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Professor, The Ohio State University College of Medicine

Dryness of mouth is usually felt before appearing for an interview mood disorder borderline personality order bupron sr overnight delivery, especially for learners mood disorder lupus buy cheap bupron sr 150mg. For taste of food to be well appreciated depression symptoms university students order bupron sr with mastercard, food particles should better be present in solution. In the absence of saliva, deglutition becomes impossible, especially for dry foods. Saliva contains bicarbonate which buffers gastric acid to some extent in the stomach, and therefore reduces heart burn. Proline rich protein in saliva protects enamel of the teeth and thus provides them strength. Saliva prevents injury to buccal mucosa by diluting the hot and irritant food materials. Other organic solids include kallikrein, blood group substances, secretory immunoglobulin (IgA), and nerve growth factor. Inorganic Solids Cations like sodium, calcium, potassium, and magnesium ions, and anions like chloride, bicarbonate, phosphate, sulfate, and bromide ions constitute the inorganic solids. The concentration of sodium and chloride ions in saliva is less than that of plasma. In animals, salivation (panting) is an important process of dissipation of heat and therefore, has contribution in temperature regulation. Control of Salivary Secretion Salivary secretion is controlled exclusively by the neural mechanisms. Mechanism of Secretion Salivary secretion occurs in two stages: secretion in the acinus and secretion in the duct. Secretion in Acinus of Gland In the gland acini, the secretion is called primary secretion in which amylase concentration is more. Neural Control Parasympathetic Stimulation Parasympathetic stimulation occurs by sight, smell, and taste of food. Secretion in Ducts the composition of secretion in the ducts when the fluid passes through the intercalated and striated ducts, is modified. The ducts do not change the volume of saliva but only modify the composition of the primary secretion. Note the processes that determine ionic compositions of primary and modified secretions. Parasympathetic activation increases salivary secre tion rich in enzymes, and mucin. Applied Physiology Xerostomia this is a condition in which there is consistent decreased secretion of saliva. Xerostomia (dryness of mouth) is a common in acute stressful situation that happens due to sympathetic stimulation Sympathetic Stimulation Stimulation of sympathetic fibers (sympathetic fibers to salivary gland originate from superior cervical ganglion) temporarily increases secretion but finally decreases it. The transient increase is due to contraction of myoepithelial cells of the glandular tissue. However, sympathetic stimulation causes vasoconstriction that decreases saliva formation and makes the secretion thick. Reflex Secretion Saliva is secreted reflexly by contact of food with the mouth cavity.

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Dendrites receive the incoming signals from other cells and transmit it to the cell body depression symptoms wiki discount bupron sr 150mg on-line. At some areas of the brain anxiety 24 hours purchase bupron sr 150 mg fast delivery, they can cause protein synthesis depression after divorce cheap bupron sr amex, also generate and conduct the action potentials. It is a long tubular process that extends away from the cell body to transmit output signals to target organs. Dendrites transmit impulses toward cell body, whereas axons carry impulses away from cell body (Table 22. The cytoplasm is known as axoplasm that contains mitochondria, Golgi apparatus, and cytoskeletal proteins. The axon arises from a thickened, tapered area of the cell body called the axon hillock. The axon hillock continues as initial segment and this part is known as axon hillock-initial segment portion of the neuron. The action potential is generated at the initial segment in motor neurons and at the first node of Ranvier in sensory neurons. Axon terminal: the terminal part of axon loses myelin and divides into several branches, called telodendria. The endings of telodendria form bulb like enlargements Nucleus the nucleus usually contains one nucleolus; sometimes there may be two nucleoli, but centrioles are absent. Though neuron is an active cell, it has lost the capacity to regenerate as indicated by the absence of centriole. The soma at one end gives rise to small branching processes called dendrites and at the other end a long process called axon. In multiple sclerosis, an autoimmune disease, patchy destruction of myelin occurs causing decreased conduction velocity in both motor and sensory neurons. The nature of this sheath is best understood by considering the mode of its formation. In this process the axon comes to be suspended by a fold of the cell membrane of the Schwann cell. In some situations the mesaxon becomes greatly elongated and comes to be spirally wound around the axon, which is thus surrounded by several layers of cell membrane. Outside the myelin sheath a thin layer of Schwann cell cytoplasm persists to form an additional sheath that is called neurilemma (also called the neurilemma sheath or Schwann cell sheath). At the junction of any two such segments there is a short gap in the myelin sheath. When an impulse travels down a nerve fiber it does not proceed uniformly along the length of the axis cylinder, but jumps from one node to the next. This is called saltatory conduction (in unmyelinated neurons the impulse travels along the axolemma). Such conduction is much slower than saltatory conduction and consumes more energy. The large diameter somatic nerve fibers as well as the preganglionic fibers of the autonomic nervous system are myelinated. The adjacent layers stick to each other tightly with the help of a protein called protein zero (P0) present in the Schwann cell membrane. The extracellular portion of P0 in one layer locks to the extracellular portion of P0 in the apposing layer resulting in compaction of myelin. Mutation of P0 cause defective myelination and decreased conduction as occurs in various peripheral neuropathies. The nucleus of the Schwann cell lies beneath the plasma membrane in the outermost layer.

