28 生理学七年制讲义.docx

第1页：letter physiology seven year

letter physiology seven year

• AletteronphysiologyforSeven-year-English-medicalClassChapter1Introduction
• 1．Whatisphysiology1).physiologyisoneofthebiologicalsciencesisastudyofthenormalfunctioninlivingbodyisastudyofthespecificfunctionchangeandmechanismsofthehumanbodyundervariouscondition
• 2.basicprinciplesoflivingbody.1).Metabolism:catabolism:catabolicreactioninvolvethebreakdownof larger,morecomplexmoleculesintosmaller,simplermolecules,duringwhichenergyisreleasedfortheactivityofthebody.Anabolism:anabolic reactioninvolve thesynthesisofcomplexmoleculesfromsimplerones.Anabolismandcatabolismaretwoopposingactivitiestakingplace simultaneouslyinthecell.2).Reactionandexcitabilityexcitatory(excitation) :increase inactivityinhibitory(inhibition):decrease inactivityExcitable tissue:muscle.Nerve .GlandExcitement:bioelectricalreaction(AP)Excitability:theability to givebioelectricalreaction whenbestimulatedStimulus:changesintheexternalor internalenvironmentcaninducereactionoflivingbody.Thresholdstimulation:thesmallestintensityofstimuluswhichcanelicitexcitementofthelivingbody.*Thehighertheintensityofstimulusneeded(thethresholdofstimulus),thelowertheexcitability,andviceverse.3).reproduction:aprocessbywhichananimalproducesoneormoreindividualssimilartoitself.3.homeostasis1)internalenvironmentoflivingbodyinternalenvironmentoflivingbody=extracellularfliud(plasma,lymph,interstitialfliud)2)homeostasisitisinactivityequilibriumbyregulationtomaintainconstantconditionofinternalenvironmentin;livingbodyexample:t 37degreeph7.35-7.45bp110/70mmg
• 4.typeoftheregulationonbodyfunction1).nervousregulation:nervoussystemreflexactivityreflexarc :receptor,afferent nerve fiber,reflexcenter,efferentnervefiber,effector1

第2页：humor regulation euro moral re

humor regulation euro moral re

• 2)humoralregulation andneuro-humoralregulationadistalcrinestiorgan,tissueplay regulationrolebneuro-humoralregulationhormone(circulation)othertissueclocateddistancetocns(+)hormonetargetcellcparacrinregulationstitissuetissueorcellshormoneorchemicalsubstancediffusiontonearbyphysiologicalroleparacrine:some hormonescandiffusethroughinterstitialfliuddirectlyandmake effectonnearcells,suchasgastrointestinalhormone3).autoregulationincertaincasesatissueoranorgancanresponddirectlytotheenvironmentchangedependingonneithernervousnoronhumoralcontrolthe homeostasisofthe bloodflowinthe brainandkidneyisautoregulation
• 5.feedbackregulationnon-autoregulationsystem(automaticcontrol)sticontrolsystemcontrolledsystemphysiologicaleffectfeedbackcontrolsystem(close-loopsystem)referenceinputcontrolsystemmessage)(+)or(-)controlsystemmonitor(feedback1).negativefeedback:feedbackmessagedecreasetheactivityofthecontrolsystemtomaintainhomeostasisprocess.Example:T37degreedeopressorreflexandsoon2).positivefeedback:feedbackmessageincreasetheactivityofthecontrolsystemtointensifytheactivityofthecontrolsystemandtoacceleratecertainphysiologyprocess.Example:urination,bloodcoagulation
• 6．Methods usedforphysiologicalstudiescellandmoleculelevel--------generalphysiologyorcellphysiologyorgan system-------------------systemphysiologywholebody----------------------integrationphysiologystudymethod:chronicexperiment,acuteexperimentacuteexperiment:experimentin vivo/invitroChapter2——thecellanditsfunction2

第3页：membrane structure transport

membrane structure transport

• 3§1themembranestructureandtransportacrossthecellmembranechemicalcompositionofthe membrane anditsstructure1)Chemicalcomposition:protein50%,lipid(phospholipid,cholesterol,e)42%carbohydrate3%weight : protein>lipids(1-4time); moleculenumber;lipids>protein(10-100time)2)Themembranestructure:thelipidbilayerofmembrane;fluidmosaicmodelofunitmembranea)lipidbilayermoleculehydrophobic;hydrophilicitismoststablemoleculecombinationbyenergyb)membranceproteinintrinsic;extrinsicproteinphysiologicalfunction:1).receptorprotein(outside)2).recognizedprotein(outside)inimmunecell3).transportprotein:carrier:channel:ionpump4).anchoringprotein5).Enzymeprotein(pump)6).channelproteinc)carbohydrates:glucoprotein,gluconate
• 1.recognize,selectiveproperties :example:atRBCmembrancesubstancetransporterthroughthecellmembrane1).Simplediffusion(randommotion)conceptfat-solublesmallermoleculesmaterialcandissolveinthecellmembraneanddiffuseacrossfromhighconcentrationtolowconcentrationdiffusionspeed:diffudionspeeddependentonconcentrationgradientandpermeabilityofmembranetransportmaterialby thisway :O2 ;CO2;NH3;N2H2Osimplediffusion(osmosis):waterchannel,lowosmoticpressuretohighosmoticpressure2).facilitateddiffusion:insolubleinlipidsmaterial(suchasKNaGandAA)diffusesacrossthecellmembrane bymediationofproteininthe membrane fromhightolowconcentrationfluxdependsonthe molecule orionconcentrationgradientpotentialgradientpermeabilityofthemembranetwotypesa).facilitateddiffusionvia carrierproteincharacteristicdependonconcentrationgradientspecificselectturnleftglucose<<turnrightglucose(chemicalspecificity)saturatedphenomenoncompetitiveinhibitiontransported material:glucose,aminoacidandsoonb).channel-mediatedfacilitateddiffusion

第4页：example absorption glucose tes

example absorption glucose tes（流程示意）

1. 4ion(Na,K )
3. << : ; } c). : , , . : .
4. ADP+ [Na] [K] :[Na] >=12[Na] [K ] >= 30[K] α β .Α 3 Na
5. 2K
6. [K] [Na] , , . . . .

第5页：port protein anti port exchang

port protein anti port exchang（流程示意）

1. 5 .Ca : , : ,I : 3). : ; ; , . ++ . : . : §2 : , .1. 1)RP: : :-90 :-70 :-10 : =0; = : |Rp| (-90….-70mv) :|Rp | (-90….-95mv)2) ) [K ] 155 ;[K]o4 ) , ) =Ek : 29.2℃Ek=60log[K]o/[K] (mv), ,Cl, . < .TEA [K] …|Rp| , 2. 1).AP: : RP
3. 0
4. (0mv
5. +mv) =AP= =

第6页：negative potential positive po

negative potential positive po（流程示意）

1. 6 . : .( , , , )b.
3. . : , . ∝1/ d. : : ,T,pH.. :sec,min… . : : 2) : ; . . : Em
4. AP : = .
10. sti

第7页：activation open activation clo

activation open activation clo（流程示意）

1. 7 : : , . :TTX : (2) : . , ,K
3. .b.
4. K
6. (RP)c. ↑
8. .(3Na: 2 K)3. 1) .F
12. 2) .F:AP: 3) : 4) , , 4.

第8页：excitability cycle change exci

excitability cycle change exci（流程示意）

1. 85. 1) : =02) : >0 3) : > 4) : < 6. :1)Rp|Rp|
2. . [K]o↑↑
3. |RP|
4. .2)
5. §3 1. :1). : 2). : .b.c. ( ,M. ) (N. ) ,d. ,e. , f. ,g. 3). : . (+) , . ; ;c. 2 d. ,K
6. =
8. Ape. : 4). . . F:M. C=1:1 ; . ;N2 ,TTV, ,666
9. = N(+)M. , (α-TC) 2. 1) ← ← ← ( , ) .

第9页：isotonic contraction muscle le

isotonic contraction muscle le（流程示意）

1. 9b. + = , – , . : (L) ++ ++ : , .c. : ( , ) ( , )2). (1)
2. ATP=ADP+
4. (1%) 2.0–2.2μm, 1.5-3.5μm(2) : .
5. (+)b. ( +)c. 2+
7. .[Ca2+]↑
8. (+)
10. [Ca2+]
11. Ca2+,[Ca2+]
12. 2+

第10页：plasma colloid osmotic pressur

plasma colloid osmotic pressur（流程示意）

1. 25 – 10 . : . ∝ , ↑
2. ↑
4. P0∝ , ↑ ↑
5. P0↑3). Ca++,NE,E
6. ↑K+,Ach,H+
8. 4.
10. one
12. .1. 3 §1 (7–8 )%/Kg. 40-45 %:WBC, RBC, 55–60% : ( ,G . , . ,F.) (Na+,K+,Ca2+,Clˉ,HCO3ˉ ; ; ; , ; ,CO2;O22. 1) ( , , )2) : . . . . §2 1. 1). : ; 2). :α1 – ,α2 –VtB12, ,β γ – , – 3). : 2. 1). :1.025–1.030; :1.6–2.42). :313 =708.9kPa=5330 :5305 –

第11页：Toformabscess11Extra-capillari

Toformabscess11Extra-capillari（流程示意）

1. 11 :7.35–7.45 : 3/H2CO3,Na2HPO4/NaH2PO4, :K2HPO4/KH2PO4, 3/H2CO33.§3 1.RBC :5x 106/μlHb 14 g/100 40-50% :4.2x106/μlHb 13 g/100 37-48% : , ; : 2–1.34ml/gHb100 –20.1 mlO2CO2 1) : : sac, , : : ( 0.5–1% )2) : . :VtB12 ., , , : / : ; ; ; .
2. BFU–E
3. CFU–E
4. (+)E–
5. (+)RBC↑
6. (+)
7. EPO↑
8. CFU–E/E– 120 3) . : 0.9% , 5%G– 0.42% – 0.35% – . : ↑
10. .c. (ESR): / ; : ≤3 mm, ≤10mm2. (4–10)x109/L4x 109/L≥WBC≥10x 109/ %: 50–70; 2–8; 20–401). : . 95%

第12页：phil ran ran tech tax

phil ran ran tech tax（流程示意）

1. Ca2+
2. 12b. 1–5% , ; . 0.5–1% , : ; 2). / . ( IL,IFN) . 3). : :70–80% , :15% , .KLC:5–15% , – ; 3. ( ,TC) :( 100–300 ) x109/L1). : . . . . 2). : . . c. : : * §4 , 1. :1–3 min; :4–8min1) N(+)
3. NE
4. 5–HT,TXA22) , ,(ADP,TXA2),Ca2+, 3) . :Ⅰ-ⅩⅢ,Ⅴ ⅥⅠ–ⅩⅢ, (PK), – – , (PF3)Tab3–3Ⅳ 2+; ; (Ⅱ,Ⅶ,Ⅸ,Ⅹ); ; .b. Ⅹ
5. Ⅹ
6. Ⅴ.Ca2+.PLⅡ
7. Ⅱ 3–6

第13页：disseminatedintravascularcoag

disseminatedintravascularcoag（流程示意）

1.  ,DIC13Ⅰ
2. Ⅰ . (Ⅹ
3. Ⅹ )Fig 3-7(1). : ;Ⅻ
4. Ⅻ . . Ⅷ,Ⅸ,Ⅺ ,B, .(2). : : Ⅲ Ⅲ
5. Ⅶ
6. Ⅶ 2+Ⅲ
7. Ⅹ
8. ⅩaB. . (Ⅱ
9. Ⅱ )(Ⅰ
10. Ⅰ )ⅩⅢⅡ
11. ⅩⅢ
12. Ⅰ

第14页：measure blood group recipient

measure blood group recipient（流程示意）

1. 1). 14 (+)
5. .§5 : ( + ) = = : : , ,B,O, 1. (1). 1)Tab3–4 2)Tab3–5 3)Fig3–9 4) . . 5). 3–4 : , , (2–8 ), 8–10age(2).
7. (-), Rh (+).1) 5 :C,c,D,E, , (+)2) :No– ,  (+) (-) , .2. (1).

