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cool. Okay. Hi, everybody. I'm just in bodies on one of the teaching leads for year. One for sleep frequently. Easy s. So I'm just gonna get riled away. Today is the basic medical science is one part one. So there is a part to next week, and I hope to see you guys all their on disease of the topic that will be covering Ah ha s. So the first thing I say is that we I've convinced a lot of information down as, uh, been said, this is from the colitis syllabus. So I prepared the slide, as as I'd like to be taught from revision sessions last year. So I'll be focusing on specific content s. I hope I get full engagement for over you guys. And so here, from all of you, just one note respiration. I'm going to be going through half of it. So how will be next week? So leaving there's a cliffhanger. So I hope to see you guys there next week going straight into it sells. We've had lots about cells, and I'm pretty sure you guys went through a lot of it during a levels on. That is why it first and present you with a table. I know you guys. You guys think it's constant heavy. I just want to let you know and not all my sides gonna look at this. But I just thought if I start off with just full of full content there, you guys gonna look at it in your own time when you get the slides later. So first, Well, I just want to focus on some certain things with the nucleus. We all know the nucleus contains or genetic material is it, for it is in the form of DNA on with DNA. The one thing I would have had it with you guys is that DNA is in a condensed form called Chromatin and you get 2000 units and Hetrick arms and on you came in one type programs in is inaccessible on diets. Within the microscope, you'll see there's the darker, coiled areas on the you. Crimson is the lighter, more accessible areas. So, as I said, I won't go through every single thing on the slide. I'll let you guys read through it, but I want to focus on certain things. Looking at next structure mitochondrion. I think we can all agree is probably the best organ out there being a powerhouse of the selling or as all of us know, it's involved in energy production. But the one thing I really want to focus on was the the structure We all know that there are there's a full dip or shin, probably called the Christa on this is involved increasing the surface area, and it's very much involved in respiration and the electron transport chain. So you wanna keep your focus there, but yeah, and then switch them to process. Endoplasm Recticare, um is involved in little production moving on the rough and department rectangular is involved in protein production and you get all the about gold. Yeah, practice is involved in protein modification and export. Those two structures I really wanted to focus on today was paroxysms and lives zones because they were ones that I didn't see a level and then no new to me coming to medicine in first year Liza zones. So what do you like zones do they digest by a lot of aging and crying, and 80 is a very important terms that you gonna need to know or to fade you being? They take old organize and puzzles cell on break it down. So quite like how macrophage is work on crying fad involves digesting excess separate products, and it's very beneficial to sell because they take these products on, um, they break it down to the most basic parts. And then there were using the cell. So a lot of recycling. The really important thing with lies owns that you guys need to know. Is they working an acidic environment around pH. Piece of five on. So they are only activated when you need them. Um, this this's abortive you to know, because what can go wrong? Obviously, if there's a leak this condemning the cell Ondas you can see their cell works in around beautiful seven, and so that's the importance of lies own. But they work by breaking down old old house, and that's the most important thing. Anything paroxysms. On the other hand, metabolic eyes, lipids in many cells, you can see that they made working liver. They're quite important, their liver having many functions. It's one important enzyme I wanna I wanna highlight to you guys. I think you may have heard about Castle is Kathleen breaks down hydro peroxide, which is usually a byproduct of a lot of reactions. But in the body on there, they break it down into water and oxygen. So again, I just want to focus on those cells, those to organize story on. Um I hope I got a little bit more understanding about that. They do. As you only saw. I'm gonna move on to my first question. So could I get the poor running this? My spiel looks very busy. I'm trying to, uh, they go Sahara. Sorry. There we go as it goes in. See? So I'll beat it out at a level IV. Whatever you did, you learn the cell membrane is made up of foster by lipid layer. More specifically, you probably heard in PCs one or in your classes and stuff. The building blocks of the membrane is called glycerophosphate lipids. And simply I just want to know what other components are this molecule. So giving you a better glue glycerophosphate lipids. I just want to see. I'll give you a few seconds on this. What people saying that's fine. And I think a cool. I'll call it their, um Well, thank you so lot of you guys are saying he and the answer is a lot of years with a a swell I think I threw you off with the three fatty acid chains. So from a level as you learn, the fossil by little layer is a a phosphate head with too fatty acid chains the phosphate head being hydro foot hydrophilic story on the two factors as a change. But how does hydrophobic yes, on biochemistry of medicine? He should just know that glycerophosphate lipids There is a glyceryl backbone that that kind of helps form the membrane as well on the glyceryl and the four State group forms ahead the hydrophilic part that you'll know. So it was just a little little question for you guys to stir get your brain's going. I know you guys had a lecture before this, but just to get you as I know so moving on, we're gonna look at membrane transport and so this is quite a big part of my talk, because I I like to think that it will links into what we're gonna look at later, especially with the action potentials and all eso, as all of you know, memory transport is split into passive on active transport on within that you have different types of movement, so you can get molecules moving freely through the membrane. Remember, it is partially probable. You can get small molecules moving through on that's through the fusion. You can get facilitated diffusion. As you can see, they're through. Channel broadens carry proteins on. This is known as passive passive Member Pass. It transports, All right. You could also get active transport, and that is, uh, through the use off a your energy through ATP. You get these proteins moving molecules usually, and with active transport, it's against its concentration. Grady int with passive transport It's a long it's constipation radiance. And so, I think, with Pastor Transport the one thing I really want to focus on you. They all move along, the constipation radiant. But the important thing is the medium that they move through on that is either freely eyes going to see in the next slide freely through her proteins or channel proteins, a specific trap type of transport I want to focus on on. I think we were giving a bit of, uh, it was given quite a lot of importance for is salute carriers. So you get you can get passive passive active. Sorry, you could get primary on secondary active transport in. So you're carrying on. There are different types of technology. That, and there's different types of movement that I would like to focus on and let you guys know about. So the first is unipolar uniforms is just the it's it is under prime reactive, so you all know that it's gonna be using ATP as it's for me. Source of energy on it moves molecules from a low construction too high concentration. Get co transport, which is two molecules. Student molecules moving in different directions both from low to high, using a TB as well. Second, reactive. And so this is mediated. Second reacted, on the other hand, uses the concentration grade end of one molecule to you to move another molecule across. Across. It's across the membrane, so the first type is anti board. You can get a molecule moving from low to high, and this called this because of push another molecule. As you can see, moving from high to low, you can get a simple, which is a molecule moving from low, too high and high, too low. It's it's, um, it's usually use is this time is usually used as co transport as well, and this is carry a mediated, as we saw previously on then, as we as we looked at passive transport passive solid carriers, you can get them from carrying mediated channel mediated or freely moving. Um, so again, another table. I'm very story that you're seeing seven tables and so much information. Seven words This table I borrowed from a prison a session last year on it just summarize is quite a lot of the transport systems that you need to know one that would be looking So we've looked at solid carriers and primary remember, transport the one we're gonna be looking as soon as gated iron channels, especially it comes to membrane voltage gated channels. But I think the one thing I wanted to focus on in this slide is aqua orange and just let you know that you can get different types of aqua borns. I'm sorry. Different overactive parents and one from fact that you might want to know is going to is controlled by anti director diuretic hormone hormone. And that's found in the kidney. So later on, you guys gonna cover kidney, kidney and water movement and water retention on it. It's good to know that there are these channels called aquaphor in that water eso As I said, I'll leave this. You're gonna look at these slides later on when you get them. So I