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By S. Altus. Governors State University.

The bonds between glutamine and lysine residues are formed between terminal domains of γ chains and polar appendages of α chains of neighboring residues order omeprazole 10mg chronic gastritis years. Flow chamber The specimen handling area of a flow cytometer where cells are forced into single file and directed in front of the laser beam discount omeprazole 40mg with amex gastritis diet 3-1-2-1. Fluorochrome Molecules that are excited by light of one wavelength and emit light of a different wavelength buy 10 mg omeprazole amex gastritis diet 80. During normal lymphocyte development omeprazole 40mg without prescription chronic gastritis gerd, rearrangement of the immunoglobulin genes and the T cell receptor genes results in new gene sequences that encode the antibody and surface antigen receptor proteins necessary for immune function. In humans, the genome consists of 3 billion base pairs of dna divided among 46 chromosomes, including 22 pairs of autosomes numbered 1—22 and the two sex chromosomes. Glutathione A tripeptide that takes up and gives off hydrogen and prevents oxidant damage to the hemoglobin molecule. Glycoprotein Ib A glycoprotein of the platelet surface that contains the receptor for von Willebrand factor and is critical for initial adhesion of platelets to collagen after an injury. Glycosylated Hemoglobin that has glucose irreversibly hemoglobin attached to the terminal amino acid of the beta chains. Usually seen in bacterial infections, inflammation, metabolic intoxication, drug intoxication, and tissue necrosis. Granulomatous A distinctive pattern of chronic reaction in which the predominant cell type is an activated macrophage with epithelial-like (epithelioid) appearance. Gray platelet syndrome A rare hereditary platelet disorder characterized by the lack of alpha granules. Hairy cell The neoplastic cell of hairy cell leukemia characterized by circumferential, cytoplasmic, hairlike projections. Helmet cell Abnormally shaped erythrocyte with one or several notches and projections on either end that look like horns. Hematocrit The packed cell volume of erythrocytes in a given volume of blood following centrifugation of the blood. Hematoma A localized collection of blood under the skin or in other organs caused by a break in the wall of a blood vessel. Hematopoiesis The production and development of blood cells normally occurring in the bone marrow under the influence of hematopoietic growth factors. Hematopoietic Specialized, localized environment in microenvironment hematopoietic organs that supports the development of hematopoietic cells. Hematopoietic stem cell Hematopoietic precursor cell capable of giving rise to all lineages of blood cells. Heme The nonprotein portion of hemoglobin and myoglobin that contains iron nestled in a hydrophobic pocket of a porphyrin ring (ferroprotoporphyrin). Hemoconcentration Refers to the increased concentration of blood components due to loss of plasma from the blood. Hemoglobin An intracellular erythrocyte protein that is responsible for the transport of oxygen and carbon dioxide between the lungs and body tissues. Hemoglobin distribution A measure of the distribution of hemoglobin width within an erythrocyte population. Hemoglobin Method of identifying hemoglobins based on electrophoresis differences in their electrical charges. Hemoglobinopathy Disease that results from an inherited abnormality of the structure or synthesis of the globin portion of the hemoglobin molecule. Hemolytic anemia A disorder characterized by a decreased erythrocyte concentration due to premature destruction of the erythrocyte. Hemolytic transfusion Interaction of foreign (nonself) erythrocyte reaction antigens and plasma antibodies due to the transfusion of blood. There are two types of transfusion reactions: immediate (within 24 hours) or delayed (occurring 2 to 14 days after transfusion). Hemopexin A plasma glycoprotein (β-globulin) that binds the heme molecule in plasma in the absence of haptoglobin. Hemosiderin A water insoluble, heterogeneous iron—protein complex found primarily in the cytoplasm of cells (normoblasts and histocytes in the bone marrow, liver, and spleen); the major long-term storage form of iron. Readily visible microscopically in unstained tissue specimens as irregular aggregates of golden yellow to brown granules. Hemosiderinuria Presence of iron (hemosiderin) in the urine; result of intravascular hemolysis and disintegration of renal tubular cells. Heparin A polysaccharide that inhibits coagulation of blood by preventing thrombin from cleaving fibrinogen to form fibrin. The abnormal shape is due to a horizontal interaction defect with abnormal spectrin, deficiency or defect in band 4. Hereditary spherocytosisA chronic hemolytic anemia caused by an inherited erythrocyte membrane disorder. Hexose-monophosphate A metabolic pathway that converts glucose-6- shunt phosphate to pentose phosphate. Hodgkin lymphoma Malignancy that most often arises in lymph (disease) nodes and is characterized by the presence of Reed-Sternberg cells and variants with a background of varying numbers of benign lymphocytes, plasma cells, histiocytes, and eosinophils. Homologous Consists of two morphologically identical chromosomes that have identical gene loci, but may have different gene alleles as one member of a homologous pair is of maternal origin and the other is of paternal origin. On Romanowsky stained blood smears, it appears as a dark purple