第15页：vol diastole close close safe

vol diastole close close safe（流程示意）

1. 0.06 <V<Ar15 2). : ,300mml, (2). 3–10 §6 4 §1 .
3. . (AA, …)c. . : . [ Ca2+]O2,CO2,GCa2+ , 2+ (+) ( 2+ ), 2+ (+):Ca2+
4. [Ca2+]
5. 2+
6. (+) +-K+ : : 1. (1). : 0.8 , : 75 / ↑
8. ↑(2). 4-2 : ,V: , : , , , :V
9. >V<Ar0.1 <V<Ar0.05
10. <V>Ar0.1
11. <V<Ar0.15

第16页：open close rapid filling phase

open close rapid filling phase（流程示意）

1. 16
2. >V<Ar0.11
3. >V<Ar0.22 (3) – 4-31) 2)P– .2. (1). 1) 2)
4. (2). ; =1/R, (3). 1). 4-2 : : 2).
5. . , . =1/6 3. (1) 1). = – – 70ml (60-80) = 5L/min2). = / (L/ min.m2) : 3–3.5L/min.m2,10 j4.0L/min.m2,80 j2.0L/min.m2(2) = / ⅹ100%, :(55-60)%(3) = 1/1000xx13.6g/cm3Pm: (g.m) /min (kg.m/min) = ( g.m) 1/1000 , ＞ ＞

第17页：regulation cardiac put cardiac

regulation cardiac put cardiac（流程示意）

1. 174. = × (1). 1)
2. = ← . 4–4( .B) . : . – ,b. . :Tab4–1 . : ↑; ↑; ↑; ↑.b. : ;lie
3. ↑
4. 2). : ,don’ .Fig4–6 : . : , [Ca2+], . :[K+],Ach,[H+], ;[Ca2+],NE,E, , . (+): (+): 3). : ↑
6. ↑
7. ↑
8. (+) ↑
12. (2). : = × ↑

第18页：heart rate cardiac put hear

heart rate cardiac put hear（流程示意）

1. 1840> >180
3. (+)
4. (+): ↑ (ENE5-HT): ↑ (40-180/min)↑
5. ↘ ↙ ( , ) (ABp)(-)← (+)(+)← (+)(+)← ↑(3). . :5L/min ; :25-30L/ : 75–20 : 145–160ml5. §2 : : , :SAN,AM,AVN,BH,PF,TPF, : :Ap
6. Na+ : : :SAN,Ap
7. Ca2+ 1. (1). 4-131).Rp =-90mv K+ ,K+ 2).Ap= Na+ ; :-70 0 ;Na+ ,Na+ , ; 1 : + + , ;4- 2 :Ca2+ ,Ca2+ , :Mn2+, + ,K+ ,3 :K+ ,Ik.Ik1 ,, : 0 3 , 4. : (+)3Na+:2K+,Ca2+-Na+ 3Na+:Ca2+

第19页：digital bit pump exchange flow

digital bit pump exchange flow（流程示意）

1. 19 ,Na+-Ca2+
2. Ca2+
3. ↑(2). 1). ; 0 , 1.2.3 ; 4 :IkK+ ; :Na+ , + : (-60
4. -100mv), (-50mv) , , , , .2). : :-70mv, :-40mv;Ap:no1,2 ; 0 70 0 mv; ‹ ;4 › 0 :ICa,Ca2+ , :Mn2+, ; 3 :IkK+ > 2+ . 4 : . ,K+ ;b. 2+ 2+(-50 );c. + ,INa+
5. Cs2. (1). : 1) :Rp , :Ach
7. K+
8. Rp
9. (-)Na+
12. 2) 4-16Fig4-17 : 0 3 ; –55mv

第20页：extra systole com pens pause

extra systole com pens pause（流程示意）

1. 20d. 4-18 : . : , .(2). !). : (SAN),AVN,BH ,TPF;Ap/min:100,50,40,25 , . : . ,b. 2) 4-19 . ↑
3. b. 4; ↑
4. ↑ (+)
5. NE,E
6. (+) ,Ica2+
7. ↑ (+)
8. Ach
9. (+)IK+
11. c.
12. ↑(3). 4-211). … (gap ), . :SAN

第21页：heart stop filling pressure bl

heart stop filling pressure bl（流程示意）

1. 0.93kPa(7 )= / 21§4 1. (1) : . : , .(2) : , .(3) : , (4) : (5) : , , .(6) – : (7) : , ,60-70% .(8) , ,toe .2. , (1) . , (Re =ρVD /η>200
2. . : ;m,cm,mm/min, (V) > (V) : . .(2). ,r: =( P-P)r4/8ηL;Q = P1–P2/R,R= 8ηL/πr4η: ,L: (3). : . :kPa(1 =0.133kPa)

第22页：venous pressure venous return

venous pressure venous return（流程示意）

1. 4. 223.ABp(1) . , 7 . 3% (1/3 )97% (2/3 ) . :L, R,ηd. (2) 1) : . :100-120 (13.3-16kPa)> 140 <80 : . :60-80 (8-10kPa)> 90 :110/70 120/80 = (40 ) = + /3
2. > ,old> > . .2) . ( , )b. 60/min < <180/ . ↑( ↑ ↑)d. ( P, )e.
4. 3. (1) : , . . ,b. (2) >> 3-5m/sec, 7-10m/sec, 15-35m/sec, , .

第23页：small reabsorption central ven

small reabsorption central ven（流程示意）

1. = (12 + 15)-(10+25 )=-8
2. 23(1). : , 4-12cmH2O(0.4-1.2kPa)
3. ↑, >16cmH2O .(2). : .
4. .
5. .
6. ↑
8. d. - ↑.e. : ↑
9. 5. (1). 1) : . ,b. ,c. ,d. . ,f. ,g. .2) : .
12. .b. –

第24页：men saliva land reproductive

men saliva land reproductive（流程示意）

2. 242) =10–8 = 2 3) . : / =5:1
3. ↑
4. ↑
5. . P
7. 
8. EFP↑
9. ↑c.
10. Cap ↑
11. .d. : .7. §5 1. (1) . : , , , (+)
12. NE+β1

第25页：era skin systole resistance bl

era skin systole resistance bl（流程示意）

1. (αR) ↑
3. 25 ↑Ⅲ. : Ⅳ. (VIP), (3). . : 1 1 b. : , , (4). 1) ↑
4. ( , )(+)
5. ( , )↑
6. . (-)
7. (-)
8. P
10. Bp
11. b. (-)
12. <5/

第26页：action relaxation biting vesse

action relaxation biting vesse（流程示意）

1. 262. (1). ( E) ( NE) β1 β1 :α ,NE
2. β2 ,NE
3. α : > > ;α <α β2 : , ;β2 > β2 (2).
4. Bp
8. Ⅰ(10 )
9. Ⅱ(8 )
10. Ⅲ( 7 ) Ⅱ( Ⅲ)
11. ↑
12. Bp↑ ↑

第27页：pulmonary pressure pressure lo

pulmonary pressure pressure lo（流程示意）

1. 2. : 27e. : β-
2. (+) (-)
3. Bp
4. f. : : , 3. (1) :CO2,H+,ATP,K+(2) 4. : .( , , )§6 5 : 02 02 : : / —. ㈠. 1. : , : , : , (1) : (2)
5. (3) : , : (4) 5-5

第28页：keep alveoli different size st

keep alveoli different size st

• tokeepthealveoliofdifferentsize stableinlungs28whenrespiration stopairwayisopen,intrapulmonaryP=atmosphericPinspirationbegin:intrapulmonaryP<atmosphericPinspirationend :intrapulmonaryP=atmosphericPexpirationbegin:intrapulmonaryP>atmosphericPexpirationend:intrapulmonaryP=atmosphericPartificialrespiration
• 3.intrapleuralpressureandpneumothorax
• (1)pleuralcavityparietalpleural/ visceralpleuraserousfluid:to lubricatethepleuralsurfaceFig5–6Fig 5–8toholdthethoracic wallandlungsincloseapposition
• (2)intrapleuralPislessthanatmosphericpressure:itisnegativepressureintrapleuralP=intrapulmonaryP-elastic recoiloflungintrapleuralP=-elasticrecoilof lung(intrapulmonaryP=atmosphericP=0)physiologicalfunctionofintrapleuralnegativeP:thelungsarealwaysforcedtoexpandtofillthe thoraciccavitytoaccelerate thebloodandlymphflowback.
• (3).Pneumothorax:airispermittedtoenterthepleuralcavity.Fig 5-9conclusion:respiratorymovementisthe primarydrivingforce of theventilationthedifferencebetweenthepressureinalveloliandatmosphericpisthedirectdrivingforceoftheventilation
• (二)pulmonaryventilationresistance
• 1.elasticresistanceandcomplianceelasticresistance:itisthetendencyofthelungorthoraxtoreturntotherestingvolumeafterdistentionRincrease,expansibilitydecrease;Rdecreaseexpansibilityincrease
• (1)compliance :itisthe volumechange perunitchangeoftranspulmonarypressure.C= ∆V/∆P=1/R∆V:lungvolume ;∆P:(intrapulmonaryP–intrapeuralP)CL=0.2L/ cmH20CT=0.2L/cmH20Ctotal=0.1L/ cmH20specificcompliance:complianceof lungvolumeperunitCsp =compliance/ total lungvolumeAffectingcompliancefactors:lungvolume ,positionanddisease
• (2)resource of lungelasticresistanceLER=tissueelastic (1/3)+surfacetention(2/3)Tissueelastic:therecoiltendencyof theelasticandcollagenousfibersininterstitialspaceSurfacetension:comefromthefluid-airinterface(P=2T/r)PulmonarySurfactant(dipalmitoylphosphatidylcholine,DPPC):a.lipoproteinb.synthesizedandsecretedbytypeⅡalveolarepitheliccellc.function:toreducethesurfacetention

第29页：keep alveoli dry prevent pulmo

keep alveoli dry prevent pulmo（流程示意）

1. =(500–150)х12/min =4.2L/min29 , : (3) = RL+ 1 /R= 1/RL+ 1/ (0.1L/cm H20)2. ( , ( 67% ), )(1) =( – )/ (2) : .
2. R↑b.
3. R↑
4. R
5. c. ↑
6. R
7. R ∝ 1 /r4 : . ↑
8. R
9. b. . : N(+)
10. R
11. (+)
12. R↑** (+)

第30页：forms gas transport blood logi

forms gas transport blood logi（流程示意）

1. 一 30Vd: = + :150 /FRC=350ml/2500ml=1 /7 一. ㈠ 5-1D ∞∆P*T* * S/(d √MW),S /d√MW= ㈡ : ;MW: ;S: ;∆P: ; : ;d: 二． 5–21㈠ ㈡O2,CO2 5–1Fig5-21三． ㈠ 1. : ↑
2. PO2↑,PCO2
3. 2. : ↑
4. ↑3. :O2 >CO2 .㈡ :6 <0.1μmor 100 5–22 : /
5. ↑SiO2
6. 矽肺
8. ↑㈢ : : 40-70m2
10. ㈣ / (VA/Q) =0.841. / 5-23(VA/Q)=0.84 (VA/Q)>0.84(VA/Q)<0.84 ↑ 2.3. /Q:VA/ /
11. ↑
12. VA/Q

第31页：curve shift left physical solu

curve shift left physical solu（流程示意）

1. pH↑, Pco2
2. P50
4. ↑31 :O2
5. 0.3 ml/100 ;CO2
6. 2.9 ml/100 : O2
7. (HbO2)
8. 98.5%
9. 94%Tab5-2CO2
10. / 2 2 二 ㈠ 5–25㈡ 1.Hb+O2
11. HbO2;Hb+O2←HbO2 , , ；O2 2 2 2+ 1g 1.34-1.39 mlO2; ; : O2 100 : O2 100 = / * : ≧5g/100 : ↑

第32页：function reg latin respiration

function reg latin respiration（流程示意）

1. ㈢ 32 : 2 2 :CO2
2. 2
3. pH↑
4. ↑
5. 2 :CO2
6. Pco2↑pH
9. 22. :T↑
12. 3.2,3-DPG↑

第33页：less first introduction neural

less first introduction neural（流程示意）

1. 33
2. IOS三 ㈠
3. ㈡ : , , , .㈢ , .四 ㈠ : ； 2
4. Pco2↑,[H]↑
5. ↑
6. ↑( PO2)㈡ :[H]↑ (CSF)
7. ↑ O2(PO2
8. )
11. ㈢ CO2,H+ 21.PCO2: ; 0.4%PCO2↑: ↑PCO2↑↑↑
12. CO2 2↑

第34页：action digestion process essen

action digestion process essen（流程示意）

1. 3. 34 : . : . : . : .一． ㈠ :1. ,2. ,3. ,4. .5. ; , (胃溃疡) .㈡ :1. :(-50)---(-60)mv,K+,Na+,Cl-2. (BER) : Na– 3. :Ca2+
2. AP
3. 二． 6–2Fig6-4㈠ : (+ )
4. (-) (+)
5. (+) (+) , ㈡ : (VIP,P,Ach)三． 1. :6-8 6-12. : 3. :1). .2) 3) 4) 四． 6–2Tab6-3㈠ ㈡ 1. 2.

第35页：action promote growth protect

action promote growth protect（流程示意）

1. 354. ㈢ :CCK, , ,SS, ？ 一． ㈠ 1.
4. HCl
6. 2. (G ,D,S,I ,K ,): ( , , )㈡ 1. ,HCl:1) :0-5 /h; :20-25 /h2) : ;H+ 3). : . . . . 2+ 2+2. :1). 2) 2.03) : , , 3. ,HCO3-1) , 2) 3) 4. 1) 2) 12㈢ 1. 1) .Ach
8. HCl↑; : ; : 2).
10. HCl↑

第36页：promote releasing pancreas bil

promote releasing pancreas bil（流程示意）

1. 3).
2. H2-R; ： 2. 1)SS
4. HCl
7. HCl
10. HCl
11. 2)

第37页：gastric motility types gastric

gastric motility types gastric（流程示意）

1. 37二． ㈠. 1 2 3 ㈡. (+)
2. ↑
3. BER,AP↑
4. ↑ (+)
5. GIP,CCK ↑
7. ㈢. 1 : > , >big, > > > :4–6h2 ( ; )3 ( ; ) 一． ㈠. :pH7.8-8.4, ,1-2L/d-1.HCO3: 2. : . (pH6.7–7.0)b. , , 2, ,c. ( & ) : , , ㈡． > > 1. : ,Ach
8. ↑;H2O,HCO3low; ↑2. : .b.
9. H2O,HCO3-↑, ;CCK
10. ↑ > >HCl>
11. . ,VIP
12. ↑二． ㈠. : , , , , , ,etc. ㈡. 1. + + =

第38页：protect cholesterol deposit la

protect cholesterol deposit la（流程示意）

1. 382. 3. .D.K.E4. ㈢. : :( >fat/ > )1. : (+)
2. ↑
3. ↑, ↑2. : .
5. ↑b.
6. ↑(HCO3↑, )c.CCK
8. .
9. ↑ 94% 三． 四． :1. 2. 3. 一． ㈠. :1. & 2. , 3. , 4. ㈡. .
10. (200m2)b. :3-8hc. , 二． ㈠. : , , ㈡. : , ㈢. 1. : , 2. :Na+
11. 2+
12. ( , )Ca2+

第39页：glucose gala set transport car

glucose gala set transport car（流程示意）

1. 39 > > 2Na+ 1 4. : ,5. : , , :* ;* ;* ; : .6. :1) 2)
3. 3) ,fat, ; . 7 1 ● : , ， .一、 1. ： ,fat, . 70 ,30 .2. : (ATP). ,fat, . ; .3. : , , . .二、 （一） : . .（二） : , . .1. :C6H12O6＋6O2
4. 6CO2＋6H2O＋△H2. , .3. .（三）

第40页：401. : 1 . ) b

401. : 1 . ) b

• 401.Caloricvalueoffood:Caloriesliberatedby1goffoodoxidizedinbody（orburnedoutofbody）.a)biologicalthermalequivalent（oxidizedinbody）b)physicalthermalequivalent（burnedoutofbody）
• 2.Thermalequivalentofoxygen:Intheprocessofoxidizingfood,CaloriesliberatedperliterO2consumed.3.Respiratoryquotient(RQ):Intheprocessofoxidizingfood,theratioofcarbondioxideproducedtooxygenused.RQ＝CO2produced(ml)/O2used(ml)
• (1)RQofcarbohydrate:1.00
• (2)RQoffat:0.71
• (3)RQofprotein:0.80
• (4)RQofmixedfood:0.854.Non-proteinrespiratoryquotient(NPRQ):Intheprocessofoxidizingthecarbohydratemixedwithfatindifferentproportion,the ratioofcarbondioxideproducedtooxygenused.
• 三、Factorsaffectingenergymetabolism
• （一）Movementofmuscles:It enhancesrateofmetabolism.
• （二）Environmentaltemperature:Metabolicrateisthemost stableduring20～30℃，riseorfallintemperatureenhancesthe metabolicrate.
• （三）Specificdynamiceffect:Afteramealisingested,themetabolicrateincreasesasaresultofthedifferentchemicalreactionsassociated withdigestion,absorption,andstorageof foodinthebody.Thiseffectoffoodonthemetabolicrateiscalledthespecific dynamiceffectoffood.
• （四）Mentalactivity:Muscle tonusandreleasinghormones andincreasesmetabolicrate.
• 四、Basalmetabolism
• （一）Concept:
• 1.Basalmetabolism:The energymetabolismunder“basalconditions”.