hope they summarize is a lot of the information for you. But moving on One thing I was acid look at was Iron Tropic on methotr. Met met a patrol picked receptors. It was kind of looked over, I think is what for ourselves in one of our tutorials on. So I just want to focus on them, give you a little information of them. So I know tropic receptors are directly linked to the channel, so they're not. They themselves on the daytime cells are linked a channel part of the channel on what they do. Activation receptor, of course, is the port or the channels open on this effectively allows the iron surpassed through the membrane. An example of this that you will see Lincoln gated sodium channels such as a seat on choline receptor. You see this in the nerve impulses and actually stencils. Uh, the other type is voltage gated sodium calcium channels with metabotropic receptors. They're not directly linked to the channel. The activation of receptor at it initiates possibly a chain of reactions or intracellular signaling. As I've said here on, do they allow a secondary messengers to be released on this will activate the channel. In question example, this is based on adrenergic receptors in the heart. And so again, this is a little bit of above your stop. This is looking further ahead. When you look at the heart, then pieces to or later on, this is quite important. No moving forward. Another thing I lost a look at, I'm going to focus on this quite a bit again. It's a big table, but I'm gonna break it down for you. Last year, my younger fellas that this was kind of overlooked of a shadow a little, a little bit what, one second just gonna move himself away. So what this table shows is glucose transporters, and so what? Our group and sounds borders very simply, the transfer blockers across the membrane. I'm going to go through each one and just keep your job in remission. about them focusing on specific information that you need to know. So gluten one is It's said to be found in a lot issue. But as I've said, you can find in blood, blood, brain, barrier and heart for a lesser extent. The other thing you need to know about this is that it's insulin independent. So with even without insulin, they are going to be transporting glucose grouped two transporters. A little bit more important, they found the liver pancreas on the small intestine. Onda again. This is insulin independent. They they have a thing called high KFOR high. McHale is constant. I don't have a problem that right? And yes, what is Make a list on stone? I are discussion. Quite then, I didn't really understand it, but what? What you have to know about High Mikhail Constant is that with that comes low affinity. What is low affinity on a lot of energy just means that the concentration of glucose needs to be really high before the transporter starts taking glucose. And so this kind of makes sense. When you think about the structure like kidney and the pancreas, like you need the blood, you need a high blood glucose level for the little toe liver to initially take up the glucose. It kind of just the liver and the pancreas. Kind of just let our the parts of the body take up the sugars first. But then, when the blue coast is high in the blood, that's when it gets activated. Know activated. But that's when the the glucose transporter starts taking up glucose. And what's the benefit of this? So in the pancreas you have beta cells, which make which detect the glucose in the blood on day initiate insulin release as a response. And so this kind of makes sense when you understand how insulin works and you will look at this later on. But with so effectively with high blood glucose you you they take, they take the glucose on. This kind of activates the pancreas on that initiates the release of insulin. Next one. Glucose gluten free Trans uh, transporter. It's round of the brain neurons and sperm again. The thing you know is that there's low cam load Mikhail's constant on a high infinity with that on, so it's kind of makes sense in the sense that you don't need a lot of glucose for them to take up, because in the blood and wherever you it will just be constantly taking up Lupus. And again, it's incident independent, great for is a little bit more important. I would like to focus on that. It's found in Still, it'll muscle, um, and muscle adipose tissue and the heart. It is insulin dependent on just one a reflux and that insulin dependent. And so you need the insulin. Activate the glucose transporter, and without it, you won't have a good for it. Always been present, but it won't be active on. So there is only uptake of glucose in response to insulin, so that kind of makes sense again. When there's high blood glucose, get release of incident and then this thing, this activates the glucose. Transport blue blue before transporter on. Then the glucose is taken from the blood into as said, squeeze the muscle muscle adipose tissue on the heart. Next one is glued five. It is found in enter sites off intestinal epithelium, the little site. The important thing to know about this one is that it's a fruit toast transporter, so it's just important in uptake and fruit toast. Moving on SGLT they are. What are they? They are sodium dependent glucose transporters. I felt like this one really focused. That was a real focus on the things they they do come later in our cases. And when you say about later. But I just wanted to give you a lot with information about them. S u O Z so So dependent Glucose transporters. The key with SGLT one is that they found it and her sides of intestinal MPD Um, the incident independent ATP and sodium dependent as set on the 10. But the important thing is that they are They are involved in glucose absorption as SGLT one on the SGLT two found in the proximal to bill of the nephron in the kidney. You're not gonna understand where that is. Just within the kidney, you get SGLT two and that's involved in glucose retention. Kind of makes sense because that's the function of the kidney to be diluting and controlling the movement of sole use and water in the blood. And so again, it's one highlight SGLT one. They're both sort independent, 80 dependents, but it's SGLT. One is involved in blue. Good. There's absolutely sorry on SGLT two in Blue goes retention. So I hope I didn't bore you with all those glucose transporters. But that is the gist of it. And I think I hope you have a better understanding of what certain terms being onboard, what the focus is on with strong supporters. And so another question could be Please get the poles up again. I'll read this one. I'm not gonna lie. It's meant to throw you off. It's a it's a bonus. Be served. Yeah, I'll read it for you guys. A three month old baby is brought into the GP after case of diarrhea, a stool samples tested, sharing acidic and fecal reducing substances, artery, flat glucose and normal fruit. Best tolerance test is conducted. It is confirmed that the child has interrogated a rare orders. Um, was a recessive disorder causing intestinal blue coastal actors mild absorption. It is caused by deficiency in the transport that is dependent on sodium. What transport is deficient in the disorder? Guys, I cannot see who is answering and what who is like what you guys aren't doing. Just I just want everyone to participate. It's just a silly little question. Don't be scared. I know there's a lot of invention even I don't know much about, but you just need to focus on what the questions really asking you, because I don't really Well, though, you guys, even even with that I try try to throw you off a little bit with down and stay still. Question. But you guys are getting it. I think. Give it a few more seconds. I want to see full participation. Honestly, everyone involved. Okay, I think we're close it there when we get quite sick. Border. Everyone One for D on D is the correct answer. Why is the correct answer? So have highlights a few things of the question. Yeah, there's a lot of things you might not know. The first biggest clues should have bean. They're dependent on sodium so that legion ox out. Three of the answers SGLT one SGLT two. Another one is that it's in the intestinal. There's there's a problem with intestinal absorption on. The biggest clue was malabsorption, so there's a problem with the absorption. And as I said, the focus was on. Um, the SGLT one is a glucose abs. Absolutely. ACOs and SGLT two Um uh, sorry. Let me let me go back to when I say it properly. Especially one is involving because absolution and SGLT two involved in Lucas retention. So you guys got it? A lot of you guys got it very well done. I would have I would throw me off so very well done to you. Guys moving quickly on sodium, potassium ATPase and sodium potassium pump. Very important bomb. It's seen all over. And it is one of those that you just have to know when you have to kind of understand. So going to give a low before CAS? The first thing to say is that sodium possessing pump is very important in maintaining member and potential. And some rink you can see those diagrams. There are a few channels and pumps established, a member of potential by an electric chemical, Brady in and concentration radiant. The sodium potassium pump creates a uneven distribution off ions, and as you can see, there's it pumps. Three sodium ions out with two sodium potassium. Mine's coming in. What this does is it creates a high concentration of sodium aisle outside and sell and ha high concentration of potassium lines within the cell. As you can see, um, there are also so they make it extra confusing. There are also potassium leaks channels on, so as even though the ions are being pumped in and this is requires ATP. Their potassium ions are also leaking out through a single inward rectifier channels, and there's important when it comes, actually tensions as well. See later on. Um, with this when the when the potassium is within the cell, they have the tendency of kind of attracting to notify on's and as they started, leave the cell the negative I can't follow. It was negative, and your your your bigger on what this causes is negative ions to congregate closer to the membrane on Really cool things happen from this. So the one thing is, there is an electrostatic, radiant form from the Islands movie. There's there's irons congregating at a membrane on, so there's a negative charged environment within the cell and a pulse different charged outside and sell. This creates an electrostatic electrostatic radiant. The next thing is as a concentration Grady in off the potassium. I was being pumped in, but also they're leaving. And so because because there's such a high concentration within cell. And so from these two, Grady Inssue get this thing called the Equilibrium potentials, which is also known as the Know Nance equally equilibrate potential. You can get this for any kind of eye on on. I'm pretty sure you guys know a lot about this now reading up on it and you probably see those things before with every eye on. Theoretically, if that was the only iron moving within an hour of cells, you'd get a thing the equilibrium potential for a specific eye on. And you can calculate this with the nerves equation. And so, as you can see right there, TASI um, the IV a little potential of potassium is around negative 92 millivolts on for sodium. It's around Positive. 