spherical granule usually near the periphery of the cell. Hydrops fetalis A genetically determined hemolytic disease (thalassemia) resulting in production of an abnormal hemoglobin (hemoglobin Bart’s, γ4) that is unable to carry oxygen. Hypercoagulable state A condition associated with an imbalance between clot promoting and clot inhibiting factors. This can be brought about by an increase in the number of cells replicating, by an increase in the rate of replication, or by prolonged survival of cells. The stimulus for the proliferation may be acute injury, chronic irritation, or prolonged, increased hormonal stimulation; in hematology, a hyperplastic bone marrow is one in which the proportion of hematopoietic cells to fat cells is increased. Hypochromic A lack of color; used to describe erythrocytes with an enlarged area of pallor due to a decrease in the cell’s hemoglobin content. Hypofibrinogenemia A condition in which there is an abnormally low fibrinogen level in the peripheral blood. It may be caused by a mutation in the gene controlling the production of fibrinogen or by an acquired condition in which fibrinogen is pathologically converted to fibrin. Hypogammaglobulinemi A condition associated with a decrease in a resistance to infection as a result of decreased γ-globulins (immunoglobulins) in the blood. Hypoplasia A condition of underdeveloped tissue or organ usually caused by a decrease in the number of cells. A hypoplastic bone marrow is one in which the proportion of hematopoietic cells to fat cells is decreased. The irf may be helpful in evaluating bone marrow erythropoietic response to anemia, monitoring anemia, and evaluating response to therapy. Immune hemolytic An anemia that is caused by premature, immune anemia mediated, destruction of erythrocytes. Diagnosis is confirmed by the demonstration of immunoglobulin (antibodies) and/or complement on the erythrocytes. The cell is morphologically characterized by a large nucleus with prominent nucleoli, a fine chromatin pattern, and abundant, deeply basophilic cytoplasm. Consists of two pairs of polypeptide chains: two heavy and two light chains linked together by disulfide bonds. Immunohistochemical Application of stains using immunologic stains principles and techniques to study cells and tissues; usually a labeled antibody is used to detect antigens (markers) on a cell. Ineffective erythropoiesisPremature death of erythrocytes in the bone marrow preventing release into circulation. Infectious lymphocytosisAn infectious, contagious disease of young children that may occur in epidemic form. The most striking hematologic finding is a leukocytosis of 40—50 X 109/L with 60—97% small, normal-appearing lymphocytes.

The parties to the Joint Statement agreed to the countries with ethnic Azerbaijanis living in Georgia and ethnic ensure regular exchange of information buy omeprazole 40 mg on line gastritis or appendicitis, synchronize action Georgians living in Azerbaijan and frequent population movements plans buy omeprazole 40mg fast delivery gastritis diet sample menu, ensure early notification of any changes generic 20 mg omeprazole with visa gastritis black stool, establish a across the border purchase 20mg omeprazole otc gastritis symptoms relief. Other countries in the Region have not reported consistent (Islamic Republic of Iran, Iraq and Saudi Arabia) and 4 countries that decreases in the number of cases (Djibouti, Pakistan, Somalia, Sudan are in the phase of preventing re-introduction of malaria (Egypt, and Yemen), although Sudan has extended the coverage of malaria Morocco, Oman, and the Syrian Arab Republic). Four countries accounted for Arabia) showed evidence of a sustained decrease of more than 50% 98% of the confrmed cases: Sudan, 70%; Pakistan, 17%; Afghanistan in the number of cases since 2000, associated with widespread imple- 6%; and Yemen, 5%. Since then the malaria burden the country has recorded no locally-acquired cases of malaria, but has declined steadily in response to a combination of intensified receives an average of 109 imported cases annually, of which 88% control interventions, improved health service coverage and socio- are due to P. It is intense and widespread in the Pacifc countries interventions appears to be low in Viet Nam which may refect the (Papua New Guinea and Solomon Islands and, to a lesser extent, focal nature of malaria in the country. In both Cambodia and Papua Approximately 247 000 confrmed cases were reported from the New Guinea there was little change in confrmed cases although Region in 2009. Three countries (Papua New Guinea, 31%, Cambodia, Cambodia reported a reduction in malaria deaths from 608 in 2000 26% and Solomon Islands, 13%) accounted for the 71% of the to 279 in 2009 (54% decrease). Despite this high importation rate, Italy had only two instances of local transmission: one case in 1997 and two cases in of reintroduction 2007, all due to P. There has been continued progress towards malaria elimination The other country in this group with local mosquito-borne trans- in several countries in 2009 and 2010. Morocco and Register is the United Arab Emirates, which reported 18 240 imported Turkmenistan were certifed free of malaria in 2010 and Cape Verde malaria cases over the period 1999–2008 (range: 1322–2629 per entered the pre-elimination stage in 2010. For 2008, the importation rate amounted and prevention of reintroduction phases as of 1 December 2010. No local transmission has been reported in the has to be made that, beyond reasonable doubt, the chain of local United