第41页：value usually corrected differ

value usually corrected differ（流程示意）

1. 41（三） 1. , .2.BMR=( – )×100% （四） 1.±10～15%—— ; ±20%—— .2.BMR↑: , , , , , .3.BMR
2. ’ , , ,etc. 2： 一、 （一） ：1. (1) , , .(2) , , .2. : . , , . :36.9~37.9℃ :36.7~37.7℃ :36.0~37.4℃（二） 1. : 24 .2.Sex: 0.3℃. , , .3.Age: .4. : .

第42页：production loss body productio

production loss body productio（流程示意）

1. 42二、 （一） ：1. = ＋ ＋ . .(二) ： （97%）, （2%）, （1%）.1. , (1) : , . , . 60 .(2) : , 3 , . , , .(3) : . , , .2. : , (1) : .(2) : .
6. 三 (一) 1. : , , .2. : , , , ; , (PO/AH) .(二) : (PO/AH).●

第43页：clear critical body core tempe

clear critical body core tempe

• 43Itisclearthatatacriticalbodycoretemperatureofabout37.0℃,drasticchangesintherateofbothheatlossandheatproduction.Attemperaturesabovethislevel,therateoftheheatlossisgreaterthanthatofheatproduction,sothebodytemperaturefallsandapproachesthe37.0℃level.Attemperaturesbelowthislevel,therateoftheheatproductionisgreaterthanthatofheatloss,sothebodytemperaturesrisesandagainapproachesthe37.0℃level.Thiscrucialtemperatureleveliscalledthe“set-point”ofthetemperaturecontrolmechanism.Thatis,allthetemperaturecontrolmechanismcontinuallyattempttobringthebodytemperaturebacktothisset-pointlevel.Chapter8KidneyPhysiologySection1GeneralFunctionandPhysiologicalAnatomy of theKidney
• 一、Generalfunctionofthekidney
• （一）Excretionofmetabolismend-product
• （二）Regulationofbodyfluidosmolarityandvolume,electrolytebalance,acid-basebalance,bloodpressure.
• （三）Secretionoferythropoitin,1,25-dihydroxyvitaminD3(vitaminDactivation),rennin,prostaglandin.
• 二、Anatomicalphysiologyofthekidney
• (一)Nephronandcollectingduct(seepage287)Nephron:thenephronisthefunctionalunitofthekidney.Eachkidneyinthehumancontainsabout1millionnephrons,eachcapableofformingurine.Eachnephronshastwomajorcomponents:
• (1)Aglomerulus.
• (2)Alongtubeinwhichthefilteredfluidisconvertedintourineonitswaytothepelvisofthekidney.
• (二)Corticalnephronandjuxtamedullarynephron(seepage289)
• 1.Corticalnephron:Thosenephronsthathaveglomerulilocatedintheoutercortexarecalledcorticalnephrons.TheyhaveshortloopsofHenlethatpenetrateonlyashortdistanceintothemedulla.Forthecorticalnephrons,theentiretubularsystemissurroundedbyanextensivenetworkofperitubularcapillaries.2Juxtamedullarynephron:About15to20percentofthenephronhaveglomerulithatliedeepintherenalcortexnearthemedullaandarecalledjuxtamedullarynephrons.Forthejuxtamedullarynephrons,longefferentarteriolesextendfromtheglomerulidownintotheoutermedullaandthendivideintospecializedperitubularcapillariescalledvasarectathatextenddownwardintothemedulla,lyingsidebysidewiththeloopsofHenle.Thevasarectainthemedullaplayanessentialroleintheformationofaconcentratedurine.3.Thejuxtaglomerularapparatus:Includingmaculadensa,extraglumerularmesangialcells,andjuxtaglomerular(granularcells)cells.Thejuxtaglomerularcellscontaingranulesthatappeartobecomposedoftheenzymerenin.Thefuctionofmaculadensaistomonitortheconcentrationofchlorideinthetubularfluidandtotransfertheinformationtojuxtaglomerularcell,therebyregulatingthereleaseofrenin.

第44页：blood supply distribution char

blood supply distribution char

• 44
• 三、Renalbloodsupply
• （一）Thedistributionandcharacteristicsoftherenalbloodflow
• 1.Highbloodflow:Bloodflowtothetwokidneysisnormallyabout22percentofthecardiacoutput,or1200ml/min,94percenttothecortex.2.Twocapillarybeds:Therenalcirculationisuniqueinthatithastwocapillarybeds,theglomerularandperitubularcapillaries.Highhydrostaticpressureintheglomerularcapillaries(about60mmHg)causesrapidfluidfiltration,whereasamuchlowerhydrostaticpressureintheperitubularcapillaries(about13mmHg)permitsrapidfluidreabsorption.
• （二）Theregulationofrenalbloodflow(RBF)
• (1)MyogenicautoregulationofRBF:Studiesofindividualbloodvesselsthroughoutthebodyhaveshownthattheyrespondtoincreasedwalltensionorwallstretchbycontractionofthevascularsmoothmuscle.Thiscontractionpreventsoverdistentionofthevesselandatthesametime,byraisingvascularresistance,helpspreventexcessiveincreaseinrenalbloodflowwhenarterialpressureincreases.
• (2)Tubuloglomerularfeedback:Themainpurposeofthisfeedbackistoensureaconstantdeliveryofsodiumchloridetothedistaltubule.Thus,disturbancesthattendtoincreasereabsorptionofsodiumchlorideattubularsitesbeforethemaculadensatendtoelicitincreasedrenalbloodflow,whichhelpreturndistalsodiumchloridedeliverytowardnormalsothatnormalratesodiumandwaterexcretioncanbemaintained.2.NeuralregulationofGFR:
• (1)Sympatheticnervefibersinnervateafferentandefferentarteriole.
• (2)Normallysympatheticstimulationislowbutcanincreaseduringhemorrhageandexercise.
• (3)Vasoconstrictionoccursasaresultwhichconservesbloodvolume(hemorrhage)andpermitsgreaterbloodflowtootherbodyparts(exercise).3.HormonalregulationofGFR:AngiotensinⅡ,epinephrineandnorepinephrinearepowerfulvasoconstrictoragentswhiletheprostaglandinisvasodilatoragentfortherenalbloodvessels.Section2GlomerularFiltration
• (1)Glomerularfiltrationrate(GFR):Amountoffiltrateproducedinthekidneyseachminute.TheGFRisabout125ml/minor180L/day.Itsmagnitudecorrelatesfairlywellwithsurfaceareaofthebody.
• (2)Filtrationfraction=GFR/Renalplasmaflow.125/660×100%=19%Thismeansthatabout20percentoftheplasmaflowingthroughthekidneyisfilteredthroughthegomerularcapillaries.
• 一、Effectivefiltrationpressure,EFP
• 1.EFP=Glomerularcapillarypressure(BP)-{Plasmacolloidosmoticpressure(COP)+Capsularpressure(CP)}

第45页：45二、 （一） :1.

45二、 （一） :1.

• 45
• 二、Factorsaffectingglomerularfiltration
• （一）Thepermeabilityandareaoffiltrationmembrane:
• 1.Thefiltrationmembranehasthreemajorlayers:
• (1)theendotheliumofcapillary,
• (2)abasementmembrane,and
• (3)alayerofendothelialcells(podocytes)surroundingtheoutersurfaceofthecapillarybasementmembrane.2.Thecapillaryendotheliumisperforatedbythousandsofsmallholescalledfenestrae.Althoughthefenestrationsarerelativelylarge,endothelialcellsarerichlyendowedwithfixednegativechargesthathinderthepassageofplasmaproteins.3.Thebasementmembraneeffectivelypreventsfiltrationofplasmaproteins,inpartbecauseofstrongnegativeelectricalchargesassociatedwiththeproteoglycans.4.Thefootprocessesareseparatedbygapscalledslitporesthroughwhichthegiomerularfiltratemoves.
• （二）EFP
• 1.Glomerularcapillarypressure(BP):Withaperfusingarterialpressureintherangeof80to180mmHg,theglomerularcapillarypressuredoesnotvary.2.Plasmacolloidosmoticpressure:Increased(decreased)glomerularcapillarycolloidosmoticpressuredecreases(increases)GFR.3.Capsularpressure(CP):IncreasingthehydrostaticpressureinBowman’scapsulereducesGFR,whereasdecreasingthispressureraisesGFR.Incertainpathologicalstatesassociatedwithobstructionoftheurinarytract,thepressurecanincreasemarkedly.Forexample,precipitationofuricacidmayleadto“stone”thatlodgeintheurinarytract.
• （三）Renalplasmaflow:Ifrenalplasmaflowisincreased,theriseinintracapillaryoncoticpressurewilloccurmoregradually,therebydiminishingtheforceopposingfiltration.Consequently,GFRtendstoincreasewithincreasingbloodflowandviseversa.Section3ReabsorptionandSecretionintheRenalTubuleandCollectingDuct
• 一、Selective reabsorptionandsecretionevidenceintherenaltubule
• 1.Urinaryexcretion=Glomerularfiltration–Tubularreabsorption+Tubularsecretion.2.GFR=125ml/min(180L/day),about1%isexcreted.
• 二、Typeofthe reabsorptionandsecretionintherenaltubule andcollectingduct
• （一）Passivereabsorption：Includesimplediffusionandfacilitateddiffusion.

第46页：reabsorption glucose tub trans

reabsorption glucose tub trans

• 46reabsorptionofglucosebytherenaltubule.
• (1)Co-transporterswillmoveonemoiety,e.g.glucose,inthesamedirectionastheNa+.
• (2)Counter-transporterswillmoveonemoiety,e.g.H+,intheoppositedirectiontotheNa+.
• 三、Reabsorptionandsecretionalongdifferentsegmentofrenaltubuleandcollectingduct
• (一)Reabsorptionintheproximaltubule:Proximaltubule,includingtheproximalconvolutedtubuleandthickdescendingsegmentoftheloop.Reabsorbabout65percentofthefilteredsodium,chloride,potassium,water,85percentbicarbonate,andessentiallyallthefilteredglucoseandaminoacids.Secreteorganicacids,bases,andhydrogenionsintothetubularlumen.1.Sodium,waterandchloride reabsorptioninproximaltubule
• (1)Thesodium-potassiumATPase:majorforceforreabsorption ofsodium,chlorideandwater.
• (2)Thesecondhalfoftheproximaltubulehasarelativelyhighconcentrationofchloride(around140mmol/L)comparedwiththeearlyproximaltubule(about105mmol/L).Inthesecondhalfoftheproximaltubule,thehigherchlorideconcentrationfavorsthediffusionofthisionfromthetubulelumenthroughtheintercellularjunctionsintotherenalinterstitialfluid.2.Potassiumreabsorption:About 67 percent potassium isreabsorbedin proximaltubule.3.Bicarbonatereabsorptionandhydrogensecretion(seep297,Fig8-13)
• (1)Hydrogensecretionismainlyatthe proximaltubules,loopofHenle,andearlydistaltubule.
• (2)Morethan90percentofthebicarbonateisreabsorbed(passively)inthismanner.Thebicarbonateisreabsorbedwiththe mode ofCO2atthe proximaltubules.4.Glucoseandaminoacidreabsorption:
• (1)GlucoseisreabsorbedalongwithNa+intheearlyportionoftheproximaltubule.Glucoseistypicalofsubstancesremovedfromtheurinebysecondaryactivetransport.Essentiallyalloftheglucoseisreabsorbed,andnomorethanafewmilligramsappearintheurineper24hours.Themechanismofaminoacidreabsorptionissimilartoglucose.
• (2)Renalglucosethreshold:Therenalthresholdforglucoseistheplasmalevelatwhichtheglucosefirstappearsintheurine.Therenalthresholdforglucoseisabout9-10.1mmol/L(160-180mg/dl)innormalperson.
• (3)Thetransportmaximumofglucose(TmG)isabout375mg/mininmenand300mg/mininwomen.
• （二）ReabsorptioninloopofHenle
• 1.TheloopofHenleconsistsofthreefunctionallydistinctsegments:thethindescendingsegment,thethinascendingsegment,andthethickascendingsegment.2.Reabsorbsabout25%ofthefilteredloadsofsodium,chloride,andpotassium,aswellaslargeamountsofcalcium,bicarbonate,andmagnesium.Thissegmentalsosecreteshydrogenionsintothetubule.3.Mechanismofsodium,chloride,andpotassiumtransportinthethickascendingloopofHenle(seep301,Fig8-15):InthethickascendingloopofHenle,movementofsodiumacrosstheluminalmembraneismediatedprimarilybya1-sodium,2-chloride,1-potassiumco-transporter.

