WELCOME

TO
PHYSIOLOGY DEPARTMENT
Undergraduate Medical Student

Four phases
 First little disappointing
• Neither you see patients nor learn about drugs
• Confined to classrooms and laboratories learning
about normal structure/ functions of human body

Disease is nothing but deviation from normal

Unless you understand normal
you cannot understand abnormal
 Second
• Start seeing patients
• Continue learning in classrooms /laboratories about
- Disease process
- Germs
- Scientific basis of drugs as therapeutic tools
- Legal medicine
By the end of second phase, foundation laid
 Third
Build on the foundation of phase one and two
• Start learning the clinical subjects
• Start examination of patients
At the end of third phase
Final Examination

Still you are not qualified to assume full

responsibility of patients
 Fourth
• Skill oriented training
• Period of rotating internship of one year

During which patient care is taken under

the supervision of senior physician/ surgeons
 Special Subject
Community Medicine / Preventive and Social Medicine
• Taught during whole course of MBBS.

• Given much importance because prevention is not

only better but easier and cheaper than cure

• Prevention does not mean preventing the disease

from occurring but it covers an entire spectrum
starting with The positive concept of health
promotion & reduction in the adverse effect
of illness
Hippocrates- Greek Physician

Charaka - Indian Physician

Susruta - Indian Surgeon

 Physiology
• Concept based

• Discuss

• Corelate
Physis -- nature logos -- discourse
Physiology --- Knowledge of nature
The term physiology was used as a synonym for
natural philosophy.
(philein: to love, Sophia: wisdom).
A student of nature has to be a lover of wisdom.
Physiology and Philosophy taken as same
Physiology
study of function of living organisms
Philosophy
study of wisdom
 Physiology
• is the science of functioning of living systems

• and the scientific methods applied to determine

how organisms/ systems/ organs/ cells/
biomolecules carry out the chemical / physical
functions in a living system
Beginning of physiology
In Ancient Greece, Aristotle emphasised on the
relationship between structure and function

Galen, was the first scientist to use experiments to

probe the function of the body He laid great stress
on teleology, looking for a purpose in everything in
body

Galen was the founder of experimental physiology

William Harvey
- First physiologist of the world
- He discovered circulation of blood

Herman Boerhaave (1660-1738)

- sometimes referred to as a father of physiology
- first described the term Physiology for the
science of body functions
- established Physiology as an independent
discipline in medical curriculum
Albrecht von Haller (1708-1777)
wrote the first textbook of physiology,
Elementa Physiologiae
 `3
Claude Bernard (1813–1878)
- propounded the concept of “milieu interieur”
(internal environment)

His statement was that living organisms are never

at rest but constantly undergo to maintain
internal equilibrium.
He established Physiology as
scientific basis of medicine
The concept of constancy of internal environment
was further elaborated and championed as
HOMEOSTASIS
by American physiologist Walter Cannon
(1871–1945).
 Physiology as Scientific basis of Medicine
• Life is a dynamic process

• Cells of the body work like machines,

consume fuels and produce waste

• Optimum environment required

- Right composition of ECF
- Appropriate pH
- Temperature et
• Each organ-system makes some contribution
towards providing optimum conditions for the
functioning of all the cells of body

• With the cooperative/coordinated activity of all parts

of body, the conditions under which cells function
are maintained at a reasonably constant level

This constancy is known as homeostasis

Homoio similar
Stasis position
• The basis of health is the organism’s success in
maintaining this balance, the concept elaborated
by Cannon who named the dynamic state as
homeostasis

• He showed that the body could adjust to meet

serious external/internal danger.
 Homeostasis 1

Study of physiology is essentially a study of how

each organ-system contributes to homeostasis.
Threat to homeostasis
The dynamic nature of life
The hostile forces in our environment
Our body is equipped
• To face the threat
• To detect the challenges
• To appropriate response to neutralize the
challenge.
 2
Homeostasis
Health depends on the success of these responses
• When the responses are inadequate in relation to
the challenge, person falls ill
• But even in illness, recovery from illness depends
on the same type of responses which operate in
good health
• The fact had been recognized by Hippocrates as
long ago as 400 BC when he stated
The body possesses the means for its
recovery from illness
 Staying healthy
Challenge Response
Body

Avoid needless challenge Improve response

Overuse of body
Misuse of body
Dust inhalation Healthy food
Dim light Healthy lifestyle
Heavy weight lifting Exercise
 Duty as Doctor (during illness)
Re-assurance
1. Every thing will be fine
(Homeostasis takes care of challenge)
2. Not to be impatient
(Homeostasis takes some time for correction)
3. Some measures to assist the body in its struggle
against the disease
4. To detect the cause
Either challenge is more or response is less
Work with nature, not against it
and for that you need knowledge of physiology
 Control system

• Negative feedback

• Positive feedback -Vicious cycle – adverse

effect/useful effect

• Adaptive control
 Control Systems
• A control system is basically designed to
maintain a controlled variable at a set point