Arab Emirates since 1997. The team makes a recommendation on and deaths, 2000–2009 certifcation based on an assessment of the current situation and the likelihood that elimination can be maintained. If only one household survey was “malaria-free” countries in the Weekly Epidemiological Record and on available then health service use was assumed to remain constant the International travel and health web site (www. In such cases an reports such instances in the annual updates of International travel estimate of the number of cases was constructed by sampling from and health. Such a procedure results with the degree of importation of parasites into an area (vulnerabil- in an estimate that shows little change over time but which also ity), the likelihood that imported parasites will encounter favourable produces a wide uncertainty interval around the point estimate. For some African ness of the public health services for any occurrence of malaria in an countries the quality of surveillance data did not permit a convinc- area in which it had not existed or from which it had been eliminated, ing estimate to be made from the number of reported cases. For these countries, an estimate of the number of malaria cases Over the period 1981–2007, the 11 countries in the European was derived from an estimate of the number of people living at Region that were certifed as having achieved malaria elimination high, low or no risk of malaria. Spain September 1964 By 1952 malaria in Turkmenistan was eliminated "as a major Bulgaria July 1965 public health problem", and P. In the 1990s, the situation deteriorated because Jamaica November 1966 of neglect of the malaria problem and increased population Cyprus October 1967 movement. In 1998, 108 cases of malaria were detected in Poland October 1967 Kushka (now Serhetabad) etrap (district) of Mary velayat (province). Netherlands November 1970 United States of America and its outlying areas of In the 10 years 1999–2008, a total of 150 malaria cases Puerto Rico and the Virgin Islands November 1970 were detected in Turkmenistan. By 2007, the Ministry of Health and France, Reunion March 1979 Medical Industry decided to aim for certification of elimination, Australia May 1981 and in 2009, after 4 years without local transmission, procedures Singapore November 1982 towards certification of the achievement of malaria elimination were Brunei Darussalam August 1987 launched. In 2009 there were an estimated 225 million cases of malaria Reference Group in 2004 (1) and also described in World Malaria th th (5 –95 centiles, 169–294 million) worldwide (Table 6. The global number of cases The number of malaria deaths was estimated by one of two was estimated to have increased between 2000 and 2005 in line with methods: population growth and decreased subsequently due to the impact of malaria control. The number of deaths was estimated by multi- by the Region of the Americas (42%) The vast majority of cases in plying the estimated number of P. This method is used for all countries outside the African Region and for countries within the African Numbers for years prior to 2009 have been updated from previous Region where estimates of case incidence were derived from publications. They are largely consistent with those given in theWorld routine reporting systems and where malaria causes less than 5% Malaria Report 2009 (14); they are accompanied by large uncertainty of all deaths in children under 5 as described in the Global Burden intervals, which overlap those of estimates published in previous of Disease Incremental Revision for 2004 (11). In situations where the but merely revisions to estimates which take into account updates fraction of all deaths due to malaria is small, the use of a case to the number of reported cases or new household survey informa- fatality rate in conjunction with estimates of case incidence was tion. The global number of malaria deaths is estimated to have mortality than attempts to estimate the fraction of deaths due to decreased from 985 000 in 2000 to 781 000 in 2009. The estimated numbers of deaths for prior years are 1–59 months in countries with less than 80% of vital registration consistent with those reported in the World Malaria Report 2009 but coverage. These data are mainly from high mortality and are accompanied by large uncertainty intervals, which overlap those lower income countries. Studies conducted in 1980 or later with a multiple of 12 months study duration, cause of death available for more than a single cause, with at in malaria cases in three countries in 2009 that had previously least 25 deaths in children <5 years of age, each death represented once, shown decreases (Rwanda, Sao Tome and Principe, and Zambia). In in intervention groups in clinical trials, and verbal autopsy studies con- ducted without use of a standardized questionnaire or with inadequate Rwanda, national-level rainfall and temperature anomalies were description of methods were excluded from the analysis. Reductions in malaria outside Africa are greater in countries Actions needed to prevent and contain resurgences. The countries that recorded more than 50% malaria cases highlight the fragility of malaria control and the need decreases since 2000 in the numbers of cases accounted for only to maintain control programmes even if numbers of cases have 14% of the total estimated cases outside Africa in 2000 (8. The countries with the highest ing of disease surveillance data both nationally and sub-nationally malaria burdens within each Region were less