第47页：reabsorption secretion vol ted

reabsorption secretion vol ted

• 47
• （三）Reabsorptionandsecretionindistalconvolutedtubule andcollectingduct
• 1.Sodium,waterandchloridereabsorption:
• 2.Potassiumsecretion(seep301,Fig8-18):Mechanismsofpotassiumsecretionandsodiumreabsorptionbytheprinciplecells of thelatedistalandcollectingtubules.3.HydrogenSecretion:Hydrogenionsecretionbytheintercalatedcellsismediatedbyahydrogen-ATPasetransportmechanism.+
• 4.Ammoniumion(NH4)secretion(see p303,Fig8-19):
• (1)Anincreaseinextracellularfluidhydrogenionconcentrationstimulatesrenalglutamine+metabolismand,therefore,increasetheformationofNH4andnewbicarbonatetobeusedinhydrogenionbuffering.
• (2)Adecreaseinhydrogenionconcentrationhastheoppositeeffect.Section
• 4.UrineConcentrationandDilution
• 一、Countercurrentmultiplicationandcountercurrentexchange
• 1.Theosmolarityofinterstitialfluidinalmostallpartsofthebodyisabout300mOsm/L,whichissimilartotheplasmaosmolarity.
• 二、Mechanismforcreatingosmotic gradientinthemedullaryinterstitialfluid
• (一)Outermedullaosmoticgradient:ThethickpartoftheascendingloopofHenleisalsovirtually impermeabletowater,butlargeamountsofsodium,chlorideareactivelytransportedfromthetubuleintothemedullaryinterstitium.
• (二)Innermedulla osmoticgradient:
• 1.Thethinascendinglimbisessentiallyimpermeabletowaterbutreabsorbssomesodiumchloride.Thus,thetubularfluidbecomesmorediluteasthesodiumchloridediffusesoutofthetubuleandwaterremainsinthetubule.2.Theinnermedullarycollectingductshavespecialureatransportersthatgreatlyfacilitatediffusion,muchofthehighlyconcentratedureaintheductsdiffusesoutofthetubularlumenintotheinnermedullaryinterstitium.Thisabsorptionoftheureaintotherenalmedullacontributestothehighosmolarityofthemedullaryinterstitiumandthehighconcentrationabilityofthekidney.

第48页：section regulation urine forma

section regulation urine forma

• 48Section5RegulationofUrineFormationintheKidneyUrinaryexcretion=Glomerularfiltration–Tubularreabsorption+Tubularsecretion
• 一、Autoregulationinthekidney
• （一）Soluteconcentrationintubularfluid
• 2.Largeamountsofapoorlyreabsorbedsolute suchasglucose,mannitol,orurea.
• （二）Glomerulotubularbalance
• 1.Concept:Theconstantfraction(about65%-70%)ofthefilteredNa+andwaterarereabsorbedinthe proximaltubular,despitevariationofGFR.2.Importance:IthelpstopreventoverloadingofthedistaltubularsegmentswhenGFRincreases.3.Glomerulotubularbalancemechanisms:Themechanismisduepartlytochangeinplasmaoncoticpressure.
• 二、Nervousandhumoralfactorsaffectingurineformation
• （一）Thefunctionofsympatheticnervesystem
• 1.Activationofsympatheticnervesystemcandecreasesodiumandwaterexcretionbyconstrictingtherenalarterioles,therebyreducingGFR.2.Sympatheticactivationalsoincreasessodiumreabsorptionintheproximaltubule,thethickascendinglimbof the loopofHenle.3.SympatheticnervesystemstimulationincreasesreninreleaseandangiotensinⅡformation,whichaddstotheoveralleffecttoincreasetubular reabsorptionanddecrease renalexcretionofsodium.
• （二）Thehormonalcontrol
• (1)Effect:ThemostimportantrenalactionofADHistoincreasethewaterpermeabilityofthedistaltubule,collectingductepithelia.
• (2)Mechanism:ADHbindsspecialV2receptorsinthelatedistaltubules,collectingducts,increasingtheformationofcyclicAMPandactivatingproteinkinases.This,inturn,stimulatesthemovementofanintracellularprotein,calledaquaporin-2(AQP-2),totheluminalsideofthecellmembranes.ThemoleculesofAQP-2clustertogetherandfusewiththecellmembranebyexocytosistoformwaterchannelsthatpermitrapiddiffusionofwaterthroughthecell.
• (3)ADHreleaseiscontrolledby:1)Increaseinextracellularfluid(ECF)osmolarity(whichinpracticaltermsmeansanincreaseinplasmasodiumconcentration).2)Decreaseinbloodvolume.3)Decreaseinbloodpressure(arterialpressure).
• (4)Waterdiuresis:Thephenomenaofincreasinginurineoutputafterdrinkingalargeamountofwateriscalledwaterdiuresis.1)AngiotensinⅡstimulatesaldosteronesecretion,whichinturnincreasessodiumreabsorption.AngiotensinⅡconstrictstheefferentarterioles,whichhastwoeffectsonperitubularcapillarydynamicthatraisesodiumandwaterreabsorption.2)Regulationofthereninsecretion:

第49页：tension afferent art stretch

tension afferent art stretch

• 491)Tensionoftheafferentartery(stretchreceptor).2)Maculadensa(contentoftheNa+ioninthedistalconvolutedtubule).3)Sympatheticnerve.4)E,NE,PGE2,PGI
• 2.
• (2)TheconcentrationofNa+andK+:Na+decreaseorK+increase.3.Theactionofparathyroidhormone:Itsprincipalactioninthekidneyistoincreasetubularreabsorptionofcalcium,especiallyinthedistaltubulesandperhapsalsointheloopsofHenle.Ithasotheractions,includinginhibitionofphosphatereabsorptionbytheproximaltubuleandstimulationofmagnesiumreabsorptionbytheloopofHenle.Section6Plasmaclearance
• 一、Conceptofplasmaclearance:
• 1.Conceptofplasmaclearance:Therenalclearanceofsubstanceisthevolumeofplasmathatiscompletelyclearedofthesubstancebythekidneysperunittime.2.Equation:U×V=P×C.WhereCistheclearancerateofasubstance,Pistheplasmaconcentrationofthesubstance(mg/dl),Uistheurineconcentrationofthatsubstance(mg/dl),andVistheurineflowrate(ml/min).Rearrangingthisequation,clearancecanbeexpressedas:C=U×V/P.
• 二、Physiologicalsignificanceofplasmaclearancetest
• （一）InulinclearancecanbeusedtoestimateGFR
• 1.QualitiesofagentstomeasureGFR:Inulin:
• (1)Freelyfilterableatglomerulus
• (2)Doesnotbindtoplasmaproteins
• (3)Biologicallyinert
• (4)Non-toxic,neither synthesizednormetabolizedinkidney
• (5)Neitherabsorbednorsecreted
• (6)Doesnotalter renalfunction

第50页：hematocrit blood flow kidney

hematocrit blood flow kidney

• 4.Ifthehematocritis0.45andRPFis660ml/min,therenalbloodflow(RBF)throughbothkidneysis660/(1-0.45)=1200ml/min.
• （三）Calculationoftubularreabsorptionorsecretionfromrenalclearances:Forexample,theclearanceofglucoseiszero.
• （四）Freewaterclearance,CH2O
• 1.Micturitionistheprocessbywhichtheurinarybladderempties.Twoprocessesareinvolved:Thebladderfillsprogressivelyuntilthetensioninitswallrisesaboveathresholdlevel;thiselicitsthesecondstep,whichisanervousreflexcalledthemicturitionreflexthatemptiesthebladder.2.Themicturitionreflexisanautonomicspinalcordreflex;itcanalsobeinhibitedorfacilitatedbycentersinthecerebralcortexorbrainstem.Chapter9NervoussystemThenervoussystemisdividedintotwoparts:
• (1)thecentralnervoussystem(CNS),composedofthebrainandthespinalcord;and
• (2)Theperipheralnervoussystem,consistingoftheganglionsandthenervesthatconnectedbetweenthebrainorspinalcordandbody’smuscles,glands,andsenseorgans.Theperipheralnervoussystemisdividedagainintotwoparts:thesomaticnervoussystemandthevegetalorvisceralnervoussystem.brainthe centralnervoussystem(CNS)nervoussystemspinalcordganglionsnervestheperipheralnervoussystemsomaticnervoussystemvegetal/visceralnervoussystem§1basicstructureandfunctionofnervoussystemneuron
• 1.structureofneuronneuronacellbody(soma)cytoplasmicprocessdendriteaxonwithterminals
• 2.classificationofnervousfiber
• 3.propagationofimpulselocalcurrent
• (1)physiologicalintegration
• (2)insulation
• (3)velocityofconduction
• (4)bidirectionalpropagation50

第51页：fatigue dec mental transport

fatigue dec mental transport

• (5)nofatigue
• (6)non-decremental
• 4.axoplasmtransportanterogradetransportretrogradetransportconductionsynapseTheanatomicallyspecializedjunctionbetweentwoneuronswhereoneneuron,thepresynapticneuron,alterstheelectricalandchemicalormetabolicactivitiesofasecondneuron,thepostsynapticneuron,iscalledasynapse.Atmostsynapses,thesignalistransmitters,alsoincludingthechemicalsbywhichefferentneuronscommunicatewitheffectorcell(e.g.,amusclecell).Thetransmittersorchemicalsreleasedfromoneneuronaltertheactivitiesofthereceivingneuronoreffectorcellbybindingwithspecificproteinreceptorsonthemembraneofthereceivingneuronortheeffectorcell.1.chemicalsynapse
• (1)structureofthechemicalsynapsepresynapticterminalsynapticcleftpostsynapticmembranetheterminalofthepresynapticneuronendsinaslightswelling,theaxonterminalalsocalledthepresynapticmembrane,whichholdsthesynapticvesiclesthatcontaintheneurotransmitter.Thepostsynapticmembraneopposingtheaxonterminalhasahighdensityofintrinsticandextrinsicmembraneproteinsthatmakeupaspecializedareacontainedreceptorsandhydrolyticenzymes.A10-to20-nmextracellularspacebetweenthepre-andpostsynapticmembraneiscalledthesynapticcleftthatseparatesthepre-andpostsynapticneurons.Thelocalcurrentcannotpropagatedirectlyfromthepresynapticneurontopostsynapticcell.Signalsfromthepresynapticneuronaretransmittedacrossthesynapticcleftbymeansofachemicalmessenger,aneurotransmitterreleasedfrom thepresynapticaxonterminal.somebasicneuronalconnections
• ①divergence:toexciteforgreaternumbersofnervefibers;
• ②convergence:signalsfrommultipleinputsunitingtoexciteasingleneuron;
• ③recurrentcircuit:afterdischarge:inmanyinstances,asignalcausesaprolongedoutputdischarge,calledafterdischarge,lastingaftertheincomingsignalisoverforafewmillisecondstoaslongasmanyminutes.Suchcircuitsarecausedbypositivefeedbackwithinaneuronalcircuitthatfeedbacktore-excitetheinputofthesamecircuit.Consequently,oncestimulated,thecircuitmaydischargerepetitivelyforalongtime.
• ④chaincircuit
• (2)transmissionofsignalinchemicalsynapse1)impulse(actionpotential)reachestheaxonterminal;2)opensvoltage-gatedcalciumchannelsinthepresynapticmembrane,causingcalciuminflux51

第52页：excitatory synapse flu releasi

excitatory synapse flu releasi（流程示意）

1. AP
2. Ca2+
5. 52 ;3) ;4) , ;5) ;6) ;7) , , , , .(3) 1) 2) ① ;② ;③ ;④ ;⑤ .3) ① ;② ;③ .4) ( , , ) , .(4) 1) (EPSP) : , , , , (EPSP). , , , . . , , .