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This is a major differentiating feature from primary hyperaldosteronism depression worse at night purchase bupron sr 150mg free shipping, in which renin secretion is less depression cherry lyrics purchase bupron sr 150 mg fast delivery. Note anxiety 2014 bupron sr 150mg without a prescription, decreased renin secretion occurs (hence, no activation of renin-angiotensin-aldosterone axis) in primary aldosteronism; therefore, edema is not a feature. In secondary aldosteronism, renin secretion is more (activation of renin-angiotensin-aldosterone axis) hence, edema is usually a feature. However, secondary hyperaldosteronism in Bartter syndrome and Gitelman syndrome occurs without edema. The secretion of adrenal androgen increases at puberty, reaches peak at about 20 years of age and then declines slowly to reach a low level in old age. Functions of Adrenal Androgens Adrenal androgens have less than 20% of activity of testicular androgen. Adrenarche: At the onset of puberty in both boys and girls, in the stage 1 (before the physical development of puberty), secretion of adrenal androgen becomes high before the gonadal secretions are significantly elevated. It is proposed that adrenarche initiates the process of puberty in which adrenal androgen sensitizes the gonads to secrete more sex hormones and sensitizes the sex organs to the effects of sex hormones. They exert masculinizing effect: However, the masculinizing effect is less in normal concentration of adrenal androgens. However, in prepubertal boys, in excess, they develop secondary sex characteristics precociously. Source of estrogen: Adrenal androgens are converted to estrogen in the peripheral tissue and serve as the major source of estrogen in males and postmenopausal females. Hyposecretion of Aldosterone Hyposecretion of mineralocorticoid is usually associated with adrenal insufficiency. However, isolated hypoaldosteronism with normal cortisol production occurs in following conditions: 1. Surgical removal of aldosterone secreting adenoma causing more resection of normal adrenocortical tissue. However, along with increased secretion of adrenal androgens, other adrenocortical hormones are secreted in larger quantity. One such example is "Adrenogenital syndrome" as described earlier in this chapter. Permissive action, metabolic action, effects on blood cells and immunity are examples. However, anti-inflammatory and antiallergic properties of cortisol are very useful in the treatment of many acute and life-threatening conditions. The immunosuppressive effect of cortisol helps in prevention of transplant rejection. Mineralocorticoids regulate serum electrolyte (especially K+) and water metabolisms of the body. Cortisol maintains vascular reactivity to assist in control of blood volume and pressure. Therefore, adrenocortical deficiency leads to delayed puberty or dysfunctions of puberty. In examination, Describe the functions of glucocorticoids (or cortisol) usually comes as a Long Question. Regulation of secretion, mechanism of action, physiological actions and dysfunctions of aldosterone may come as a Long Question. List the hormones of adrenal cortex and the layer from where they are secreted, Specific enzymes involved in synthesis of adrenocortical steroids and the diseases produced by their deficiencies, Functions of cortisol especially permissive actions of cortisol, effects of cortisol on inflammation, allergy, immunity and blood cells, Why steroid therapy should not be stopped abruptly Why bone X-ray should be checked in patients receiving steroid therapy for a prolonged period

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