successful in reducing is essential. Since most countries in sub-Saharan Africa had inad- the numbers of cases of malaria nationally, which may be related to equate data to monitor disease trends, greater eforts are needed smaller per capita investments in malaria control. Major epidemiologi- cal events could be occurring in other countries but are not being Significant reductions in malaria burden are estimated to have detected and investigated. The number of cases of malaria was estimated to have decreased globally from 244 million in 2005 to 225 million Reductions of cases outside Africa. The number of deaths due to malaria was also estimated to in the reported number of cases of malaria between 2000 and 2009 have decreased from 985 000 in 2000 to 781 000 in 2009. Zambia national malaria indicator survey 2006, Lusaka, Ministry of Health, Government of the Republic of Zambia, 2006 www. Zambia national malaria indicator survey 2008, Lusaka, Ministry of Health, Government of the Republic of Zambia, 2008 www. Zambia national malaria indicator survey 2010, Lusaka, Ministry of Health, Government of the Republic of Zambia, 2010 9. Estimating the distribution of causes of child deaths in high mortality countries with incomplete death cer- tification. Malaria in São Tomé and Principe: on the brink of elimination after three years of effective antimalar- ial measures. Impact of artemisinin-based combination therapy and insecticide-treated nets on malaria burden in Zan- zibar. For countries or areas in the African Region, and for Sudan in the Eastern Mediterranean Region and Papua New Guinea in the Western Pacifc Region, the total of the probable and confrmed cases was used as numerator 1. It should be noted that case incidence rates malaria due to all species was 1 or more per 1000 population per for 2009 do not necessarily refect the endemicity of areas in previous year in 2009. If subnational data on population or malaria cases were lacking, an administrative unit was labelled “no data” on the map. Transmission in these areas is generally the result of modifcations to administrative boundaries or the use of highly seasonal, with or without epidemic peaks. Malaria-free areas, where there is no continuing, local, mosquito- borne malaria transmission, and all reported malaria cases are Vector and parasite species imported (2). Areas may become malaria-free The species of mosquito responsible for malaria transmission in a due to environmental factors or as a result of efective control country and the species of Plasmodium involved are listed according eforts. The population at risk is often used The frst graph shows four indicators: as the denominator in calculating operational coverage of malaria t Number of confrmed cases in all ages per 1000 population per year: interventions, and hence in assessing current and future needs, This indicator helps to asses changes in the incidence of malaria taking into account the population already covered. For countries or over the years, provided that there has been consistency in case areas in the pre-elimination and elimination stages, population at reporting over time.

Learning Outcomes for Study Session 7 When you have studied this session omeprazole 10 mg lowest price gastritis diet 3-2-1, you should be able to: 7 order omeprazole 10mg mastercard gastritis pain remedy. Vitamins are necessary in small amounts in our diet to facilitate growth cheap omeprazole 40mg otc gastritis or appendicitis, maintenance of health and reproduction order omeprazole 10 mg line gastritis causes. Although minerals make up only a small portion of body tissues, they are essential for normal growth and functioning. Because only very minute quantities of vitamins and minerals are needed for health, they are called micronutrients. These elements are essential; they cannot be manufactured by the human body and must be obtained through 79 dietary means. Among these micronutrients, three have obtained worldwide attention and are the focus of this study session due to their high public health significance. Vitamin A, iodine and iron deficiencies lead to grave health, social and economic consequences; but the good news is that there are cost- effective strategies to overcome these deficiencies. You can also work with the women in your village to help identify potential problems and families who need support. The overall goals and objectives of the prevention and treatment of micronutrient deficiencies in Ethiopian are shown in Box 7. To increase coverage of the programmes that improve the micronutrient status of the population. In Ethiopia, one out of every 1000 people is affected and about 50,000 prenatal deaths occur yearly due to iodine deficiency disorder. This is in part because of the marked decrease in the amount of iodised salt being consumed in Ethiopian households compared with a decade ago. Anaemia is a widespread health problem affecting more than two billion people worldwide — one third of the world’s population. More than half 80 Study Session 7 Preventing Micronutrient Problems in Ethiopia (54%) of Ethiopian children age 6-9 months and 27 % of Ethiopian women aged 15-49 are anaemic (mainly due to low blood iron status). Iron deficiency can delay muscular and nervous system development and mental performance, especially in preschool age children. In adults, anaemia reduces work capacity, mental performance and reduces tolerance to infections. Iron deficiency anaemia can also cause increased maternal mortality due to bleeding problems. Maternal anaemia can