第53页：binding receptor permeability

binding receptor permeability（流程示意）

2. Na+,K+
3. Na+ +
6. AP2) (IPSP) : , , . , , (IPSP).AP
7. Ca2+
11. Cl-,K+
12. K+

第54页：amount neurotransmitter releas

amount neurotransmitter releas（流程示意）

1. 54 , , . . . , . , , , , . . , .(1)
8. ( , ) (2) /
9. 5-HT
10. +
12. Ca2+ ↑

第55页：released pre synaptic membrane

released pre synaptic membrane（流程示意）

1. (2) ;(3) ;(4) .2. (1) (2) (3) (4) (5) 3. , , , , (1)
3. (2) : ; (3) :Ca2+ ; (4) : 4. 1. (1) + RAR(2) + + RCR+AR(3) (4)
4. 2. 3. 55

第56页：channel rapid channel channel

channel rapid channel channel（流程示意）

1. (1) : Na+;K+ :Cl-(2) 1) ;2) ;3) ;4) . 1. . : :Ach/ : ： :ACh(1) 1) +
2. Ach+COA
3. + 2) : : 3) 4) , M:M1;M2;M3 . . ,N:N1;N2 (e.g., ) .(2) 1) , (DA), (NE) (E) .56

第57页：car box thy one storage

car box thy one storage（流程示意）

1. 2) , 3) : 2. (1) , 1)  2) , , : .100μmol/l,10 : ,Ca2+ 3) : 4 4) : (LTP) (2) (IAA)Gly1) , , , 2)
3. (IPSP)3) :§2 1. (1) , , , , , , . Ⅰ,Ⅳ,Ⅴ, Ⅵ. . , / ( , , ), 57

第58页：special cortex called specific

special cortex called specific

• specialareaofthecerebralcortexareallcalled specificprojectionsystem.58thalamicnuclei.Fromhere,thesignalsaretransmittedtothesomatosensorycortex.
• (2)deepsensorypathway(thedorsalcolumn-mediallemniscalsystem)Thesetypesofsignalsincludeproprioceptivesensation,critical/precisetactile.Carriessignalsupwardtothemedullaofthebrainmainlyinthedorsalcolumnsofthecord.Then,afterthesignalssynapseandcrosstotheoppositesideinthemedulla,theycontinueupwardthroughthebrainstemtothethalamusbywayofthemediallemniscus,andthentothecortex.Thedifferentiationofsensationstransmittedinthetwosystem1)anterolateralsystem
• ①pain
• ②thermalsensations,includingbothwarmthandcoldsensations
• ③crudetouchandpressuresensationscapableonlyofcrudelocalizingabilityonthesurfaceofthebody,
• ④tickleand itchsensatios
• ⑤sexualsensations2)dorsalcolumn-mediallemniscalsystem
• ①touchsensationsrequiringahighdegree of localizationof thestimulus
• ②touchsensationsrequiringtransmissionoffinegradationsofintensity
• ③phasicsensations,suchasvibratorysensation
• ④sensationsthatsignalmovementagainsttheskin
• ⑤positionsensationsfromthejoints
• ⑥pressuresensationshavingtodowithfinedegreesofjudgmentofpressureintensity
• 2.facialsensorypathwaySensoryfunctionofthalamus

第59页：side face point point cortex

side face point point cortex

• fromthesame sideoftheface).59Itispointtopointtothecortex,andmakesthespecializedsensory.
• (2)non-specificprojectionsystemDiffuseprojectionsfromthenonspecificprojectionnucleiconnectingtheascendingreticularactivatingsystemtowidespreadareasofcortexhavearoleinmodifyingthestatesofconsciousness.thedifferencesbetweenspecificandnonspecificprojectionsystemnonspecificprojectionsystemspecificprojectionsystemrespondtovariousstimulirespond to acertainstimulusmulti-synapsesfewsynapsesonlydiffuseprojectiontothecortexpointtopointtothecortexmaintainofconsciousnesssensoryperception
• (3)ascendingreticularactivatingsystemThesystemisnonspecific,andthemainfunctionofthisascendingsystemistoexertanactivatinginfluenceonthecortex.If,inasleepinganimal,thereticularinformationisstimulatedwithimplantedelectrodes,theanimalwillawaken.Sensoryformationsfromreticularformationareprojecteddiffuselytothenonspecificnucleiofthalamus.Sensoryfunctionofcerebralcortex
• 1.structuralcharacteristicsofthecerebralcortexThecerebralcortexcontainssixlayersofneurons,beginningwithlayerⅠnexttothebrainsurfaceandextendingprogressivelydeepertolayerⅥ,theneuronsineachlayerperformfunctionsdifferentfromthoseinotherlayers.Ⅰ:molecularlayer;Ⅱ:externalgranularlayer;Ⅲ:layer ofsmallpyramidalcells;Ⅳ:internalgranularlayer;Ⅴ:large pyramidcelllayer;Ⅵ:layerofpolymorphiccells.Theneuronsofthesomatosensorycortexarearrangedinverticalcolumnsextendingallthewaythroughthesixlayersofthecortex,eachofthesecolumnsservesasinglespecificsensorymodality.AtlayerⅣ,wheretheinputsensorysignalsfirstenterthecortex,thecolumnsofneuronsfunctionalmostentirelyseparatelyfromoneanother.Atanotherlevelsofthecolumns,interactionsoccurthatinitiateanalysisofthemeaningsofthesensorysignals.2.somatosensorycorticalareas
• (1)somatosensoryareaⅠ,SⅠSⅠliesimmediatelybehindthecentralfissure,locatedinthepostcentralgyrusofthehumancerebralcortex(inBroadmann’sareas3,1,and2)
• ①eachlateralsideofthecortexreceivessensoryinformationalmostexclusivelyfromtheoppositesideofthe body(withthe exceptionofaverysmallamount ofsensoryinformation

第60页：widespread super layers skin

widespread super layers skin

• widespreadin thesuperficiallayersoftheskin aswellas incertaininternaltissues.Pain canbe60
• ②thesizeoftheseareasaredirectlyproportionaltothenumberofspecializedsensoryreceptorsineachrespective peripheralarea ofthebody.
• ③theheadisrepresentedinthemostlateralportionofsomatosensoryareaⅠ,andthelowerpartofthebodyisrepresentedmedially.
• (2)somatosensoryareaⅡ,SⅡLocatedbetweenprecentralgyrusandinsula,andlocalizationispoor,althoughroughly,thefaceisrepresentedanteriorly,thearmscentrally,andthelegsposterioly.Thesignalsenterthisareafrombrainstem,transmittedupwardfrombothsidesofthebody.Inaddition,manysignalscomesecondarilyfromSⅠaswellasfromothersensoryareasofthebrain,evenfromthevisualandauditoryareas.ProjectionsfromSⅠarerequiredforfunctionofSⅡ.RemovalofpartsofSⅡhasnoapparenteffectontheresponseofneuronsinSⅠ.
• (3)proprioceptivecorticalrepresentationLocatedintheprecentralgyrusofthehumancerebralcortex(inBrodmann’sarea4).Sensationsandanalysisinthecentralnervoussystem
• 1.somaticsensation
• (1)tactilesensationsAlthoughtouch,pressure,andvibrationarefrequentlyclassifiedasseparatesensations,theyarealldetectedbythesametypesofreceptors.Therearethreeprincipaldifferencesamongthem:
• ①touchsensationgenerallyresultsfromstimulationoftactile receptorsinthe skinorintissuesimmediatelybeneaththeskin;
• ②pressuresensationgenerallyresultsfromdeformationofdeepertissues;
• ③vibrationsensationresultsfromrapidlyrepetitivesensorysignals,butsomeofthesametypesofreceptorsasthosefortouchandpressureareused.
• (2)thermalsensationsThe humanbeingcanperceivedifferentgradationsofcoldandheat,fromfreezingcoldtocoldtocooltoindifferenttowarmtohottoburninghot.Thermalgradationsarediscriminatedbyatleastthreetypesofsensoryreceptors:coldreceptors,warmthreceptors,andpainreceptors.Thepainreceptorsarestimulatedonlybyextremedegreesofheatorcoldand,therefore,areresponsible,alongwiththecoldandwarmthreceptors,for“freezingcold”and“burninghot”sensations.Thecoldandwarmthreceptorarelocatedimmediatelyundertheskinatdiscreteseparatedspots,inmostareasofthebody,thereare3to10timesasmanycoldspotsaswarmthspots.
• (3)proprioceptivesensationsTheycanbedivided into twosubtypes:
• ①positionsensation
• ②movementsense orkinesthesia

第61页：often person fell spain part

often person fell spain part

• 1)oftenapersonfellspainina partofthebodythatisfairlyremotefromthetissue causingthe61elicitedbymultipletypesofstimuli.Theyareclassifiedasmechanical,thermal,andchemicalpainstimuli.Ingeneral,fastpainiselicitedbythemechanicalandthermaltypesofstimuli,whereasslowpaincanbeelicitedbyallthreetypes.Someofthechemicalthatexcitethechemicaltypeofpainareserotonin,bradykinin,histamine,acids,acetylcholineandpotassiumions.fastpain:
• ①isfeltwithinabout0.1secondafterapain stimulus isapplied;
• ②isalso describedby suchassharppain,prickingpain,acutepain,andelectricpain;
• ③theyaretransmittedintheperipheralnervestothespinalcordbysmalltypeAδfibersatvelocitiesbetween6and 30m/sec.slowpain:
• ①beginsonlyafter1secondormorethenincreasesslowlyovermanysecondsandsometimesevenminutes;
• ②burningpain,achingpain,throbbingpain,chronicpain,nauseouspan;
• ③itcanleadtoprolonged,unbearable suffering,itcanoccur bothintheskinandinalmostanydeeptissue ororgan;
• ④istransmittedtothespinalcordbytypeCfibersatvelocitiesbetween0.5and2m/sec.2.visceralsensation
• (1)characterics1)anystimulusthatexcitespainnerveendingsindiffuseareasofthe visceralcancausevisceralpainSuchstimuliincludeischemiaofvisceraltissue,chemicaldamagetothesurfacesoftheviscera,spasmofthesmoothmuscleofahollowviscus,excessdistentionofahollowviscus,andstretchingoftheconnectivetissuesurroundingorwithintheviscus.2)allvisceralpainthatoriginatesinthethoracicandabdominalcavitiesistransmittedthroughsmalltypeCpainfibersand,therefore,cantransmitonlythechronic-aching-sufferingtypeofpain.3)itispoorly localized,unpleasant.4)associatedwithnauseaandautonomicsymptoms.5)somevisceralpaincausedwith parietalpainandreferredpain.
• (2)parietalpainWhenadiseaseaffectsaviscus,thediseaseprocessoftenspreadstotheparietalperitoneum,pleura,orpericardium.Theseparietalsurface,liketheskin,andsuppliedwithextensivepaininnervationfromtheperipheralspinalnerves.Therefore,painfromtheparietalwalloverlyingaviscusisfrequentlysharp.Forexample:aknifeincisionthroughtheparietalperitoneumisverypainful,whereasasimilarcutthroughthevisceralperitoneumorthroughagutwallisnotverypainful,ifpainfulatall.
• (3)referredpain

第62页：inter neuron individual muscle

inter neuron individual muscle

• interneuronthatinhibitstheindividualmusclewithoutaffectingadjacentmuscles.62pain.ThisiscalledreferredpainForinstance,paininoneofthe visceralorgansoftenisreferredtoanareaonthe bodysurface.2)mechanismofreferredpain:Branchesofvisceralpainfibersareshowntosynapseinthespinalcordonthesamesecond-orderneuronsthereceivepainsignalsfromtheskin.Whenthevisceralpainfibersarestimulated,painsignalsfromthevisceralareconductedthroughatleastsomeofthesameneuronsthatconductpainsignalsfromtheskin,andthepersonhasthefellingthatthesensationsoriginateintheskinitself.§3controloftheposture&motorbythenervoussystemMotorfunctionofthe spinalcord
• 1.organizationofthe spinalcordformotorfunctionTheintrafusalfiberscontractinresponsetoactivationbymotorneurons,butthemotorneuronssupplyingthemarenotthesameonesthatactivatetheextrafusalmusclefibers.Themotorneuronscontrollingtheextrafusalmusclefibersarelongerandareclassifiedasalphamotorneurons,whereasthesmallermotorneuronswhoseaxonsinnervatetheintrafusalfibersareknownasgammamotorneurons.Motorunits:stimulationofasinglealphanervefiberexcitesanywherefromthreetoseveralhundredskeletalmusclefibers,whicharecollectivelycalledthemotorunit.Motorunitsarethephysiologicalfunctionalunitinmuscle
• 2.basalpatternofcontrolofthemotor&posturebyspinalcord–spinalreflexes
• (1)musclestretchreflexConcept:wheneveramuscleisstretchedsuddenly,excitationofthespindlescausesreflexcontractionofthelargeskeletalmusclefibersofthestretchedmuscleandalsoofcloselyalliedsynergisticmuscles.1)receptorsofthestretchreflex
• ①musclespindles,whicharedistributedthroughoutthebellyofthemuscleandsendinformationtothenervoussystemaboutmusclelengthorrateofchangeoflength.Eachspindleis3to10millimeterslong.Itisbuiltaround3to12verysmallintrafusalmusclefibersthatarepointedattheirendsandattachedtotheglycocalyxofthesurroundinglargeextrafusalskeletalmusclefibers.
• ②golgitendonorgans,whicharelocatedinthemuscletendonsandtransmitinformationabouttendontensionorrateofchangeoftension.golgitendonorgansprovidesthenervoussystemwithinstantaneousinformationonthedegreeoftensionineachsmallsegmentofeachmuscle.Signalsfromthetendonorganaretransmittedthroughlarge,rapidlyconductingtypeⅠbnervefibers,transmitsignalsbothintolocalareasofthecordand,aftersynapsinginadorsalhornofthecord,throughlongfiberpathwayssuchasthespinocerebellartractsintothecerebellumandthroughstillothertractstothecerebralcortex.Thelocalcordsignalexcitesasignalinhibitory