67 millivolts on again. This is This is if that one iron was moving I/O of the cell regardless, other islands with that calculation, then you can work out a thing called the membrane potential on this is just the overall net potential off that the membrane and sell effectively on. So that comes around negative. 86 medals again. It's not just those two are moving I/O there, a lot of hands moving I/O. So calculation is a really complicated operation. I'm pretty sure you've seen the patient, but, um uh, with that comes eso What we have to know is potassium around Nathan. 92 sodium around. Positive 67 on the memory potential around negative 86. You don't have to really remember these figures, but they're just good to know, just to get an idea of how how, Member. But it'll work. Especially. It helps understand? Understand? Why? What? What was the reason of the sodium potassium pump? Okay, I have a seat seek and linked that you do video on there. I'm not gonna play a few guys now. You guys can look at that in your entire squad. It's quite a quite good explanation there. It's been at the whole sodium, potassium and the number of potential. Quite well, if you don't understand it from what I was explaining, so I know you just had a question, but moving on, I'm gonna give you another question. Please. Could you get pulled up again? So this one a little bit. Matsui, I'm going to give you a little bit extra and just, uh oh, I think it's a wrong pol. Sorry. Um, I can't see diarrhea. Uh, would you mind getting the other polyp? Thank you. Any question, three. I'll give you as a bit of time to get the get your cartilage is little. This goes so we can simplify the nerves. Secretion from the left or right or the left. One is a little bit more complicated, but I want us to use the simplified one on using the using the values below I want I want you guys to work out the equilibrium potential of sodium eso. The concentration inside the cell is 12 animals on the construction outside of the cell is 140 animals. And using that equation, I would like you guys to work out. What is the equilibrium? Potential sodium? Uh, very nice. A resounding bladder cancer. Very nice. Very nice. Come on, guys. I want everyone to get involved. I just I know you guys had a long day. Actors. No, that's fine. I think we'll call it there because you guys have all got the just. And even if you haven't, I'll explain it in the slide. Coming so as you can see. So as the pole ended, there we go. That's fine. That's enough s as everyone said it was C, and the answer is very well done. It will see 66.15 millivolts again. It's no figure that you mention or anything like that. But if you were presented with math equation and putting numbers into the calculator that you can get test on that so he doesn't understand it was simply the sodium them. Equally, the equilibrium potential sodium comes to 62 times the log of the concentration of the sort of the eye on outside of cell versus going over the construction of the eye on inside the cell. And that comes in 66.15 millivolts Very well. Don't ever got that amazing. Wow, we are moving very stiff before I don't see the time going, but moving on to the nervous system introduction. And I know we all love a mean So either start put that this is the light. I had a light hearted banter, so nervous system with anything in when you're learning science, you should always be able to break it down to his basic components on. So I think you know the system. The most important thing you guys need to know is the subdivision from groups she has. Although the nervous system is split into the central and peripheral nervous system Central very simply having spinal cord and the brain on. I'm sure you guys all know this, but the focus for this session is the peripheral nervous system purpose perform efforts never still a little bit more complicated. What it involves is the autonomic nervous system on the somatic No system, as you can see it a little bit of focus on or go because it will help you understand what what it's about. The autonomic nervous system is you guys and see carries visceral sensation. It innovates when I say mistral sensation. I like to think with their service to get visceral and peripheral mistral meaning within an inside so little sensation innovate stuff like the smooth muscles and plans on within the body. It is involved in involuntary processes, so stuff like heart rate, BP, respiration, digestion and sexual arousal. Um, so you find out weird because eh? So you um sorry. Well, come on to that the autonomic is split and do sympathetic, meaning the fight or flight response on the parasympathetic nerve system. Sympathetic. I think we've all heard this of that. Even fight or flight is, you think, increase in heart rate, increasing love her BP. But one thing I I wouldn't have thought is a decrease in digestion and kind of makes sense, because when you're in a 10 situation in your sympathetic nervous system, as we activated, you want to have blood pumping. You're, you know, increase BP. Increase respiration. But you know, thinking about eating and digesting are arresting effectively. And so with sympathetic you, it's not a simple as it activates and everything increases. Your body's going to overload. But that's what I'd like to think about. That's how I like to think about it. Um, but as I said, it's involved in involuntary processes, and conversely, the somatic carries peripheral sensation and is involved in voluntary processes. On this is muscle movement by the sleeves of muscles. As you can see it split into Afrin's and different loves. I am sorry I I honestly could not find like a pneumonic, and I don't know how I remember it, but there's no better way to know it other than just know that Afrin is century on. Different is motor. I'd like to think of it Africans first and the friend. So you send something and then you have a response. And that's when your body moves. And that's the motor response. But the most important thing you need to know if that's a magic pill splitting the Afrin any from nerves on It's involved in 100 processes on order. Know, maybe auto involuntary processes is automatic. Eso I hope you have understood the breakdown of that. Another question. Oh, my gosh. S p a r s v a. So this one is a little bit tricky. I'm not expecting you guys to have knowledge of this, I hope. I mean, okay, I don't know what I just don't remember if you start this in, like recess one. But the question goes as follows. Jim, a 30 year old man, has recently been involved in a minor car crash. Stepping out of the car gym feels his heart rate and breathing breathing rate has increased. Confused Gym also realizes something peculiar about his eyes. What has happened to gym Xyzal. What autonomic response causes this? Another read up a lot. The answers. Yeah, So I could see. So I'd like everyone's got this patient. Please. I want honestly, everyone involved in this, um you're getting different responses, but I think people are getting the right answer. Um, So you may have seen this in, like, a level or anything. Give a few more seconds. Just get everyone's not. Especially after you broke a few people this yet? Okay. I think we're gonna call it, um, so everyone has gone for D on. The answer is very much so. I don't know why I did that. It is the very well done. Oh, so no, no, no. It is the on. Just give a little quick explanation of that. It's a little bit confusing, cause pupils dilating. Why would the people's out again? As I said, it's kind of that same digestion. Thought that had the thing. I said, with the pupils, they are automatically controlled on the way I like to remember is that you just need to know the pupils dilate in dim lighting and dark lighting to allow as much lighter. That's possible. So you'll be able to see it so much, it's possible the people's also constrict in a lot of lighting because if you have a lot of light and you let it in, you can damage to the retina. And then I'd like to think of the response a little bit like this. So you're when you're in the dark. Obviously, you're scared. You your fighter flight response is activated on What is the flight of flight response. A sympathetic control on. That's when you're in the dark on. So when you're in the dark, your pupils need to be dilated and again. When you the light, you're fine. You're not scared. So that's the rest of digesting system on that responsive parasympathetic with the sympathetic