lead to prenatal infant loss, low birth weight, and pre-term births. Ask teachers if there are children who miss school (children with anaemia may be too tired to attend). Ask family members if there are mothers and children who find it difficult to see after dusk and if children frequently get sick (possible signs of vitamin A deficiency). Ask community leaders/families if there are any children/adolescents who have swelling in front neck area (goitre: a sign of iodine deficiency). Salt iodisation will improve the physical and mental development of millions of people. The intellectual and cognitive development of whole generations of Ethiopian children will be reduced by around 10% unless adequate iodine is provided. For example, if a diet is lacking in oils or fats, vitamin A is not well absorbed and utilised. The immune systems become weak and illness is more common and more severe, increasing under-five death rates. The eye could be damaged with appearance of lesions, and when severe, blindness can occur. There is an increased risk of a woman dying during pregnancy or during the first three months after delivery. Iodine is found naturally in topsoil, but in most areas of the country and especially the highlands, top soil has been lost due to deforestation, erosion and flooding, and thus food crops lack iodine resulting in dietary iodine deficiency. Its direct causes can be broadly categorised as poor, insufficient or abnormal red blood cell production, excessive red blood cell destruction, and excessive red blood cell loss. Contributing causes include poor nutrition related to dietary intake and dietary quality (iron deficiency in particular), infectious and parasitic diseases; inadequate sanitation and health behaviours; lack of access to health services; and poverty. The two major direct causes of anaemia, with excessive red cell destruction, are malaria and worm infections. Increase access to five, by one third by 2015 iodised salt among Supplement 70% of households up to 80% postpartum women with high doses of vitamin A within 45 days of delivery 7. The vitamin A intake of a breastfed child depends on the vitamin A status of the mother, the stage of lactation, and the quantity of breastmilk consumed. From birth to about six months of age, exclusive, frequent breastfeeding can provide the infant with all the vitamin A needed for optimal health, growth and development. Therefore, exclusive breastfeeding until six months of age helps ensure sufficient vitamin A intake. Vitamin A capsules given twice yearly at six months intervals to children 6 to 59 months is protective, and sufficient for a child’s requirement. Vitamin A capsules given to postpartum mothers within 45 days after delivery increases the amount of the vitamin A in the breastmilk and therefore the infant’s intake of vitamin A. Dietary approaches are also important and include: ◦ Fortification which is the process of adding vitamin A to foods commonly consumed by vulnerable population. It is an effective and sustainable strategy to combat vitamin A deficiency ◦ As well as breastfeeding, home gardens are also an essential component of vitamin A deficiency reduction programmes. You should order enough supplies for follow-up doses every four to six months through routine services. Doses and schedules for vitamin A supplements Vitamin A supplementation should be given to those at risk using the amounts given in the table below. If the answer is no, ask the caregiver to hold the child firmly and make sure the child is calm. Cut the nipple of the capsule at the middle (not at the tip or bottom) with scissors and immediately squeeze the drops of liquid into the child’s mouth (see Figure 7. Do not give a vitamin A capsule to any woman of reproductive age during an Enhanced Outreach Strategy Programme. A large dose of vitamin A supplements can damage the fetus if the woman is pregnant. Do not put the vitamin A capsule into the child’s mouth or allow the child to swallow the capsule. If obstruction persists, turn the infant over and give five chest thrusts with two fingers, one fingerbreadth below nipple level in midline (see Figure 7. If the obstruction persists, go behind the child and pass your arms around the child’s body; form a fist with one hand immediately below the child’s breast bone (sternum); place the other hand over the fist and pull upwards into the abdomen; repeat this Heimlich manoeuvre five times (see Figure 7. If the obstruction persists, check the child’s mouth for any obstruction, which can be removed. It also describes how you can prevent these from happening and what actions you need to take to overcome these problems if they occur. As a Health Extension Practitioner, you are expected to encourage family members to grow and consume vitamin A rich foods at all times. You can initiate and coordinate the establishment of horticultural demonstration gardens in health post and schools, as well as agricultural extension demonstration plots in farming areas. These horticultural gardens can also serve as examples for dissemination of information on the use of fruits and vegetables, and the distribution of seedlings that could be grown around rural homes. Health Extension Practitioners can therefore play a significantroleinpromotingthe introduction of vitamin A rich foods and improving consumption and storage of such foods. The best food sources are animal foods such as egg yolks, organ meats such as liver, whole milk and milk products, small fish with the liver intact, fish, cod liver oil, butter, and ghee.