第63页：neuron circuit stretch reflex

neuron circuit stretch reflex

• 2)neuronalcircuitryofthestretchreflex.AtypeⅠaproprioceptornervefiberoriginatinginamusclespindleandenteringadorsalrootofthespinalcord.Abranchofthisfiberthengoesdirectlytotheanteriorhornofthecordgraymatterandsynapseswithanterioralphamotorneuronsthatsendmotornervefibersbacktothesamemusclefromwhichthemusclespindlefiberoriginated.MosttypeⅡfibersfromthemusclespindleterminateonmultipleinterneuronsinthecordgraymatter,andthesetransmitdelayedsignalstotheanteriormotorneuronsorserveotherfunction.Wheneversignalsaretransmittedfromthemotorcortexorfromanyotherareaofthebraintothealphamotorneurons,inmostinstancesthegammamotorneuronsarestimulatedsimultaneously,aneffectcalledcoactivationofthealphaandgammamotorneurons.Thiscausesboththeextrafusalskeletalmusclefibersandthemusclespindleintrafusalmusclefiberstocontractatthesametime.Thepurposeofcontractingthemusclespindleintrafusalfibersatthesametimethatthelargeskeletalmusclefiberscontractistwofold:First,itkeepsthelengthofthereceptorportionofthemusclespindlefromchangingduringthecourseofthewholemusclecontraction,therefore,coactivationkeepsthemusclespindlereflexfromopposingthemusclecontraction.Second,itmaintainstheproperdampingfunctionofthemusclespindle,regardlessofanychangeinmusclelength.tendonreflex3)typesofthestretchreflex:musclereflex
• ①tendonreflex(dynamicstretchreflex)whenamuscleissuddenlystretched,astrongsignalistransmittedtothespinalcord;thiscauseaninstantaneousstrongreflexcontractionofthesamemusclefromwhichthesignaloriginated,thus,thereflexfunctionstoopposesuddenchangesinmusclelength.Itisalsocalledphasicstretchreflex.Itisoverwithinafractionofasecondafterthemusclehasbeenstretchedtoitsnewlength.Itismonosynaptic.Theafferentnervefibersinthestretchedmusclesynapsedirectlyonthemotorneuronstothatmusclewithoutanyinterneurons,thisportionofthestretchreflexiscalledmonosynaptic.
• ②muscletone(tonicstretchreflex/staticstretchreflex)Whenthereceptorportionofthemusclespindleisstretchedslowly,thenumberofimpulsestransmittedfromboththeprimary(Ⅰa)andthesecondary(Ⅱ)endingsincreasesalmostdirectlyinproportiontothedegreeofstretching,andtheendingscontinuetotransmittheseimpulsesforseveralminutes.
• (2)flexorreflexandcrossed-extensorreflex1)flexorreflex&crossed-extensorreflex:Painfulstimulationoftheskin,asoccursfromsteppingonatack,activatestheflexor63

第64页：bro man classification muscles

bro man classification muscles

• asarea6 inBrodmann’sclassification.64musclesandinhibitstheextensormusclesoftheipsilateral(onthesamesideofthebody)leg.Theresultingactionmovestheaffectedlimbawayfromtheharmfulstimulus,andisthusknownasawithdrawalreflex.Thesamestimuluscausesjusttheoppositesideofthebodyfromthestimulus.Motorneuronstotheextensorsareactivatedwhiletheflexormusclemotorneuronsareinhibited.Thiscrossed-extensorreflexenablesthecontralaterallegtosupportthebody’sweightastheinjuredfootisliftedbyflexion.2)babinski’ssign3)intersegmentalreflexe.g.scratchingreflex.Itinvolvestwofunctions:
• ①apositionsensethatallowsthepawtofindtheexactpointofirritationonthesurfaceofthebody,and
• ②ato-and-froscratchingmovement.3.integrativefunctionofthespinalcordWhenthespinalcordissuddenlytransectedintheupperneck,atfirst,essentiallyallcordfunctions,includingthecordreflrxes,immediatelybecomedepressedtothepointoftotalsilence,areactioncalledspinalshock.Thereasonforthisisthatnormalactivityofthecordneuronsdependstoagreatextentoncontinualtonicexcitationbythedischargeofnervefibersenteringthecordfromhighercerters,particularlydischargetransmittedthroughthereticulospinal,vestibulospinaltracts,andcorticospinaltract.Controlofthemuscletoneandposturebybrainstem
• 1.controlofmuscletonebybrainstemDecerebraterigidity:whenthebrainstemofananimalissectionedbelowthemidlevelofthemesencephalon,butthepontineandmedullaryreticularsystemsaswellasthevestibularsystemareleftintact,theanimaldevelopsaconditioncalleddecerebraterigidity.Thisrigiditydoesnotoccurinallmusclesofthebodybutdoesoccurintheantigravitymuscles-themusclesoftheneckandtrunkandtheextensorsofthelegs.Thereasonisthattheinhibitoryareasthatdrivethereticularinhibitorycenterareremoved.Dischargeofthefacilitatorareacontinues,butthatoftheinhibitoryareaisdecreased.Consequently,gammaefferentdischargeisincreased,andstretchreflexbecomehyperactive.2.controlofposturebybrainstem
• (1)posturalreflex
• (2)controlof eyepositionControlofthesomaticmotorfunctionbythecerebralcortexAnteriortothecentralcorticalsulcus,occupyingapproximatelytheposterioronethirdofthefrontallobes,isthe motorcortex.1.motor cortexorcorticalmotorarea
• (1)primarymotorcortexandpremotorareaPrimarymotorcortexisthesameasarea4inBrodmann’sclassificationofthebraincorticalareas.thepremotorarealies1to3centimetersanteriortotheprimarymotorcortex.Itisthesame

第65页：character cross section overla

character cross section overla

• Character:1)cross-sectional(overlap)2)relativesizesofthebodystructuresareproportionaltothenumberofneuronsdedicatedtotheirmotorcontrol.3)“placeupsidedown”(inverting)
• (2)othermotorareas:SupplementarymotorareaItliesmainlyinthelongitudinalfissurebutextendsafewcentimetersontothesuperiorfrontalcortex,thisareafunctionsinconcertwiththepremotorareatoprovidebody-wideattitudinalmovements,fixationmovementsofthedifferentsegmentsofthebody,positionalmovementsoftheheadandeyes,andsoforth,asbackgroundforthefiner,motorcontrolofthearms,andhandsbythepremotorareaandprimarymotorarea.2.pathwaysfromthemotorcortextothemuscles
• (1)pyramidalsystem:apathwaythatoriginatesinthecerebralcortexandendsinthemotorneurons.Themostimportantotputpathwayfromthecortexisthecorticospinaltract,alsocalledthepyramidaltract,thecorticospinaltractoriginatesabout30percentfromtheprimarymotorcortex,30percentfromthepremotorandsupplementarymotorareas,and40percentfromthesomatosensoryareasposteriortothecentralsulcus.Afterleavingthecortex,itpassesthroughtheposteriorlimboftheinternalcapsuleandthendownwardthroughthebrainstem,formingthepyramidsofthemedulla.Themajorityoftheoppositesideanddescendintothelateralcorticospinaltractsofthecord,finallyterminatingprincipallyontheinterneuronsintheintermediateregionsofthecordgraymatter;afewterminateonsensoryrelayneuronsinthedorsalhorn,andaveryfewterminatedirectlyontheanteriormotorneuronsthatcausemusclecontraction.Afewofthefibersdonotcrosstotheoppositesideinthemedullabtpassipsilaterallydownthecordintheventral/anteriorcorticospinaltract.Manyifnotmostofthesefiberseventuallycrosstotheoppositesideofthecordeitherintheneckorintheupperthoracicregion.Thesefibersmaybeconcernedwithcontrolofbilateralposturalmovementsbythesupplementarymotorcortex,conticonucleartractorcorticalbrainstemtract:apathwaythatbeginsinthesensorimotorcortexandendsinthebrainstem.Theconticonuclearfibersprovidethemainsourceofcontrolforvoluntarymovementofthemuscleoftheheadandneck,whereasthecorticospinalfibersservethisfunctionforthemusclesoftherestofthebody.Forconvenience,wewillincludethecorticonuclearpathwayinthegeneraltermcorticospinalpathways.
• (2)extrapyramidalsystemcorticallyoriginatingextrapyramidalsystemparapyramidalsystemThetermextrapyramidalmotorsystemiswidelyusedinclinicalcirclestodenoteallthoseportionsofthebrainandbrainstemthatcontributetomotorcontrolbutarenotpartofthedirectcorticospinal-pyramidalsystem.Theseincludepathwaysthroughthebasalganglia,thereticular65

第66页：formation brainstem vest often

formation brainstem vest often

• formationofthebrainstem,thevestibularnuclei,andoftentherednuclei.Thisissuchanall-inclusiveanddiversegroupofmotorcontrolareasthatitisdifficulttoascribespecificneuronphysiologicfunctiontotheso-calledextrapyramidalsystemasawhole.Forthisreason,theterm“extrapyramidal”isbeingusedlesssoftenbothclinicallyandphysiologically.Rolesofbasalgangliainmotorcontrol
• 1.motorfunctionsandneuronalcircuitsofthebasalganglia
• (1)functionsofthebasalgangliaThebasalgangliareceivemostoftheirinputsignalsfromthecerebralcortexitselfandalsoreturnalmostalltheiroutputsignalsbacktothecortex.Oneachsideofthebrain,thesegangliaconsistofthecaudatenucleus,putamen,globuspallidus,substantianigra,subthalamicnucleus,andrednucleus.caudatenucleusneostriatumputamencorpusstriatumglobuspallidus------paleostriatum
• (2)neuronalcircuitsofthebasalganglia1)putamencircuit:Theybeginmainlyinthepremotorandsupplementaryareasofthemotorcortexandinthesomatosensoryareasofthesensorycortex.Nexttheypasstotheputamen(mainlybypassingthecaudatenucleus),thentotheinternalportionoftheglobuspallidus,necttotheventroanteriorandventrolateralrelaynucleiofthethalamus,andfinallyreturntothecerebralprimarymotorcortexandtoportionsofthepremotorandsupplementarycerebralareascloselyassociatedwiththeprimarymotorcortex.
• ①controlcomplexpatternsof motoractivity
• ②performsubconsciouslyourskilledmovementse.g.,shootinga basketball,passingafootball,writingaletter.2) caudatecircuitThecaudatenucleusextendsintoalllobesofthecerebrum,beginningauteriorlyinthefrontallobes,thenpassingposteriorlythroughtheparietalandoccipitallobes,andfinallycurvingforwardagainliketheletter“C”intothetemporallobes.Afterthesignalspassfromthecerebralcortextothecaudatenucleus,theyarenexttransmittedtotheinternalglobuspallidus,thentotherelaynucleioftheventroanteriorandventrolateralthamlamus,andfinallybacktotheproforntal,premotor,andsupplementarymotorareasofthecerebralcortex,butwithalmostnoneofthereturningsignalspassingdirectlytotheprimarymotorcortex.Thecaudatenucleusplaysamajorroleinthiscognitivecontrolofmotoractivity.e.g.seeingalionapproachandthenrespondinginstantaneouslyandautomaticallyby:
• ①turningawayfromthelion;
• ②beginningtorun;
• ③evenattemptingtoclimbatree.3)substantianigra-neostriatumcircuit66

第67页：sub anti compact date put

sub anti compact date put（流程示意）

1. SNc
2. ∣ , ,SNr←------- 2. (1) : ’ . , . . . . ’ , .(2) : ’ ① ;② 3 6 , ③ , . . , . ’ : . . : . : ’ . : , . : . .( , , )§4 , 67

第68页：spinal reflex stem hypothalamu

spinal reflex stem hypothalamu

• 1.spinalreflex68stem,andhypothalamus.Also,portionsofthecerebralcortex,especiallyofthelimbiccortex,cantransmitimpulsestothelowercentersandinthiswayinfluenceautonomiccontrol(theautonomicnervoussystemalsooftenoperatesbymeansofvisceralreflexes).Theefferentautonomicsignalsaretransmittedtothevariousorgansofthebodythroughtwomajorsubdivisionscalledthesympatheticnervoussystemandtheparasympatheticnervoussystem.Thesympatheticandparasympatheticnervefiberssecretemainlyoneortheotheroftwosynaptictransmittersubstance,acetylcholineornorepinephrine.
• ①Allpreganglionicneuronsarecholinergicinboththesympatheticandtheparasympatheticnervoussystem.
• ②Eitheralloralmostallofthepostganglionicneuronsoftheparasynapticsystemarealsocholinergic,and
• ③mostofthepostganglionicsympatheticneuronsareadrenergic.However,thepostganglionicsympatheticnervefiberstothesweatglands,tothepiloerectormusclesofthehairs,andtoaveryfewofthebloodvesselsarecholinergic.Theterminalnerveendingsoftheparasympatheticsystemallorvirtuallyallsecreteacetylcholine,andmostofthesympatheticnerveendingssecretenorepinephrine,butafewsecreteacetylcholine.1.Acetylcholinereceptors:MandNreceptorsM-receptorsarefoundonalleffectorcellsstimulatedbythepostganglionicneuronsoftheparasympatheticneuronssystemaswellasonthosestimulatedbythepostganglioniccholinergicneuronsofthesympatheticsystem.N-receptorsarefoundatthesynapsesbetweenthepreganglionicandpostganglionicneuronsofboththesympatheticandparasympatheticsystem,anditisalsopresentatmanynon-autonomicnerveendings-forinstance,attheneuromuscularjunctionsinskeletalmuscle.2.Adrenergicreceptors:αandβreceptorsnorepinephrineandepinephrine,bothofwhicharesecretedintothebloodbytheadrenalmedulla,havesomewhatdifferenteffectsinexcitingthealphaandbetareceptors.norepinephrineexcitesmainlyalphareceptorsbutexcitesthebetareceptorstoalesserextentaswell.Conversely,epinephrineexcitesbothtypesofreceptorsapproximatelyequally.Therefore,therelativeeffectsofnorepinephrineandepinephrineondifferenteffectororgansaredeterminedbythetypesofreceptorsintheorgan.Iftheyareallbetareceptors,epinephrinewillbethemoreeffectiveexcitant.3.characteristics
• (1)thetwosystemsoccasionallyactreciprocallytoeachother,butmostorgansaredominantlycontrolledbyoneortheotherofthetwosystems(dualinnervation).
• (2)“tonic”function:sympathetictoneandparasympathetictone,thevalueoftoneisthatitallowsasinglenervoussystembothtoincreaseandtodecreasetheactivityofastimulatedorgan.Itislowfrequencydischarge.
• (3)haverelationswiththeeffectersituation.
• (4)regulatingphysiologicalactionsofthebody.Centralregulationofvisceralaction

第69页：waves occur frequencies greate

waves occur frequencies greate

• 2)beta-waves:occuratfrequenciesgreaterthan14cyclespersecondandashighas80cycles692.low brainstem:vitalcenters
• 3.hypothalamus1)regulationofbodytemperature2)regulationoffoodintake3)regulationofwaterbalance4)controlof pituitarysecretions§5higherfunctionofthebrainLearningandmemory
• 1.classificationoflearning
• (1)non-associativelearning
• (2)associativelearning
• 2.conditionedreflex
• (1)classicalconditionedreflex
• (2)operantconditioning
• 3.conditionedreflexofthehumanbeingandtwosignalsystemtheories
• 4.classificationofmemoryPhysiologically,memoriesarestoredinthebrainbychangingthebasicsensitivityofsynaptictransmissionbetweenneuronsasaresultsofpreviousneuralactivity.theneworfacilitatedpathwaysarecalledmemorytraces.§6electricactivityofthecerebralcortex,sleepandwakefulnesselectric activityofthecerebralcortex
• 1.evokedcorticalpotentialevokedpotentialsarevoltagechangeswithintheEEGthatareevokedorelicitedbysuddensensorystimuli,suchaselectricalstimulationofthefinger,aclick,oralightflash.2.electroencephalogram,EEGElectricalrecordingsfromthesurfaceofthebrainorevenfromtheoutersurfaceoftheheaddemonstratethatthereiscontinuouselectricalactivityinthebrain.boththeintensityandthepatternsofthiselectricalactivityaredeterminedbythelevelofexcitationofdifferentpartsofthebrainresultingfromsleep,wakefulness,orbraindisease.Theundulationsintherecordedelectricalpotentials,arecalledbrainwaves,andtheentirerecordiscalledanEEG.
• (1)basic typesofbrainwavesinthe normalEEG1)alpha-wave:arerhythmicalwavesthatoccuratfrequenciesbetween8and13cyclepersecondandarefoundintheEEGsofalmostallnormaladultpeoplewhentheyareawakeandinaquiet,restingstateofcerebration,theirvoltageusuallyisabout50mv.Duringdeepsleep,thealphawavesdisappear.