control eso with the eyes pupils do dilate on. The reason for that is when you're in your fight or flight response, you want to take up much information in this possible that involves the people's dilating, allowing us much lighting. It's possible, and that's how I like to think about it. But that was just a little bit of extra. Does that lower thinking. I want you guys to do on, But moving on the peripheral nervous at the approval for now. Structure again. I'm a big believer of you. Look at it from the bigger picture, and then you go down to a smaller. So where are peripheral nerves found? So you can, as we were talking about. There's theseventies nervous system on then the performer system central being the brain and spinal cord. So you start from the spinal cord and this is spinal cord section. Moving on. You can see a five mg three, a nerve fiber coming from that and and so and nothing on the focus on is the There's there's a ventral and dorsal know that's Ventura. Adults on their fibers, they correspond with Afrin. Different ventral bring front and also being back. I'm sure on do with know if I was it looks something like this. The first, most obvious thing is the vasculature. The vascular should provide the blood supply for a while. The the, uh for a while, the best fascicle in the nerve. And what a fascicle. Come on to that. So the first thing that you need to know is the connective tissue that embodies all of these structures on the nerves. So the most outer connective tissue layer that covers the peripheral nerve is the epidural. Um, within the epineurium you get a bundle, you get a bunch of different fascicle on water. Fascicle fascicle are groups of nerves and your aunts running on they are wrapped around in paronychium on. So just looking back at that, you get the epineurium, which covers a perforin of. Then you get the peri, the parent, your e, um, of covering one fascicle and you get a bundle a bunch of different vassals within the personal note. The FASCICLE contains my lated accents, and Shaun says I'm going to look into that on what covers a single. Now you're on on. That is the end of your E um, S O that's the main focus of this one was a connective tissue that is closing each of these structures, every neuron being the performance of parent, you know, being the fascicle on again, even smaller, the neuron. It's covered by an end in your, um um looking at the neurons structure. So we mentioned about accents and the shown cells. But what are they, sudden? On one end, you can see there's an axon terminal. What? What does the accent, and we'll do the research. It receives nerve impulses from multiple other dendrites and other New York from other neurons. On it effectively forms a gap bridge between your on's. The next one is an axon. You can see the length of the axon it what two accidents do, that somebody runs long and it's covered by showing cells and for themselves a maid of mile and sheet on. I'm pretty sure a lot of you've probably seen it on a level and probably you know now that theatrics on itself. If it wasn't myelinating how how nervous pulses work, it would be really slow because there's a There's a change in iron construction along the length of the axon on with Shaun cells a mile in chief. You, uh, the mileage cheese made up. Made up of fact, she's a fat. They insulate the axon on form. The structures in between called nodes of ram, be a on it. Effectively insulating the axon increases thie uh, the nerve transmission speed and rate by only only, um, So I have lost my words. The note. Arava is the only point where the, uh the nerve will never implant is gonna be sent on dumb. So that is effectively how the nerve impulse wax. And if there, if it wasn't myelinating be never possibly slower. I'm going to get on that a little bit more. Soma, also known as the Body of the Neuron, contains the nucleus on, but obviously we all know about the nucleus, then writes The's are started to communicate with other and you're on. So I know this eventually Quite sure but axons and this one you're on can be quite a quite a long. It can run from the handled. Wait till the brain. It can be sure to be longer on, so dendrites also communicate with other, um, accent. I'm a nose and other neurons forms this body off things communicated system of a never felt nerves on your on's. And so we were I've got a question for you guys. Are your blood level of that question for you guys and alli want to give it on the chat? I might be able to see it. I think I can allow neuron smiling it. That's my question. Oh, no one's violated. Let's people saying no, no, uh, that is around very Well, that and do you have? I will tell you why you were alert is later on. When it comes to pain and sensation, not all new ones violated because yeah, when you get myelinating, you're on's increases the speed of transmission. But there are certain instances where you want transmission to be slower example of this. And you will learn more about this This briefly touching up on it. You get your hair, This thing called alpha Delta fibers and these Alpha Delta know on your nerve fibers are mild. Waited on day, they form that initial. So when when you feel pain there for my initial fast sensation of pain on, then you can get unlimited C fibers, which is involved in that slow, uh, feeling a pain that helping afterwards on. So the one thing I did want to focus on is, yeah, you see these mile in eight mile in sheets and sunshine cells in these diagrams. But the important thing to know is that not all new ones are violated on, but they they do have different functions. Um, moving safely on, I wanted to look at the difference between myotome and dermato. Um, so this thing is I was asked Look at this because it wasn't. It wasn't clearly stated to us what these were. But you get these. You get the structure you weigh. Have these groups called my terms and dermatitis. So what is a might of effectively, Um, I there is a group of muscles innovated by the motor fiber stemming from specific now fruit on, um, my term, then, is just a set of muscles that is inundated by specific on single single spinal nerve. Most muscles in the limbs receive innovation from more than one spinal, a spinal nerve root, and hence a compromise of multiple my rooms. So we will look at the Alavert. I'll give you example of what that means. Dermatomes of the other hand. So these are the example. So you can see C six involved in elbow fracture of missing sentient. Um, these are my atones Dermatomes, On the other hand, are areas of skin innovated by sensory fibers stemming from a specific nerve root on. Um, I'm pretty sure you've heard of dermatomes areas of skin on. Do you need to know? Especially come to break up Lexus will Look at this. A little bit more. You'll see things like areas of skin that lost sensation on. Do you need to be using the correct terminology? So my a termin damaged on the difference? Uh, well, I remember it Very simple. It's I don't think people find it very hard to remember dermatome being scared. Sensation my sternum, your muscles motor. Um, example of a myotome is the biceps breaking I the bicep break I was the whole event. It flex is the elbow on it isn't innovated by the muscular cutaneous? No. What is the muscular cutaneous? What routes, um, innovate or provide? Make up the muscular cutaneous nerve. It is a C five, c six and C seven and know fruits. And so we would say that C five c six c seven is associated with elbow flexion on. That's an example of the Maya toe dermatomes. On the other hand, key points that you need to know a little bit more important keep ones are that there's eight cervical. There's 12 thoracic, five number and five sacred, and they make up this image. Ah, weird tattoos, body person on disease, just areas of skin that is supplied by a different nerve roots first there. Another important thing is, you know, is that see? One has no damage. Um, s it's It starts from C two on the another. Another thing that we will touch one again, see eight. Extends from below sea said the C seven vertebra on what I mean by this is each each, uh, cervical like each route comes from a specific about abre. But see eight that there's no see eight vertebra. It comes from the C seven. It comes on the seventh cervical vertebra on, but we'll we'll touch upon this later on. Now they bought a thing that you know about dermatomes is that nerve roots overlap, which just makes our job a little bit more complicated because you will never It just makes it a little bit harder to identify, which now it might be damaged. Azo An example of those in the torso. Adjacent nerve roots overlap on so t 5 45 there's a little bit of teeth for it, and there's a little to six in there on day. So when identifying which dermatomes which area skin has which area skin has a problem? Lost, lost sensation of damage and try to identify The thedy're bit of affected. You have to realize that it could be multiple multiple efforts affected. So it is hard to identify specific, no birds. But in the case of arms, there are no overlap. And that's important to know, moving a little bit on. So I was told, um, Sahara. I don't know how this is what would be like a like a quick two minute break. This's kind of like part way through my presentation. I kind of want to give people Yeah, we can do to try a break. So I think I didn't look in, you know? Sorry. You come back a 25 past or just Yes. Yeah. Pacify. So, please, I want to quickly the quick sip of water and we'll get back right back into because we're gonna change topic a little bit from here. So I think we will continue very much into that break. I'm I'm sorry. Say, I'm feeling a little bit old, but sorry. We will continue. Um So actually, Central's saying a little bit quick breathing for this one because there's a lot of contact coming up active attentional The first thing we need to know is how