The membrane is asymmetric in nature cheap omeprazole 20mg on line bile gastritis diet, the outer and inner leafets of the bilayer differ in composition cheap 40 mg omeprazole visa diet chart for gastritis patient. Uncharged large polar molecules and charged molecules do not diffuse and they need proteins to get transported order omeprazole 40mg with mastercard gastritis honey. Outside cell Carbohydrate Chain Glycolipid Phospholipid bilayer 5 nm Peripheral Protien Integral Integral (transmembrane) membrane glycoprotein protien Cholesterol Inside cell Fig purchase 10 mg omeprazole otc gastritis diet . In passive transport, the substances move from higher concentrations to lower concentrations generally without the help of any protein. The transport continues until the concentration of the substance becomes same on both the sides of the membrane. Pinocytosis, in which the fuid material is engulfed and phagocytosis, in which large sized solid material is engulfed. During the process, the plasma membrane invaginates into tiny pockets, which draw fuids from the surroundings into the cell. Finally, these pockets pinch off and are known as pinosomes or phagosomes, which fuse with lysosomes and liberate their contents into the cell cytosol. Vesicles containing secretory materials fuse with the plasma membrane and discharge their contents into the exterior. Table 1 Similarities and differences between facilitated diffusion and active transport Facilitated Diffusion Active Transport 1. Needs a carrier protein and they are Needs a carrier protein and they are named as transporters or channels. Solutes are transported from high Solutes are transported from low concentrations to low concentrations concentrations to high concentrations 6. The co-effcient of viscosity of a liquid is defned as the force in dynes required to maintain the streamline fow of one fuid layer of unit area over another layer of equal area separated from one another by 1 cm at a rate of 1cm/sec. If a small sphere of radius ‘r’ and density ‘r’ falls vertically through a liquid with the density ‘r’at a steady velocity ‘u’, inspite of the acceleration due to gravity (g), the co-effcient of viscosity and density are related as follows. The lubricating property of the synovial fuid is achieved mainly by the viscous nature of the mucopolysaccharides present in the synovial fuid. But a surface molecule (b) suffers a much greater intermolecular 7 attraction towards the interior of the liquid than towards the vapour phase, because fewer molecules are present in the vapour phase. Surface tension (¡) is defned as the force acting perpendicularly inwards on the surface layer of a liquid to pull its surface molecules towards the interior of the liquid mass. Density - Macloed’s equation relates surface tension to the density of the liquid (r) and that of its vapour (r’). As the temperature of the liquid increases, the surface tension decreases and becomes zero at the critical temperature. Solutes - Solutes that enter the liquid raise the surface tension of the solvent, while solutes that concentrate on the surface lower the surface tension. Emulsifcation of fats by bile salts - Bile salts lower the surface tension of the fat droplets in the duodenum, which aids in digestion and absorption of lipids. Surface tension of plasma: The surface tension of plasma is 70 dynes/cm, which is slightly lower than that of water. Hay’s test for bile salts - The principle of surface tension is used to check the presence of bile salts in urine. When fne sulphur powder is sprinkled on urine containing bile salts ( as in jaundice), it sinks due to the surface tension lowering effect of bile salts. Dipalmitoyl lecithin is a surfactant that is secreted by the lung alveoli, which reduces the surface tension and prevents the collapse of lung alveoli during expiration. Osmosis is a colligative property of solution that depends on the number of molecules or ions of the solute in the solutions. A solution having lower or higher osmotic pressure with respect to the other is called as hypo-osmotic or hyperosmotic solutions respectively. The osmotic pressure exhibited by these impermeable solutes is called as the tonicity of the solution. A solution having lower or higher tonicities with respect to the other is called as hypotonic or hypertonic solutions respectively. The ability of the membrane to withstand hypotonic solution depends upon the integrity of the membrane. Certain genetic disorders like sickle cell anemia and defciency of vitamin E makes the erythrocyte membrane more fragile. Osmotic pressure of blood is largely due to its mineral ions such as sodium, potassium, chloride, calcium and protein. The osmotic pressure exerted by proteins is of considerable biological signifcance owing to the impermeability of the plasma membrane to the colloidal particles. The net difference in the hydrostatic pressure and osmotic pressure is responsible for the fltration of water at the arterial end of the capillary and the reabsorption of the same at the venous end. The renal excretion of water is regulated partly by the osmotic pressure exerted by the colloids in the blood plasma. Increased urination (polyuria) occurring in diabetes patients is due to the increased water retention by the urinary glucose. Donnan Membrane Equilibrium Let us consider two compartments separated