: Hyperthyroidism
• • Reason: Increase secreation of T3 & T4
• • Gland: Thyroid gland.
• • Features:
• • ↑ BMR
• • Heat intolerance
• • Thyrotoxic myopathy – weight loss
• • Undue fatigue, osteoporosis
• • Skin – warm, moist & soft
• • Tachycardia.
• • protrusion of the eyeballs Exophthalmos

7. • Clinical disease/disorder: Myxedema
• • definition: Hypothyroidism in adults
• • Reason: Decrease secretion of T3 & T4 in adults
• • Gland: Thyroid gland.
• • Features:
• Goiter
• Puffiness of the face, periorbital swelling
• loss of scalp hair
• low BMR
• Ptosis
• hoarseness of voice
• Constipation
• Weight gain and water retention
• Bradycardia

8. • Clinical disease/disorder: Cretinism
• • definition: Hypothyroidism in Children.
• • Reason: iodine deficiency which leads to
Decrease secretion of T3 & T4 in children.
• Gland: Thyroid gland.
• • Features:
• Dwarf child
• Mentally retarded child
• enlarged, protruding tongues.
• stunted physical and mental growth
due to untreated congenital deficiency of thyroid hormones
• failure of sexual development

9. • Clinical disease/disorder: Hypocalcemia Tetany
• • definition:
• • Reason: Decrease plasma calcium.
• • Gland: parathyroid gland.
• • Features:
• Chvostek’s sign: A quick contraction of ipisilateral facial muscles
• Trousseaus sign: A spasm of the muscles of the upper limb causes flexion of wrist &
thumb with extension of fingers
• Laryngospasm / Bronchospasm / Carpopedal spasm
• Tetany , Seizures

10. • Clinical disease/disorder: Cushing’s Syndrome
• definition:
• Reason: increase secretion (Hypersecretion) of cortisol.
• Gland: Adrenal cortex
• Features:
• • Moon like face
• • Striae: Prominent reddish purple scars – rupture of sub dermal tissue
• • Upper body weight gain
• • Hypertensive
• • Skin that bruises easily.

11. • Clinical disease/disorder: Addison’s Disease
• definition: a disease characterized by low blood pressure, great weakness, and bronze discoloration of the skin.
• Reason: decreased secretion of cortisol and aldosterone (Hypoadrenalism)
• Gland: Adrenal cortex
• Features:
- Hyperpigmentation of face and hand (bronze color)
- Weakness
- Weight loss
- Hypoglycemia
- Gastrointestinal problems

12. • Clinical disease/disorder: Diabetes Mellitus
• definition: It is a syndrome of impaired carbohydrate, fat, and protein metabolism.
• Gland: Pancreas.
• Reason: decrease sensitivity of the tissues to insulin.
• Normal blood glucose level: 70-110 mg/dl

13. • •Types of Diabetes Mellitus:
• • Type 1 Diabetes
• insulin-dependent diabetes mellitus (IDDM)
• caused by lack of insulin secretion.
• • Type II Diabetes
• non-insulin dependent diabetes mellitus (NIDDM)
• caused by decreased sensitivity of target tissues to insulin. (insulin
resistance )

14. General Review

15. Based on the location of receptor identify the type,
and give an example ?
1-Receptor in nucleus :
ex: Biogenic amines thyroid hormone (T3 & T4)
2-Receptor in cytosol :
ex: Steroid hormone (testosterone)
3-Receptor on surface of cell membrane :
ex: Protein hormone (Growth hormone)

16. Type:
Biogenic amines
Examples:
Thyroid hormones
Thyroxine (T4)
Triiodothyronine (T3 )
Adrenal medulla hormones
Epinephrine, Norepinephrine
Identify the type of hormone and give an example?

17. Type:
Steroid hormone
Examples:
Cortisol,
Estrogen,
Testosterone
Identify the type of hormone and give an example?

18. Type:
Protein or peptide hormone
Examples:
Hypothalamic hormones,
Pituitary (Ant. & Post.),
Islets of Langerhans,
Parathyroid hormone
Identify the type of hormone and give an example?