does the cells become excitable? Ondas. We completely see for a cell to be excitable, Teo for the rash attentional. I also need to be able to move between the interior exterior. So, as we as we have been talking about so far, it's remember transport systems. This causes a change in the chemical concentration of the ions on it generates an electrical potential due to the difference of their charges on, so we gotta look into that a little bit more. But these figures you do see these around all the time, the in concentrations. It's not something that you need to know, but it's a good thing to be aware of. So arresting a membrane, you just need to know that consolation off sodium ions is great outside construction. So potassium ions greater inside on. All right, eye on straight outside as well, which is weird. But, um, it's just something you just need to know it generally of knowledge, but coming to it. So, as I said, if you've been looking at So, um, remember and transport systems on the next one, I want us to look at there's two more that we're going to look at and they're important in action potentials. First is voltage gated sodium channels and I said, We'll be looking at this. The important thing that you need about you know about gold educated sodium channels is that they have three possible shapes. They can be closed on this. This just means 70 miles cannot pass through. This is usually the state that they're in before the exponential arrives. They could be open, say, in response to the action potential on this allowed sodium ions through is gonna make a bit more sense when we talk about the actual potential on kaolin looks and how blacks. But you just need to know that the voltage gave the iron has to be states in the final one being closed on this is not just closed, but this is inactivated on the boat. My bowl diagrams kind of moved out a little bit, but the boys will be covering the channel and this is where they're It's not capable of opening, and on top of that, the arms can't move through. And this is you just seen at the peak off the actual potential on. So this there's these different stages at the seven stages, you'll see what how that causes different islands to move in in the action, potential moving and look up next. But the one thing I just wanted the thing I wanted to focus on was the different state of the different states that the sodium voltage a gated channels could be next, one being the voted gated potassium channel, this one can either be open, all closed, and so they're. I messed up inside there, but it could be over closed. And as you can see, it's very simple. When they opened this plastic and move through and close, they just can't but they have it. It's a little bit different, so it's not just that they're open and close, but they're slow putting a slow closing on, as you can see for an actual potential, you need time before depolarizations because repolorization on so slow opening allows gets time for the deep organization took up on the slow closing allows hyper a proton is Asian to occur on what does that will me. So I just I just said a lot of things to you, but now we're gonna look at this little diagram again. I'm gonna ask for audience interaction for this one. And if you wouldn't mind taking a chat as well for this one, So a few questions. I'm just gonna go through little questions for you guys. Um, first one is what is approximately, what is the threshold potential of a cell? Excitable cell. Get a constant childhood and 55 Very, very well done. It is my 55 millivolts on. So it What? What does that mean? What is the actual potential? It is the potential that the cells the cell needs to reach the excitement cell mates for beach before the actual potential can occur. And I'm pretty sure you guys have all heard of all or nothing. Um, actually tensions. It's It describes the fact that if there if it doesn't reach the threshold potential, there won't be an actual potential. We'll see that further on. But if it does the resection potential, you'll definitely get the national debt or you'll get a graph that looks like this. So an expression of God for you guys. So a second see you will get a stimulus way, the stimulus And, um, the first question I have is what channels and now open when a stimulus arrives. Okay, what do you say? Odm eso you? You will see some soda boaters, gator sodium channels open. There's just allows some movement a sodium ions into the cell and just allows because they're moving down the concentration. Radiant. Remember, there's greater sodium are in construction outside of the cell, and so a few er open, so they will slowly start leaking in. Um, then if the stimulus is strong enough on it causes an actual potential. What happens then? What? So this will be number two. What? One of the people thinking that my questions Sorry. Remotely. What is happening? What happens to the channels? So you're gonna see a little diagram there. Altered gait Is sodium channels open? Yes. So you get a sudden opening off all these sodium miles, so starting channel Sorry. On this, just cause the rapid influx of sodium into the cell and this rapid influx causes a membrane potential on. But if it's great enough, you'll get the remember protect. It will reach the pressure potential on, then an actual central form on. So what is this known as what is this? I mean, I've been using the time a little bit. What is that first blip called this in the shop? Depolarizations. Yes. Very well done. Is Depolarizations you think it really is the outset? Sorry, Depolarizations and so her before the So what is depolarizations that the sodium irons are going into moving into the cell and it effectively is moving closer to the equilibrium potential of sodium. And and if we remember correctly, it was around 67 millivolts. So that's why it's rapidly rising. But before it could reach that 67 millivolts around about that, you'll something happens to the islands. And I think I think you saw in the as if something happens the channels and I think you're So what happened there? What happens to the channels? What happens there? Any channels? Okay, potassium channels open just before the potassium channels open. You get so you guys are right. That is, it's very close Together. You get sodium aisle sodium gait. They close, and this is that inactivated state that we were talking about. This is where that ball and chain it closes, and it's it's it's closed for a certain period of time before it open. again correct what? The other thing that happens in the peak of the potassium iron channels have opened on this allows the memory potential to be restored. And that's why you see this quick dip. Because there's there's now such a concentration off sort of lines within the cell vaccines Quickly rush in on this is known as What is this known as There's a quick dip. The first initial Do I want you as an answer for yourselves. I'm gonna I want you guys still look repolarization very well done. So it is reported ization. And so you. There is an activation of sodium pressing pumps of this point as well. On everybody is a shin, but a certain something happens. They don't it doesn't just report rise, but something else happens. And what is that? Number eight, referring to hyper very hyper polarization on. This refers back to what we're talking about about potassium bolted gator channels. They are slow opening a slow closing, so they opened quite slowly, allowing that depolarizations and then they close quite stay close by. It's only a swell. Allow this read a hyper polarization state on do this this period, they can see right there is called the Factory refractory period. It's better to to you can get the absolute and then you get, uh, you get relative refractory period. Absolutely. Factory period is a point where another after potential cannot occur because it's just too far away from the threshold potential on. Then you get a you get the relative refractory period, a period where potential accidental can occur, and we'll we'll be looking at that. And what what that means for nerve impulses. Then the final. Finally, we reached the memory potential. What state are the eye on channel that now what? The sodium and that we know that it's the sodium and potassium. What are they looking like? Are they open that they closed? That is one open is one closed. Let's just see it quickly in the chat before everyone. Uh huh. No one's answering Nothing so far. Sounds as both closed. Both those very well done. Very well done, I think. France, for extraction, I should brush. But yes, they're both closed on the at this point. The membrane. The Saudi protesting pump is working, so the memory retention is being restored. But, um, the disaffected day allows another actor potential to be generated or nothing to be generated. But that's how it works, because effectively answered, all of that feels very well on be will move on to a question. It's been a while since the other question. There's a little bit tricky as well to throw you off a few words and stuff that you might not know just a Z yet. But I want to see everyone give a good attempt. So you get the problem running. Thank you. Um, question number five. There are increasing studies investigating the involvement of neurotransmitters and schizophrenia. One study heaven 11 study heavily is don't be an inhibitory neurotransmitter don't mean by It's receptive that causing inhibit reaction on the post sign ups. What is this action again? A very difficult question. I'm not. I'm not. I don't expect you to know this because we are going to look into what it has to neurotransmitters, but give it a good stab unless the full engagement guys, I see more more people to answer. Just I see these holes and I just get a good answer. Very well done. Get a few more seconds. It's the most talking about, you know way. Um, very nice. And I think we will call it