by a semi permeable membrane, which is permeable to water and crystalloids, but not to colloidal particles. One of the compartment (A) is flled with a moles of NaCl, and the other compartment (B) is flled with b moles of NaR, in which R happens to be a non diffusible ion. So, the ionic concentration at equilibrium in both the compartments will be as follows, (A) (B) a-x Na+ Na+ b + x a-x Cl- R- b. Due to imbalance in the electrolytes, swelling of proteins occur, which is called as Donnan osmotic effect. Due to metabolism and dietary intake, large quantities of acids and bases are produced in the body and they have to be transported through blood for elimination. This is effectively done in the body by means of the buffers present in the blood and by two mechanisms, namely the respiratory mechanism and the renal mechanism. Since the concentrations of phosphate and organic acids are low in plasma, they do not play a major role in regulation of pH. Hemoglobin buffer system The buffering capacity of hemoglobin is due to the presence of imidazole groups in its histidine residues. When the blood returns to the lungs, O2 tension in the lungs is high resulting in the oxygenation of Hb. These acids are effectively buffered by the bicarbonate system, but at the expense of the bicarbonate, which is called as the alkali reserve of the body. In acidemia, inorder to bring the low pH to normal, the excessive H+ ions should be excreted and bicarbonate excretion should be reduced. On the other hand, during alkalemia, the kidneys excrete the excess bicarbonate producing an alkaline urine (pH 8. The three important mechanisms attributed by the kidneys to regulate the blood pH are (i) Reabsorption of bicarbonate (ii) Buffering by phosphate buffers (iii) Formation of ammonium ions. It starts in the mouth, continues in the stomach and small intestine and is completed in the large intestine. Saliva contains ptyalin, an a amylase, which attacks the a 1-4 linkages resulting in the formation of monosaccharide glucose, disaccharide maltose and trisaccharide maltotriose. However, because of steric hindrance caused by the branches, some of the interior a 1-4 linkages are inaccessible for the enzyme. Glycogen, Starch Glucose, Maltose, Maltotriose, Limit Dextrin Glycogen Limit Dextrin When food along with ptyalin reaches the stomach, ptyalin is inactivated due to low pH. Its action is similar to that of the ptyalin, but it is more powerful because (i) It can act upon raw starch.

Nervous signals eventually leave the retina and exit the eye through the optic nerve on the posterior surface of the eyeball buy 40mg omeprazole amex gastritis symptoms come and go. After leaving the eye buy omeprazole 40 mg online chronic gastritis meaning, the optic nerves enter the brain and travel to the visual cortex of the occipital lobe buy omeprazole 10 mg on-line gastritis diet 321. In this area of the brain best 40mg omeprazole gastritis and back pain, visual interpretation of the nervous impulses that 187 Human Anatomy and Physiology were generated by light stimuli in the rods and cones of the retina result in "seeing". As we shall later see, the stimulation or "trigger" that activates receptors involved with hearing and equilibrium is mechanical, and the receptors themselves are called mechanoreceptors. Physical forces that 188 Human Anatomy and Physiology involve sound vibrations and fluid movements are responsible for initiating nervous impulses eventually perceived as sound and balance. A large part of the ear, and by far its most important part, lies hidden from view deep inside the temporal bone. The auricle is the appendage on the side of the head surrounding the opening of the external auditory canal. It extends into the temporal bone and ends at the tympanic membrane or eardrum, which is a partition between the external and middle ear. The skin of the auditory canal, especially in its outer one third, contains many short hairs and ceruminous glands that produce a waxy substance called cerumen that may collect in the canal and impair hearing by absorbing or blocking the passage of sound waves. Sound waves travelling through the external auditory canal strike the tympanic membrane and cause it to vibrate. Middle Ear The middle ear is a tiny and very thin epithelium lined cavity hollowed out of the temporal bone. The names of these ear bones, called ossicles, describe their shapes − malleus (hammer), incus (anvil), and stapes (stirrup). The "handle" of the malleus attaches to the inside of the tympanic membrane, and the "head" attaches to the incus. The incus attaches to the stapes, and the stapes presses against a membrane that covers a small opening, the oval window. When sound waves cause the eardrum to 190 Human Anatomy and Physiology vibrate, that movement is transmitted and amplified by the ear ossicles as it passes through the middle ear. A point worth mentioning, because it explains the frequent spread of infection from the throat to the ear, is the fact that a tube− the auditory or eustachian tube− connects the throat with the middle ear. The epithelial lining of the middle ears, auditory tubes, and throat are extensions of one continuous membrane. Inner Ear The activation of specialized mechanoreceptors in the inner ear generates nervous impulses that result in hearing and equilibrium. Anatomically, the