• The value of the controlled variable is

continuously monitored by a sensor

• The current value of the controlled variable is

conveyed by the sensor to controller in the
form of a feedback signal
 Control Systems
• The feedback signal is naturally affected by
any disturbance which alters the value of the
controlled variable

• The controller compares the feedback signal

with the set point and the difference between
the two is called the error

• The output of the controller conveyed to an

effecter
 Control Systems
• As a result, the effecter applies a correction which
takes the controlled variable towards the set point

• Most of the regulatory system of body follows this

characteristic pattern
A control system such as this one is called a
negative feed back system because the effecter
response is negative to the initiating stimulus
(disturbance)
Set point

Controller
Input Set point-Feedback=Error
Output

Feed back signal Effector

Sensor Effector response

Current Value

Controlled Correction
Variable

Disturbance
 POSITIVE FEEDBACK

• If a disturbance increases the value of controlled

variable, the controller will respond to disturbance
by increasing the value of controlled variable still
further

• Now the feedback signal gets still stronger resulting

in a still stronger response

• Thus the control system actually increases the rate

at which the disturbance would produce its effect
and also increases magnitude of the effect.
 Positive feedback
• Less common in the body
• Whereas negative feedback systems are designed to
resist change, positive feedback systems reinforce
change
• Positive feedback systems move the controlled
variable even further away from a steady state

Example
Using the furnace and temperature example, the
room would get progressively hotter
 Positive feedback-- useful
• During labour, uterine contractions push the fetus
towards cervix. Stretching of cervix stimulates
uterine contraction by positive feedback

• Blood coagulation reactions are autocatalytic in

nature, thrombin triggers the formation of more
thrombin (Cascade)
Positive feedback- Vicious cycle - harmful
Force of contraction in heart decreases in
circulatory shock
 Positive / Negative feedback

Mild degree of positive feedback can be overcome

by negative feedback and vicious cycle fail to
develop
Regulation
1. Nervous system
2. Endocrine system (Hormones)
 Coupling
• Sometimes two control systems are coupled --
when simultaneous changes in effectors of both
are likely to be useful

• Hypoxia stimulates respiration

• But because of the coupling of respiratory and

cardiovascular control systems, the BP also rises
simultaneously
• In hypoxia, if in addition to hyperventilation,
the blood pressure also rises, it is helpful
because it increases blood flow through the
organs

• Similarly fall in BP stimulates respiration

thus increasing the oxygen availability
 REGULATORY FACTOR (R)
is a measure of accuracy of regulation
Disturbance leads to some residual change in
the controlled variable in spite of regulatory
system, but, to a lesser extent.

R Change with regulation___

Change without regulation
 Gain of control system
• The degree of effectiveness with which a
control system maintains constant condition is
determined by the gain of negative feed back
• The control system is not 100 % efficient
• Some error always remain ,
• Gain is
correction
error
 How to calculate Gain
BP – 120 mm of Hg
Hmg occurs and BP becomes
100 mm with regulation and
60 mm without regulation
Error -- 20 mm
Correction 40 mm
Gain 40 / 20 = 2
• Correction – 40 mm
• error ---- 20 mm
• Gain 40 /20 = 2
 Gain

BP 100 BT given 175mm hg

(BR not functioning)

125mm hg
(BR functioning)
CORRECTION-- 50mm hg
BP 25mm hg remains-- called Error
 GAIN
Gain--- Correction / Error
50 / + 25 = 2
A cold exposure which is expected to
bring the body temperature down to
20°C actually brings it down only to
36.5°C.
Thus the observed change is only 0.5°C
Expected change without regulation 17°C
Correction 16.5°C
Gain 16.5°C / 0.5°C = 33

The gain of the system is 33.

Gain in temp control in cold is -33
 Anticipatory Control
• Some variables, which are regulated very accurately,
are controlled by anticipating a disturbance.

• Instead of monitoring only the controlled variable,

the controller also monitors the factors which may
lead to a disturbance.

• In this way the correction can be initiated before the

disturbance has actually taken the value of the
controlled variable much away from the set point
 Temperature homeostasis
In humans, temperature is controlled by the
hypothalamus.
The thermoregulatory centre receives input from
two sets of thermoreceptors
a. Receptors in the hypothalamus monitor the
temperature of the blood as it passes through
the brain (the core temperature)
b. receptors in the skin monitor the external
temperature.
 Thermoregulation
• The hypothalamic thermo-sensors detect changes
in the controlled variable - body temperature
• In addition, the hypothalamic controller also
monitors the environmental temperature by being
in touch with the cutaneous thermoreceptors
• Thermoregulatory responses is initiated before
the changes in environmental temperature have
succeeded in changing body’s core temperature
• That is why thermoregulation has such a high
gain
 Complexities in Control systems
Servomechanisms
• In some control systems, the set point is not a
fixed entity
• The stretch reflex which regulates muscle length
is an example of a servo mechanism
• The resting muscle length of a given skeletal
muscle changes in different positions of limb
• the set point at which the length is regulated is
different in different positions of the limb.
QUESTION --
If we have homeostatic
mechanisms for regulating blood
pressure , why do some people get
hypertension ?