there. Every woman for a well, sorry. Most people went for a and B answer is a that there is a temporary hypothyroidism, a shin of the first sign up. So what does this mean? So we're gonna look at this. I think the one thing I just want to say is with this question were asking about inhibit tree actually inhibitor for neuro transmitters. It's the rule of time. If it's inhibitory, something is being stopped. So a lot of those increased and huge influencing to it probably wouldn't be the answer. But don't take that as, like mood of thumb. It's just when you don't understand the question best ago. That's the best way to still give a good stab. But what? What we'll be talking about looking at Epps Peas and I ps PSEO Does anyone can I don't put in the chart. What is an E, p S P and I PSP Give it a second thought. It was a long time, right? Atri potential like exc excited tree postsynaptic potential people synaptic potential. That's it. Very well done on So What are those? The's potentials. Are it? Basically, you get, um I try to freeze it So you're basically an influx or positively charged irons with excited very person. Actiq. Psoriatic potentials. Such a mouthful. Epps pees yet influx of positively charged islands. And this could be sodium What this causes a membrane bold change of the member voltage off the postsynaptic cell on this. Either things basically brings the remember of attention closer to that pressure potential that we were talking about. That 50 negative 55 of oats and this is increases. The likelihood it'll mean it causes a exponentially increases the likelihood of the action potential attorney you can you can get certain excited Torrey. Newer transmitters and examples of these are blue to made nor epinephrine and which is basically your A nor Drennen adrenaline. This is just a little side note. Adrenaline is the whole morning, and nor jenaline is the neurotransmitter. I just thought they were opposites, but I was wrong. So nortriptyline be in the new transmitter, adrenaline being the whole night. I PSV's, conversely, is inhibitory personality potentials is where there's an e flat PSA, positively charged islands, and this can either be from the movement of sodium ions. Or it could be from the influx off chloride islands on there. Again, there's a change of the membrane, a member of voltage of the person that postsynaptic cell. This brings a member of attention further from the special potential and decreases the likelihood of an actual potential occurring. And so, just as we talked about, there are inhibitory neurotransmitters within the body. There's one is GABA serotonin and dopamine on gum so that that was what that question was on about with inhibit inhibitor neurotransmitters. And so if we go back to just to give it a bit more, focus it. There was a temporary hyperpartisanship of the post Sinus, and that's what happened. All the other answers would have called. It is either caused by an excited, very person Actiq potential or it was just wrong. But yes, so that's what the inhibitory neurotransmitter did. 10 very hyper hyper organization off postsynaptic because it brings the brings the membrane potential further from the special potential. So this leads us on to certain types off. Uh, certain types off potentials. 11 Very simple. One is a PSP i p s P cancellation on. As you can see, it's where there's an excited to repeat ensure and then in hit inhibitory potential that follows on just no accidental occurs because they kind of cancel each other out. It's kind of it's kind of an easy one to know. The two that I wanted you guys to remember and focus on is station summation and 10 consummation. What is that special situation is when an exciting potential person, after potential from many different neurons, triggers the threshold potential on. So it's when you remember when we talked about the nuance structure, the accent terminal. There's loads of different dendrites that they are attached to. You get multiple know you get never impulses from different neurons, and that's that's important with spacial summation. Different neurons, that kind of some mate they build up on bring the memory protective closer to that special potential. Again, the, uh um, all or nothing theory works with little the older nothing, Uh, thing works with this. Once you reach the national potential, you will have an actual potential 10 presentation. Similar concept, a little bit different. It's when there's many e PSP's from one. You're on that then triggers the special potential. So it's just one potential after the other exciting potential. After that idea and it builds up on, then it reaches the actual potential so on. So this is what we're talking about with the absolute refractory period on through the relative refractory period. There's a set of period once that once a potential once the active attention is Kurd, then you can get more PSP's coming through and you can it. You you want another action potential, but you physically can't. And that's what the absolute factory period is mentioning is referring to. There's a period of time where you cannot general actual attentional as many inhibitory alecks excite story potentials you send to that neuron. But so that kind of break this a very whistlestop to again. I'm I'm sorry if I'm not focusing on things I wanted to hear or look at, but I wonder focus on key aspect. As we said, These are things that I felt wasn't focused on very well in my teaching and just things that do come up in the examine that you should know you have a good concept off, get a good grasp of it and we are simply moving on to a respiration. The science of aspiration. And again, as I said, I like to breaking sounds now or quit is an old consent, but I like to break things down into Why, what, how and where. So the first question being what is selling a respiration? I know as all if you can see it's a chemical reaction involving the intake of oxygen and the release of carbon dioxide for the production of energy through oxidation, off a complex or organic substance on off the weight and be focusing on glucose. But you can respire and metabolize certain other complex or get organic substances. But the one we're going we're looking at is glucose. The next one is wanted. The overall process is so how is it broken down? And this is what I was talking about, right? The beginning of my presentation you get, they're broken down into glycolysis that the link reaction Krebs cycle and electrons France, which I'll let you read in stopper. We have read that afterwards, but we're gonna be looking at we're going to look at my cholecystostomy link reaction and what that involves. Krebs Cycle and Electron transportation will be covered by my friend Sri next week. So I hope to see you guys all there. But moving on where is all happening? So I think one thing I forgot to mention by the beginning with mitochondrion the and sell your respiration occurs in most cellarette. Respiration occurs in the mitochondria except glycolysis, which occurs within cells cytosol. And so just just to give you guys a little bit of image of what's going on. And this is why I want to focus on with the structure of the major country, the mitochondria. You have an out a membrane and liver brain between that intramembrane space. Get crystal. Which is that? That folding that we're talking about which increased the surface area. And then you get it in a fluid area called matrix on a little bit more, A little more complicated. You can see this might control electoral transport chain. I'm I'm showing you guys I know we're going to talk about the electron transport change, but it's just to give you guys an idea where things like that where things are taking place. So obviously glycolysis which we're gonna talk about now because in the cycle within the cell on, then the products of the Micardis is a moved into the cell on this is where Krebs cycle occurs on. Um uh, this is where then ATP is produced on, um, where the election electrons are transported. So again, that's it. That's a quite a general explanation of it. If you guys understand, that's fine, because we have a look at like offices and, like reaction on the rest will be covered by three next week. This is a huge simplification of that. Any of that. Just understand this. What happens in several respiration glucose in Austin React. There's a serious of reactions, primarily making NADH fad a gym in a look at that, they're electron carriers. There's a bit of a to be made along the way, but the majority of ATP is made in the election transport chain. Um, as I said, Yeah, so it's not just a little bit a lot. A lot of it is made in the actual transport chain, as you will see when you put these two parts together. And so a quick question. This is quite simple. I it's either you know it or you don't but This is what we're going to be looking at. I just want to see if I was going to see how you respond to this. Which glad politic reaction cannot be directly reversed in blue cone. Your genesis. So a lot of words that you might understand. You see, Look at that. But which of these steps off, like all assists cannot be directly reversed. Blue. That's see full participation, guys. It's like 50% of the you have said, Yeah, few more to get a few more seconds. Um, it's fine if you don't know it. That's what I'm gonna look at the steps. Um, your brain just see me guys standing. So a lot of you guys have gone for It's very close between a and see three point for you. I'm sorry that we know the option. Um, and so you end up all their thanks on a, um a lot of you guys went. I think the majority when you went for a Unfortunately, the answer is one second. The answer is see? So why is that what I mean? What did any of these mean? We could look at that right now, Like all of this. So it looks like this and I'm not the life similar. See you guys. I saw that. Sounds like what