19. Chemical Group definition Example Receptor location
Steroid hormone Derivatives of cholesterol
- Cortisol,
- Estrogen,
- Testosterone
Receptor in cytosol
Biogenic amines
Derivatives of tyrosine or an
amino acid
Thyroid hormones
- Thyroxine (T4),
- Triiodothyronine (T3)
Adrenal medulla hormones
- Epinephrine,
- Norepinephrine
Receptor in nucleus
Protein hormone
(peptide hormones)
Chains of amino acids, 4 –
200+ amino acids
- Hypothalamic hormones,
- Pituitary (Ant. & Post.),
- Growth hormone,
- Islets of Langerhans,
- Parathyroid hormone
Receptor on surface of
cell membrane

20. What is the type of deep sensation and define it?
The ability of the person to differentiate weights put in the hand while
it is supported & eyes closed.
1- Pressure sense.
It is the sense of pressure applied to different parts of the body.

21. What is the type of deep sensation and define it?
The ability of the person to differentiate weights put in the hand
when the hand is unsupported & the eyes closed.
2- Tension sense.
It is sense of the degree of muscle contraction (muscle tension).

22. What is the type of deep sensation and define it?
placing the base of vibrating tuning fork on bony prominences.
3- Vibration sense.
It is sense of vibration applied to different parts of the body.

23. What is the type of deep sensation and define it?
The ability to tell the position of different parts of the body while the
eyes closed.
4- Sense of position.
It is orientation of different parts of the body in relation to each other
with the eyes closed.

24. What is the type of deep sensation and define it?
The ability of detection of joint movement while the eyes closed.
5- Sense of movement.
It the sense of movement applied to joint while the eyes closed.

25. Types of Fine Touch?
A) Tactile localization (one point localization):
It is the ability of the person to localize exactly the touched point with his
eyes closed.
B) Tactile discrimination (two point discrimination):
It is the ability of the person to feel two points of the skin touched
simultaneously as two separate points, with eyes closed.
The distance between the two points is more than the threshold distance.
C) Stereognosis (judge & choose known objects):
It is the ability to know known object from its shape, and texture
with eyes closed

26. Threshold distance of two point discrimination:
It is the minimal distance a person can feel two stimulated
points simultaneously as two separate points with eyes closed.
Distance:
It is short about 2 mm:
in distal parts of fingers, tip of the tongue, and lips.
It is long about 4 cm:
in the back.

27. • Urine formation:
The rates at which different substances are excreted in the urine
represent the sum of the three renal processes. (L/day)
• The three renal processes:
1) glomerular filtration.
2) reabsorption of substances from the renal tubules into the blood.
3) secretion of substances from the blood into the renal tubules.
Excretion = Glomerular Filtration – Tubular absorption + Tubular secretion
Excretion = G.F – T.A + T.S

28. Calculation of net filtration pressure:
(Glomerular hydrostatic P. + Bowman's oncotic P.) – (Bowman's hydrostatic P. + Glomerular oncotic P)
Net filtration pressure = (G.H.P + B.O.P) – (B.H.P + G.O.P)
Net filtration pressure = (G.H.P + B.O.P) – (B.H.P + G.O.P)
= (60 + zero) – (32 + 18)
= 10 mm Hg.

29. Measurement of GFR:
It is measured by the use of Inulin or creatinine clearance.
Clearance of a substance is :
the volume of plasma cleared from that substance / minute.
U (x) × V
C (x) = ------------------- = ( ml / min )
P ( x )
U ( x ) = concentration of substance x in urine ( mg /ml ).
V = urine flow rate ( ml / min )
P ( x ) = concentration of substance x in plasma (mg / ml )

30. •Calculation of Filtration fraction:
It is the percentage ratio of renal plasma flow (RPF) that becomes
filtrated (OR) it is the percentage ratio of GFR to RPF.
= GFR ÷ RPF = 125 ÷ 650 = about 20 %

31. • Calculation of Filtered load of a substance:
= GFR x concentration of substance in plasma
Q) If glucose concentration in blood is 100 mgm% (1 mgm/ml) and
GFR = 125 ml/min, Filtered load of glucose = 125 x 1 = 125
mgm/min. Calculation of Excretion rate of a substance ?
= (urine volume/min) x (concentration of substance in urine)