inner ear consists of three spaces in the temporal bone, assembled in a complex maze called the bony labrynth. This odd shaped bony space is filled with a watery fluid called perilymph and is divided into the following parts: vestibule, semicircular canals, and cochlea. The vestibule is adjacent to the oval window between the semicircular canals and the cochlea (Figure 7-16). Note in Figure 7-16 that a ballonlike membranous sac is suspended in the perilymph and follows the shape of the bony labyrinth 191 Human Anatomy and Physiology much like a "tube within a tube. Within each canal is a specialized receptor called a crista ampullaris, which generates a nerve impulse when you move your head. The sensory cells in the cristae ampullares have hair like extensions that are suspended in the endolymph. The sensory cells are stimulated when movement of the head causes the endolymph to move, thus causing the hairs to bend. It is surrounded by endolymph filling the membranous cochlea or cochlear duct, which is the membranous tube within the bony cochlea. Specialized hair cells on the organ of Corti generate nerve impulses when they are bent by the movement or endolymph set in motion by sound waves (Figures 7-16 and 7-17). The Taste Receptors The chemical receptors that generate nervous impulses resulting in the sense of taste are called taste buds. About 10,000 of these microscopic receptors are found on the sides of much larger structure on the tongue called papillae and also as portions of other tissues in the mouth and throat. They respond to dissolved chemicals in the saliva that bathe the tongue and mouth tissues (Figure 7- 18). For this reason a cold that interferes with the stimulation of the olfactory receptors by odors from foods in the mouth markedly dulls taste sensations. The Smell Receptors The chemical receptors responsible for the sense of smell are located in a small area of epithelial tissue in the upper part o the nasal cavity (Figure 7-19). The location of the olfactory receptors is somewhat hidden, and we are often forced to forcefully sniff air to smell delicate odors. Each olfactory cell has a number of specialized cilia that sense different chemicals and cause the cell to respond by generating a nervous impulse. To be detected by olfactory receptors, chemicals must be dissolved in the watery mucus that lines the nasal cavity. After the olfactory cells are stimulated by odor-causing chemicals, the resulting nerve impulse travels through the olfactory nerves in the olfactory bulb and tract and then enters the thalamic and olfactory centers of the brain, where the nervous impulses are 197 Human Anatomy and Physiology interpreted as specific odors. The pathways taken by olfactory nerve impulses and the area where these impulses are interpreted are closely associated with areas of the brain important in memory and emotion. Progressive reduction of the sense of smells often seen in smokers because of the damaging effects the pollutants in tobacco smoke. In olfaction, as with all the special senses, advancing age often brings a structural degeneration that result in reduced function. It is no wonder that many older adults become isolated and depressed when their contact with the outside world, the special senses, is gradually lost. Caring health professionals recognize these signs of aging and provide assistance needed by their aged patients to enjoy life. General Sense Organs Groups of highly specialized and localized receptors are typically associated with the special senses. You can hardly miss stimulating at least one receptor and almost instantaneously 198 Human Anatomy and Physiology experiencing a sensation of touch. Stimulation of some receptors leads to the sensation of heat; Stimulation of others gives the sensation of cold, and stimulation of still others gives the sensation of pain or pressure. When special receptors in the muscles and joints are stimulated, you sense the position of the different parts of the body and know whether they are moving and in which direction they are moving without even looking at them. Perhaps you have never realized that you have this sense of position and movement a sense called proprioception or kinaesthesia. Lippincot Company) 199 Human Anatomy and Physiology Disruption of general sense organs can occur by a variety of mechanisms. For example, third degree burns can completely destroy general sense receptors throughout the affected area. This commonly occurs when you put your legs in a position that presses your legs in a way that reduces blood flow. When you try to stand up, you cannot feel you legs because the general sense organs are temporarily impaired. What are the functions of the sympathetic part of the autonomic nervous system, and how do these compare with those of the parasympathetic nervous system? For example, the nervous system acts by means of electric impulses and chemical stimuli; where as the endocrine system has more widespread, slower, and longer lasting effects. The endocrine system also has more generalized effects on such activities as growth, metabolism, and reproduction. The blood reaches all cells of the body, but only certain cells respond to specific hormones; these responding cells are unique in that they have receptors to which the hormones attach.

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