am I looking at? Is this This is medicine. I'm learning so much biochemistry, it does not complicated. There's a lot of molecules right there, But we'll get that again. There's a revision sessions. I'm not going through every single step. I'm not gonna tell you what everything means, but I'm going to give you the most important under focus on the most important best. And what's the first thing? I want you guys to notice that to ATP is produced within. Like all this is one stage of the whole cell. Your respiration in glycolysis two ATPase are used on diet note from down there and then for ATP is produced. So there's a net production off two ATP from Glycolysis. And that's the fact that you do have to know. So two ATP has made from crack on assist. The other thing I want you to know is that in, like on says to Nad haters are made again electron carriers, they're not gonna be as important and glycolysis and infraction. You're not gonna understand what they are, but Tree will mention them in the next session. But to NADH are made, and that is important on then to hit two monitors of automated well, but most of the other thing is net two ATPase I made and 20 g. H is made. So rather than looking at that really complicated scary diagram was appointed that we're gonna look at this a little bit more simplified, little more focused If you don't take anything away from, uh, biochemistry today, does this one day on Want us take away from this? And that is the three irreversible steps. There's the most important thing that you have to know. What are the three rough, be reversible steps? The first one is glucose to glucose six. Phosphate requires a TB, and he uses enzyme called hexokinase on. But what is the kindness you can see? The corner kind of eases it. Catalyze is transfer of the phosphate group from a high energy molecules to a substrate it on this is usually usually from ATP, as you can see that luckily, luckily for you, all three irascible steps use kind is is that's very nice, eh? So that's the first or a bus will step that first step the glucose breaking down or like catalyzing into people. Six prostate is there irreversible step. But the next one is fruit or six phosphate two fructose 16 bisphosphonate bisphosphonate The enzyme that catalyze this is false or fructokinase just really rules of the tangles there on, um, there's also requires ATP Finally, cause I can't say it, I'm gonna call it be be be, uh, I'll give it attempt to fast for spoke and no pyruvate but PBB is good enough. And a pbp to pyruvate is the last irreversible step in glycolysis. This one produces two ATP. I know this diagram is a bit misleading, but they're too late to be made here and to be made here on. But that works out of that to a to be met over made on the enzyme, for this is part of a kindness. So what? I'm telling you guys, that's why I was important of the three of us. It'll steps hold onto that thought on. We're gonna come on to that when it comes to continue Genesis. But the important thing you need to do that if you don't understand, like like all this is step by step in each different molecule. Just know these molecules. That's the most important thing. And what enzymes catalyzed? Um, that's what's important. And so the next step often, like all assist, you get the product so you get the product higher late, so I should have come back with a pirate. Eight. What does the link reaction do? It kind of a cell. What's on the 10 you? It links glycolysis to the crop cycle. So I am kind of leaving it on a cliffhanger here because, cyclist, it's going to talk about later on that next week. Sorry, but that's what effectively, effectively it does. It produces. It takes the products of glycolysis, and it takes them over to, uh, within the microphone. Draw matrix on, then for the cramps cycle. So things you need to know really important thing you need to know Pyruvate is a three carbon compound. Sorry. Oh, three. Carbon molecule on bad breaks down into us. A acetylcholine A, which is a to carbon compound. There is an intermediate. I think it has to see in the diagram because, see, there's a split pyruvate and it's called acetate that's not as important. But the thing is you know, is the pyruvate becomes a settle away. Onda, How does it do that? It does it through an enzyme called coenzyme A on coenzyme a d carboxylate pyruvate on what is covered and what is a carb oxalate? What is that enzyme carboxylase transfers CO2 groups with the help of bite it Ondas you can see carboxy. It's kind of in the name product, A byproduct of that too. You also get one nad hate Monica produced, as you can see later used in the electoral transport chain. So recapping we had to NADH is from black Colaces and now one from the link reaction Amazing. So many NADH is certainly electrons being transferred on. As I said, the most important thing is that the acetylcholine is that used in the Krebs cycle And so we certainly come to gluconeogenesis. I don't know about you guys, but the biochemistry was told really awkward leakers. It wasn't that wasn't real structure to it. It was just told, like here and there. But I hope this is gonna be more strong to do it locally. Genesis isn't part of cellular respiration, but it is part off. It is part of the the steps to sell your respiration and, like Colaces is how, because again, it just it kind of works. And how do you cosign it? So unless his focus on what? What? What is it? What it's gonna Genesis is a process that transforms non carbohydrate substances. So substrate Sorry, started lactate. I mean, I since and let's roll into glucose So obviously we're not focusing on lacked any of those. We'll look at pyruvate, but effectively, you can make pyruvate from lactate. So where does this will take place? It usually detoxification and stuff like this and the liver is just amazing. Liver has so many things going on on one of it in school quitting Genesis mainly because of the liver that some of the kidney and even less in the brain, heart and a screen a muscle. And so this is where the three arrestable steps become important. This is why I focused on it in gluconeogenesis it effectively. Very simply, it is the reverse of like on a cyst. But it's too simple to say that because, like cholecystorrhaphy is three of the muscle steps so include a genesis. What do you do? What? What is How do you compensate for that? And that's what we're going to focus on. So the first irreversible step pyruvate eso the pee pee pee becoming pyruvate through pyruvate kinds of. We said this cannot be reversed and it can't repair. It can become pee pee pee again. So an intermediate is made called Doxil. Uh, acid eight. Your eyes might of heard of assassinate Well of folks. We're not gonna focus on it today, but it is. The substrate reacts with pyruvate in the Krebs cycle later on. So that's where you're gonna hear it in textbooks. It's probably the you see. Okay. And that's that's how you gonna see it. But pyruvate of the motor, the units nose pyruvate becomes the substrate called oxalacetate on that, then gets converted into pee pee pee Thean porton enzyme that you need to know is pyruvate carboxylase again. What is the cabinet about? Carboxylase do that? That's what we're talking about on. Um, you don't even not as important pap carboxy kinds. That's not as important. But what you need to know is that part of a Combigan vertebrae bpp so it forms this intermediate on. Then that becomes pee pee pee the second intermediate step. So we're going to skip that middle one will come on that later. But the second off I want to focus on is glucose becoming glucose six phosphate. So that was the first step in glycolysis. Blucas converts into glucose six phosphate through hexokinase. But it kind that again. As we said, it's a reversible. So what enzyme is there can do that and that is glucose six phosphatase kind again. Roll up the tongue. But it makes it easy to remember. And that's what I wanted us to focus on. The slide is a bit incomplete, a little bit complicated, but I just want us to understand that said the middle step there 30 reversible step was when fruit or 64 So it becomes fruit. Does 16 bisphosphonate. This is done by phosphofructokinase on before it was more specifically phosphofructokinase one PFK one. The reverse of this is catalyzed by catalyzed buy fruit Does 16 baseball stitch days I can dispose of the tongue. Uh, f 16 bp BPH is specifically on. So what is most important about this system, you can learn the more more specific details. But what I really wanted it. What you guys want you guys to focus on is what regulates the enzyme fructose once is. Uh, this also days. So you get up regulation and you could get down regulation and molecule. That up regulates. It is citrate, and where you have had a citrate is in the crib cycle. What down regulates fructose? 