第70页：person even difficult use sens

person even difficult use sens

• ②thepersonisevenmoredifficulttoarousebysensorystimulithanduringdeepslow-wave70persecond.Theyarerecordedmainlyfromtheparietalandfrontalregionsduringspecificactivationofthesepartofthebrain.Whentheawakeperson’sattentionisdirectedtosomespecifictypeofmentalactivity,thealphawavesarereplacedbyasynchronous,higher-frequencybutlower-voltagebeta-waves.3)theta-waves:havefrequenciesbetween4and7cyclespersecond.Theyoccurnormallyintheparietalandtemporalregionsinchildren,buttheyalsooccurduringemotionalstressinsomeadults,particularlyduringdisappointmentandfrustration.theta-wavesalsooccurinmanybraindisorders,oftenindegenerativebrainstates.4)delta-waves:includeallthewavesoftheEEGwithfrequencieslessthan3.5cyclespersecond,andtheyoftenhavevoltagetwotofourtimesgreaterthanmostothertypesofbrainwaves.Theyoccurinverydeepsleep,ininfancy,andinseriousorganicbraindisease.Theyalsooccurinthecortexofanimalsthathavehadsubcorticaltransectionsseparatingthecerebralcortexfromthethalamus.Therefore,delta-wavescanoccurstrictlyinthecortexindependentofactivitiesinlowerregionsofthebrain.
• (2)originofthebrainwavesManythousandsorevenmillionsofneuronsorfibersmustfiresynchronously;onlythenwillthepotentialsfromtheindividualneuronsorfiberssummateenoughtoberecordedallthewaythroughtheskull.Thus,theintensityofthebrainwavesfromthescalpisdeterminedmainlybythenumbersofneuronsandfibersthatfireinsynchronywithoneanother,notbythetotallevelofelectricalactivityinthebrain.Wakefulnessandsleep
• 1.maintainof wakingstateascendingreticularactivatingsystem
• 2.twotypesofsleep1)slowwavesleep,SWSThissleepisexceedinglyrestfulandisassociatedwithdecreaseinbothperipheralvasculartoneandmanyothervegetativefunctionsofthebody.Forinstance,thereare10to30percentdecreasesinbloodpressure,respiratoryrate,andbasalmetabolicrate,althoughslow-wavesleepisfrequentlycalled“dreamlesssleep”,dreamsandsometimesevennightmaresdooccurduringslow-wavesleep,andthedreamofslow-wavesleepusuallyarenotremembered.Slow-wavesleepisdividedintofourstages.Inthefirststage,astageofverylightsleep,thevoltageoftheEEGwavesbecomesverylow,thisisbrokenby“sleepspindles”,thatis,shortspindle-shapedburstofalphawavesthatoccurperiodically.Instage2,3,and4ofslow-wavesleep,thefrequencyoftheEEGbecomesprogressivelysloweruntilitreachesafrequencyofonly1to3wavespersecondinstage4,thesearetypicaldeltawaves.2)paradoxicalsleep,PSorrapideyemovement,REMsleepcharacteristicsofREMsleep:
• ①itisusuallyassociatedwithactivedreamingandactivebodilymusclemovement;

第71页：era sensation sleep yet people

era sensation sleep yet people

• 3)Visceralsensation71sleep,andyetpeopleusuallyawakenspontaneouslyinthemorningduringanepisodeofREMsleep;
• ③muscletonethroughoutthebodyisexceedinglydepressed,indicatingstronginhibitionofthespinalmusclecontrolareas;
• ④heartrateandrespiratoryrateusuallybecomeirregular,whichischaracteristicofthedreamstate
• ⑤despitetheextremeinhibitionoftheperipheralmuscle,irregularmusclemovementdooccur.theseareinadditiontotherapidmovementsoftheeyes;
• ⑥thebrainishighlyactiveinREMsleep,andoverallbrainmetabolismmaybeincreasedasmuchas20percent.The EEGshowsapatternofbrainwavessimilartothosethatoccurduringwakefulness.Thesetypeofsleepisalsocalledparadoxicalsleepbecauseitisaparadoxthatapersoncanstillbeasleepdespite markedactivityinthebrain.Chapter10PhysiologyofSenseOrgansSection1Introduction
• 一、Sensoryreceptorsandsenseorgans
• (一)Sensoryreceptors
• 1.Primarysensorycell:Receptorsarespecializednervecellsthattransduceenergyintoneuralsignals.2.Secondary sensorycell:eye(rodandcone),ear (haircell).
• (二)Senseorgans:sensorycellandotherstructure
• 二、Classificationofreceptors
• 1.Location1)Exteroceptor:Locatedonthebodysurfaceorspecializedtodetectexternalstimuli,e.g.pressure,pain,temp,touch,etc.2)Interoceptor:includingvisceroceptorsandproprioceptors●Visceralreceptors:Locatedwithininternalorganstodetectinternalstimuli,e.g.bloodpressure,pain,fullness.●Proprioceptors:Foundinthejointsandmuscles,alsointhevestibularstructuresandthesemicircularcanalsofthe innerear,e.g.limbandbodypositionandmovment.2Modalities1)Mechanoceptive2)Thermoceptive3)Nociceptive(pain)4)Photoreceptors5)Chemoceptive
• 三、Sensemodalityandquality
• 1.Specialsence
• 2.Somaticsensation1)Superficialsensation2)Deepsensation

第72页：72四、 （一） . .（二

72四、 （一） . .（二

• Whentheciliarymuscleisrelaxed,parallellightraysstrikingtheopticallynormal(emmetropic)72
• 四、Characteristicsofreceptors
• （一）AdequateStimulusEachtypeofreceptorishighlysensitivetoonetypeofstimulusforwhichitisdesignedandyetisalmostnonresponsivetonormalintensitiesofothertypeofstimuli.Thestimulustowhichagivenreceptorhasthelowestthresholdistermedtheadequatestimulusofthesensoryreceptor.
• （二）Transduction
• 1.Concept:Theprocessbywhichanenvironmentalstimulusbecomesencodedasasequenceofnerveimpulses inanafferentnervefiberis calledsensorytransduction.2.Principles:1)Receptorpotentials:Changesinthetransmembranepotentialofareceptorcausedbythestimulus.2)GeneratorPotential:Areceptorpotentialthatisstrongenough(reachesthreshold)togenerateanactionpotential.
• （三）Sensorycoding:Convertingtheexternalstimulitoactionpotentials,thereceptorsnotonlytransformtheenergytootherkindofenergy,butalsotransformtheinformationfromtheenvironmentintoatrainofnerveimpulses.Thequalityofthestimulusisencodedinthefrequencyoftheactionpotentialstransmitteddowntheafferentfibreandthenumberofsensoryreceptorsactivated.
• （四）Adaptation:Whenasenseorganisstimulatedforacertainperiodoftime,thesensoryimpulsefrequencydeclinesshortlyaftertheonsetofstimulation,thisphenomenoniscalledadaptation.Section2VisualSenseOrgan
• 一、Functionofthedioptricsystemandvisualaccommodation
• （一）CompositionandopticscharacteristicsofrefractivesysteminhumaneyeTherefractivesystemofthehumaneyeiscomposedofthecornea,aqueoushumor,crystallinelens,andvitreoushumor.Themorealensbendslightrays,thegreaterisitsrefractivepower.Thisrefractivepowerismeasuredintermsofdiopters(D).Therefractivepowerindioptersofaconvexlensisequalto1meterdividedbyitsfocallength.
• （二）ReducedeyeIfalltherefractivesurfacesoftheeyearealgebraicallyaddedtogetherandthenconsideredtobeonesinglelens,theopticsofthenormaleyemaybesimplifiedandrepresentedschematicallyasareducedeye.Inthereducedeye,asinglerefractivesurfaceisconsideredtoexist,withitscentralpoint17millimeterinfrontoftheretinalandatotalrefractivepowerof59diopterswhenthelensisaccommodatedfordistantvision.
• （三）Visualaccommodation

第73页：eyes brought focus retina long

eyes brought focus retina long

• 73eyesarebroughttoafocusontheretina.Aslongasthisrelaxationismaintained,raysfromobjectscloserthan6mfromtheobserverarebroughttoafocusbehindtheretina,andconsequentlytheobjectsappearblurred.Theprocesswherebynearobjectsarebroughttoasharpfocusontheretinaiscalledaccommodationofeyeorvisualaccommodation.Accommodationinvolvesfollowingreflexes:
• 1.Accommodationoflens:
• (1)Increasebulging(refraction)oflens.
• (2)Viacontractionofciliarymuscle,relaxesthesuspensoryligaments(parasympatheticfibers).Thevisualaccommodationismainlythroughincreasingcurvatureofcrystallinelens.●nearpoint:Thenearestdistanceoftheeyeatwhichanobjectcanbeseendistinctlyiscalledthenearpoint.●Presbyopia(Oldsightedness):Thecrystallinelenstendstohardenandthecapsuleitselfbecomeslesselasticwithage.Thenearpointofdistinctvisionmovesfurtherandfurtherawayfromtheeyewithage.Thefarpointisnormal.Maybecompensatedbyplacingaconverginglensinfrontoftheeye.2.Pupillaryreflex:Decreasesizeofpupils(parasympathetic)preventsdivergentlightraysfromentering.3.Convergenceofeyeballs:Viewingnearobjectcausesreflexlybotheyestomoveinwardtofocusonanearobject,thisprocessiscalledconvergencereflex.
• (四)Errorofrefraction：Causedbyshapeofeyeand/orpoweroflens
• 1.Myopia(Nearsightedness):Eyeistoolongand/orlensistoopowerful.Lightfocusesinfrontofretina.Correctwith“concave” lenstoreducepower.2.Hyperopia(Farsightedness):Eyetooshortand/orlenstooweak.Lightfocusesbehindretinal.Crrectwith“convex”lens toaddpower.3.Astigmatism:Abnormalcurvatureofthecornea.Lightfromverticalandhorizontaldirectiondonotfocusesinthe samepoint.Correctwith“cylindrical” lenstocompensate.
• （五）Pupillaryreflex：
• 1.Lightreflex:Whenlightisshoneintotheeyes,thepupilsconstrict,areactioncalledthepupillarylightreflex.Thefunctionoflightreflexistohelptheeyeadaptextremelyrapidlytochanginglightconditions.Iflightisdirectedprimarilyintooneeye,thepupilofthateyegreatlyconstricts,whilethepupilofothereyeshowsamuchsmallerdegreeofconstriction.Itiscalledindirectlightreflex.2.Convergenceofeyeballs:seeabove
• （六）Aqueoushumorandintraocularpressure
• 1.Aqueoushumor:
• (1)Aqueoushumoriscontinuallybeingformedandreabsorbed.ThebalancebetweenformationandreabsorptionofAqueoushumorregulatesthetotalvolumeandpressureoftheintraocularfluid.Aqueoushumorisformedintheeyeatanaveragerateof2to3microliterseachminute.

第74页：essentially secret liar proces

essentially secret liar proces

• 74Essentiallyallofitissecretedbytheciliaryprocesses.
• (2)Mechanism:Aqueoushumorisformedalmostentirelyasanactivesecretionbytheepitheliumoftheciliaryprocesses.Secretionbeginswithactivetransportofsodiumionsintothespacebetweenepithelialcells.Thesodiumionspullchlorideandbicarbonateionsalongwiththemtomaintainelectricalneutrality.Thenalltheseionstogethercauseosmosisofwaterfromthebloodcapillarieslyingbelowintothesameepithelialintercellularspaces,andtheresultingsolutionwashesfromthespacesoftheciliaryprocessesintotheanteriorchamberoftheeye.2.Intraocularpressure:Theaveragenormalintraocularpressureisabout20mmHg,withrange17to24mmHg.●Giaucoma:Giaucomaisoneofthemostcommoncausesofblindness.Itisadiseaseoftheeyeinwhichtheintraocularpressurebecomespathologicallyhigh,sometimesrisingacutelyto60to70mmHg.Extremelyhighpressurescancauseblindnesswithindaysorevenhours.
• 二、Functionofthephotosensorysystemandinformationtransmission
• （一）StructureofretinaanditstwophotoreceptorsystemsA.Structureofretina:Theretinaisthelightsensitiveportionoftheeye.Fromoutsidetoinside:
• (1)Pigmentlayer:Theblackpigmentmelanininthepigmentlayerpreventslightreflectionthroughouttheglobeoftheeyeball.ThepigmentlayeralsostoreslargequantitiesofvitaminA.VitaminAisanprecursorofthephotosensitivechemicalsoftherodsandcones.
• (2)Photoreceptorcelllayer:rodsandcones.
• (3)Bipolarcelllayer:carrysignalsfromreceptorstoganglioncells.
• (4)Ganglioncelllayer:axonsofganglioncellsformthe opticnerve.B.RodsandCones
• 1.The photoreceptorcellsaretwotypes,rodcells(rods)andconecells(cones)Themajorfunctionalsegmentsofeitherarodoracone
• (1)theoutersegment
• (2)theinnersegment
• (3) thenucleus
• (4)thesynapticbody.Theoutersegmentsofthephotoreceptorcellcontainstacksofmembranousdiscs.2.Differencebetweenrodsystemandconesystem
• (1)Rods:Thescotopicvisionsystemconsistsofrodsandsubsequentbipolarcellsandganglioncells.1)Theoutersegmentofarodcellhasarod-likeappearance.2)locatedmainlyinperipheryofretina.3)responsiblefornightvision.4)detailnotdetected.5)seeblack,white,andgray(nocolor).6)Severalrodsshare1bipolarand1ganglioncell7)rodvisionlacksdetail,but,bycombiningtheirefforts,groupsofrodsallowustoseeinlowlight

第75页：needed evidence two photorecep

needed evidence two photorecep

• 75needed.3.Otherevidencethattwophotoreceptorsystemofretinaexit.1)Thenocturnalanimalshaveapreponderanceofrods,whereasthediurnalanimalshaveapreponderanceofconesintheirretina.2)Thevisualpigmentintherodsisonlyrhodopsin.Therearethreeclassesofconesintheretina,eachcontainingdifferentpigmentsensitive toparticularregionofvisiblespectrum.
• （二）Transductionoflightenergybyrodcell
• 1.Rhodopsin:Thevisualpigment(light-sensitivepigment)intheoutersegmentofrodsistherhodopsin.2.Photochemicalreactionandmetabolismofrhodopsin:Therhodopsinisacombinationofaproteinpart,scotopsin(opsin),andacarotenoidpigment,11-cisretinal.Thiscisformoftheretinalisimportantbecauseonlythisformcanbindwithscotopsintosynthesizerhodopsin.Whenlightenergyisabsorbedbyrhodopsin,therhodopsinbeginwithintrillionthsofasecondtodecompose.Thisdecompositionconverts11-cisretinal(bentshapeform)intoall-transretinal(straightchainform).Inordertomaintaintheabilitytodetectlight,therodsmustreconverttheall-transretinalinto11-cisretinal.Thisprocessrequiresmetabolicenergyandiscatalyzedbytheretinalisomerase.All-transretinolisoneformofvitaminA.Theall-transretinolisconvertedinto11-cisretinolundertheinfluenceofisomerase,andfinallyinto11-cisretinalthatcombineswithopsintoformrhodopsin.Therefore,vitaminAisalwaysavailabletoformnewretinalwhenneeded.NightblindnessoccursinanypersonwithseverevitaminAdeficiency.3.Receptorpotentialofrods:
• (1)Theinnersegmentcontinuallypumpssodiumfrominsidetherodtotheoutside,therebycreatinganegativepotentialontheinsideoftheentirecell.However,theoutersegmentoftherodinthedarkstate,isveryleakytosodiumions.Therefore,positivelychargedsodiumionscontinuallyleakbacktotheinsideoftherodandtherebyneutralizemuchofthenegativityontheinsideoftheentirecell.Thus,undernormaldarkconditions,whentherodisnotexcited,thereisreducedelectronegativityinsidethemembraneoftherod.
• (2)Whentherhodopsinintheoutersegmentoftherodisexposedtolight,therhodopsinbeginstodecompose,andproducemetarhodopsinwhichactivatesGprotein.Gproteinactivatesmanymoremolecularofphosphodiesterasewhichimmediatelyhydrolyzecyclicguanosinemonophosphate(cGMP)anddestroyit.ReducedcGMPclosessodiumchannels.Theneteffectoflightistohyperpolarizetheretinalreceptorandreducethereleaseofglutamate.
• （三）Photochemistryofcolorvisionbycones

第76页：light sensitive substances one

light sensitive substances one

• 76Thelightsensitivesubstancesintheconeshavealmostexactlythesamechemicalcompositionasthatofrhodopsinintherods.Thelight-sensitivechemicalsinthecones,calledconepigmentsorcolorpigments.Theonlydifferenceisthattheproteinportion,theopsin,calledphotopsin(asscotopsininrods)inthecones,aredifferentfromthescotopsinoftherods.Therefore,thecolorsensitivepigmentsintheconesarecombinationsof11-cisretinalandphotopsin.Whentheconesareexposedtolight,theresultingreceptorpotentialisalsohyperpolarizationpotential.
• （四）Darkadaptationandlightadaptation
• 1.Darkadaptation1Concept：Frombrightlylightedsurroundingtoadimlylightedenvironment,theretinasslowlybecomemoresensitivetolight.Thisdeclineinvisualthresholdisknownasdarkadaptation.2Mechanism:Firstphaseisduetoneuraladaptation.Receptorcells(cones),whichhadadaptedtopersistentstrongstimulation,recovertheirsensitivitywhenthestrongstimulusiswithdrawn.Thetimerequiredfordarkadaptationisdeterminedinpartbythetimerequiredtobuilduptherhodopsinstores.Thesecondphaseisduetochemicaladaptation.Duringthisphase,rods,whichhadgotdepletedofrhodopsininbrightlight,replenishtheirrhodopsin.2.Lightadaptation:1Concept：Whenonepassessuddenlyfromadimtoabrightlylightedenvironment,thelightseemsintenselyandevenuncomfortablybrightuntiltheeyesadapttotheincreasedilluminationandthevisualthresholdrises.2Mechanism：Therhodopsinisdecomposed.
• (五)SignalprocessinginretinaLikerodsandcones,horizontalandbipolarcellsdonotgenerateimpulses.Twotypesofbipolarcellsprovideopposingexcitatoryandinhibitoryinthevisualpathway
• (1)thedepolarizingbipolarcelland
• (2)thehyperpolarizingbipolarcell.TheganglioncellcangenerateAP.
• 三、Spacevisionandcolorvision
• (一)Spacevision
• 1.Visualacuity:Itismeasuredbydeterminingtheminimumdistancebywhichtwopointsmustbeseparatedinordertoappearastwodiscreteentities.2.Visualfield:Thefieldofvisionisthevisualareaseenbyaneyeatagiveninstant.●Colorfield:white>blue>yellow>red>green
• 3.Binocularvision:Thevisualfieldsofthetwoeyesoverlapinthecentralparttoprovidebinocularvision.Theimagefallingonthetworetinaarenotidenticalbutneuralmechanismsallowthemtobeinterpretedassingleimages.Forthisfusiontooccurtheimageofanobjectmustfalloncorrespondingpointsofeachretina.
• （二）Colorvision
• 1.Theoriesofcolorvision:trichromatictheory

第77页：theories color vision based we

theories color vision based we

• 77Alltheoriesofcolorvisionarebasedonthewell-knownobservationthatthehumaneyecandetectalmostallgradationsofcolorswhenonlyred,green,andbluemonochromaticlightareappropriatelymixedindifferentcombinations.2.Colorblindness:Whenasinglegroupofcolor-receptiveconesismissingfromtheeye,thepersonisunabletodistinguishsomecolorsfromothers.
• •Sex-linkedconditions:GenesonXchromosome,somorecommoninmen.Section3AuditorySenseOrgan
• 一、Physicalcharacter ofsoundwaveThe humanear candetectsoundwavesof betweenapproximately20to20,000Hz.1.Pitch:determinedby“frequency,”thenumberofcyclespersecondofasoundwave,measuredinhertz(Hz).2.Soundpressure: determinedby“amplitude”(height)ofthesoundwave,measuredindecibels(dB).3.Timbre:determinedby“complexityandshape”ofthesoundwave,giveseachsounditsuniquequality.
• 二、Auditorythresholdandaudiblearea:
• 1.Auditorythreshold:Soundmustbeexceedacertainsoundpressurelevelinordertobeheard.Thisleveliscalledauditorythreshold.Theauditorythresholdisfrequency-dependent,thehumanearbeingmostsensitiveintherange1,000to3,000Hz.2.Maximumauditorythresholdandaudiblearea:Theauditoryperceptiongraduallyincreaseswithanincreaseinsoundintensity.Ifthesoundintensityexceedsacertainlevel,theresultisasensationofpaininthe ear.Thisleveliscalledmaximumauditorythreshold.Theareabetweenauditorythresholdandmaximumauditorythresholdiscalledaudiblearea.
• 三、Soundtransmissionintheexternalandthemiddleear
• (一)Actionofexternalear:Outer eariscomposedofpinnaandauditorycanal.1.Pinna(auricle):directssoundwavesintotheauditorycanal.2.Auditorycanal:conductssoundtotheeardrum.
• (二)Actionofmiddleear:Middleearconsistsoftympanicmembrane,chainofossicles,eustachiantubeandtympaniccavity.1.Tympanicmembrane(Eardrum):thinmembranethatvibratesinresponsetosound,andtransferssoundenergytobonesofthemiddleear.2.Chainofossicles:threetinybones(malleus,incus,stapes)“amplifysound”andtransfersoundenergytotheinnerear.Attachedtothetympanicmembraneisthehandleofthemalleus.Themalleusisboundtotheincusbyminuteligaments.Theoppositeendoftheincusarticulateswiththestemofthestapes,andthefaceplateofthestapesliesagainstthemembranouslabyrinthofthecochleaintheopeningoftheovalwindow.3.Transmissionactioninthemiddleear:
• (1)thesurfaceareaofthetympanicmembraneisabout55squaremillimeters,whereasthesurfaceareaofthestapesaverages3.2squaremillimeters.So

第78页：sound waves transmitted panic

sound waves transmitted panic（流程示意）

1. 78 , 17- .(2) , 1.3.(3) 17×1.3=22- .5. (三) 1. :(1)
5. .(2)
9. .2.
11. .四、 （一） 1. : ; . . .2. : . . , .（二） 1. , . . , “ ” .( .)2. : , （三） :1. , . .K+ .2. , . , , , . , , .

第79页：rapidly acting neurotransmitte

rapidly acting neurotransmitte（流程示意）

1. 79 . , .（四） 1. (EP): (EP) 80-100 . .2. (CM): , . , . (1) .(2) (3) (4) .3. (AP): . . .(1) : (CF): .(2) – : , .（五） 4 :1. .2. . 11 : , .Fig11–1 : . : , , , . 一.
4. ㈠. : ㈡.

第80页：signal trans pathway oxytocin

signal trans pathway oxytocin（流程示意）

1. GnRH , , .80㈢. : ㈣. : , , ㈤. :Fig11–2,3Tab11–1二. ㈠. :1. :1) : ,E ; ,NE; ;2) : (TRH,ACTH,GH,PRL,MSH,FSH,LH)2. : 3. : ,PG㈡. (三，四)五. ㈠. :1. :ACTH,GH ,2. : ㈡. 1. 2. : 3. 六. ㈠. : 1. :1) +R
4. cAMP,cGMP,Ca2+……2) + R
6. (mRNA)
7. 2. : , – ;㈡. – 1. (1). 11–101)cAMP,cGMP: , ,LH,TSH, , . ; –PKG2) 3Fig11-11 ,PLC

第81页：function channel pathway secon

function channel pathway secon（流程示意）

1. 1. 813).Ca2+ (Ca2+ )(2). 11–12,13 , – 1,IGF1,EGF,NGF,FGF,GH,PRL, , .2.
6. 11–14(H: , ) 二． : ,MgC(H
7. ) ,PvC(H
8. )二． 11-2三． 一． : ㈠. ,vp( ,ADH)ADH : 2 2 .ADH↑
10. ↑㈡. : ; 二． :㈠. 11–31.
12. hGH

第82页：substance metabolism car rate

substance metabolism car rate（流程示意）

1. 82(1) :1) : . : ; .b. .c. .2). : . : , , ↑
2. .b. .3). : . : ,b. ( , ).(2). :1)
3. 2)
4. ↑
5. ↑
6. ↑ ↑↑, 3) :RBC,TC, ↑
7. 4) 5) (ACTH,GH,PRL)
8. ↑
9. ↑6) : .2. : + 2 +｝
10. ↑
11. Bp↑㈡. 1. 1).CRH↑
12. ACTH ↑

第83页：storage thy enough used days

storage thy enough used days（流程示意）

1. 83 (T3,T4) 50–120 ; : ; : ,TBG(60%), (30%), (10%);Fig11-20一. ㈠. (T3,T4)1. ( , )2. I-3. (MIT,DIT)
2. (-) , ㈡. 1.TRH↑
3. TSH↑
4. T3,T4↑2. ↑
5. TSH
6. T3,T4↑
7. TSH
8. 3.二.㈠.I
9. TSH↑
10. C.N. ; 3,T4 .㈡. 1. : :1mg
11. 4180KJ; :T3,T4
12. (+), ↑

第84页：diabetes coma glucagon anti in

diabetes coma glucagon anti in（流程示意）

1. 84 , , 二. : – .三. , :Ss
2. (-) , : . 一. ㈠.
3. 1,25–(OH)2D3: 2+ ㈡. ,PTH: 2+, 2+ , ,Ca2+ 1,25–(OH)2-D3㈢. : 2+, 二． : , 12 1. ？2. ？3. ？