16. This foster days is frutos to six pills. Phosphate. There's a very complicated system off how the production of fructose to six months for state can upregulation and up effectively up, regulates gluconeogenesis and down regulates. Where concepts. But what I want you to take away that that there's a There's a long detailed system here, that congressman today because we're running all the time. I do notice that what I just want us take away from this is that there's an enzyme called PFK two. So no PFK one. Okay, two foster fructokinase to on how far so good for your kindness effectively works. It's a by functional enzyme, so it both it's both a kind is on day four Phosphatase sick it waas double. It's one enzyme that can convert Frutos to six months phosphate into foot toes. 1 ft does one phosphate on. Then, when fractures one for state has made, you can use it in Glycolysis. But obviously we're looking at what Down regulates foot does once it's bisphosphonate. So what I want you to take away is that as a kind of a zoo, what one function of PFK, too, is that the kind is on. It makes food goes to six. There's phosphate on, but that does, as as you can see it down regulates that that enzyme that converts fruit does 16 bisphosphonate to foot those six phosphate it simply it down regulates gluco neogenesis on. So that's important that Pierre PFK to system. That was a lot of truth. Doses of this letter was just too much, and as a Saturday is kind of incomplete. I've left you guys with a really good video that really explained a lot of that system. But again, what I just want you guys to take away is what up regulates. This enzyme on that is sort of borderline regulates his enzyme, and that is pretty close to six bisphosphonate, and that's the most important thing you used to know right by a chemistry done. I'm running short of time and I see that you guys getting tired. So we're going to speed through this little bit upper limb anatomy. So sorry, I have a big believer of you just can't I I sat through vision such a rush in and asked me was told to me, But you there's no way. And after we can be told to you other than you discolor, revise and recall it and just understand it to the best that you can, it's It's no anything you need to understand. There's no concept, understand? It's more the fact that, um just need to know where these are, What innovative, what the blood supply is s. So I hope I've convinced that admission doubt it's the most specific and most important about sports. Sorry. One second. Eso. I hope this is going to be a bit of a whistle stop tour, but I'll focus on specific things that is important when it comes up. A little polyp in after me. So you guys can see that there's a little bit Sorry. Um, as I said, the best way I think everybody is looking at each time. So we're gonna focus a little bit on bone, the nerves, arteries, veins, muscles. The important thing that I want, I'm going to prescribe quickly because it's quite plain knowledge. But I want to recap on it. Because why know this and that and atomical terminology, lecturers, and like your attitude is everyone will just use these times knowing that you kind of just thinking that you know it. So the best thing is just, you know it so quickly. Anatomical position. Well, seen it and diagrams and all great anatomy fans. You know, the the key things keep its to note is that the in A in a position the person is facing forward standing up palms facing forward the feet Also the 0.4 on um s so I kind of birth. So sorry. The problems facing forwards The most important bet You remember when the parents of facing forward when we talk about midline and made a lateral the thumbs are the most out of part on I think something that wasn't really talk about overlooked in male anatomy. In terms of male anatomy, the Penis is erect as well. So that's another important bit that you need to know now looking at what around it seems, Know, first of all, there are three planes, so you guys can all see the three planes sagittal. It's it's goes down value body splitting your, uh, the last me into left and right. Yet kurono, which splits the body into front and back, and transversus, which is kind of special worry into top and bottom or inferior superior. Uh, how have you like to see it left and right? I know it's a shame we have to mention in the left and right. Just remember to your ent it yourself. Especially comes the higher that the stuff like this a superior inferior simply up and down. There's cranial and Kordell cranial and total is mostly used in terms of brain. You won't see it. You're you superior superior, But you know about brain. It's cranial being up and called being the bottom. Then you get anterior posterior being front and back. You get proximal and distal little bit. Focus on this one, proximal distal. I was confused about it in relation to the body, so use use for limbs. You get a proximal part which is closer to the body and the distal part, which is distant to the body. And that's quite obvious. A lot of folks on it too much on one. Now I kind of found hard and going to be sometime. The grass was medial and natural. Eso this is usually this is focusing on a point in in relation to the midline. So you know you can get the sagittal play in the midline going down your body, and then maybe it'll means closer to the mid mid point in the natural being further out. But I think another thing you just need to remember the one thing I mentioned with hands the anatomic position. The pinky is close to the body. The thumb is father. Everybody's. So when you say medial actually in the pinky is closer on glass of the farm, it's further away, and I think you should know that you can use me the lateral in terms off. Uh, not just midline regarding the body, but any kind of mid point in any part of the body. So the hand you can have medial part, which is closer to the middle of the heart of the lateral parts s. So that's that's it's just terms used in relation to think eso Why it Why is it important? Allows precise, comparable and reliable descriptions of injuries on identify it helps you identify specific anatomical structures s Oh, that's fine. I think you guys understand that technology is very important. The thing I wanted to focus on with bones. If the types of moms with upper limit that I've left you this off the US and see the slides, you can see it. Let me drunk. You can see that there are these different types of bones, but the most important one. When it comes up a little, it's longer, short ones of flat bones. The things I want to focus on our with lung bones. There is no they support rate of splitting movement. But also a good thing to know is that they have some significant amount of bone marrow on. So these are major sites of human human toe paresis on that is a bone out blood and direction blood, and so examples of things are humorous and the radius you can get short bone, which provide stability, and for subsets of movement. Lucky for you guys, most of her in the ankle and breast. So you do have to know the ones in the wrist. Starches, the lunate on the scale for it. Flat bones such as the scapular production of multiple internal organs. And they act as an origin and attachment point for muscles. I don't remember the The scapula is a major side of origin, an attachment for a lot of muscles of the upper limit. And they usually thin, flat and possibly curve to touch the cranial bones. But as I said, I'll let you read about a sectional bones at the regular ones. Later, I put these. Put these in here just for completeness. You guys can. You probably have your own set of notes. You probably have your revision set, but this is just so bad it's there so you can look at it if you ever if you ever need to look back at the slides, the thing I did want to focus on but handguns and I know everyone has a row like human accent. I just want to look at the key points in the clinical relevance quickly. So with the carbo bones skate before lunatotriquetral person form trapeze the entropy zero capitate and hook up the hamate People have their own nuance. I quite like some lovers. Try position they can handle. The problem with this is then you kind of forget. Like where and where do you start and where does it go? So obviously looking from the thumb side from the lateral side, you're going to split them into four and four. So some lovers try positions Is the scale for a lunatic request from person form on the other four along the top? Another thing that was kind of confusing to me was trapezium a trapezoid. Very similar. They're right next to each other. Where which where does which one go? I like to think of trapezium as some kind of sounds. Same sex trapezium is at the bar. And to be so it is that the first finger certainly moving. You have a skate food a discern factors that you need to know. So first one is skate for fracture. He probably had a lot about this, but we've been testing it quite a bit. Stay for fracture is also known as food. A four on outstretched hand on. It's a most common type of carpal bone fracture. You'll feel a pain in the anatomical stuff looks. Which is this? The area near between the farm of the wrist. It's a triangle and section You can you can also you also the test on boxes Fracture, which is 1/5 metatarsal metacarpal. Sorry, neck fracture on. It's caused by a strike with the Lantus. Hence the name box fracture. Move quickly on again. Nerves. Very good nexus. I really want to do an interaction with you guys, but I'm gonna swiftly move on. So you know that that's put in two different that subdivision. Starting with roots. There's a C five to see a derm and t one, There's trunks, you get superior, middle, inferior divisions. You get anterior division and a posterior division. So I showed you a certain to like this because the superior middle interdependence fused together to form ascension on the inferior kind of goes by itself. The good thing about the posterior. They come together to form the posterior cord. The next subdivision. Sorry. Eso The cords are lateral posterior medial. Why is it named that way? Because I was able to put the image in, but you can kind of see that the auxiliary artery goes through this branch. Plexus on the cords are named in relation to the where they are in relation to the auxiliary artery. So the last visit laterally posture being behind the medial, being legally the next, the next the final bit of the branches. So you again I would've tested you guys on it, but I'm swiftly go through them. You have the muscular Tania's oximetry radio all that meeting on. I'm sure you guys have seen this them. I will tell you what the most important things are to know about these, but it's good to have an idea of this, uh, just an idea of, like what? The terms of branches are, what the subdivisions are on, kind of how they formed. So again, You guys probably have all your immune onyx. I've heard some dirty ones. When it comes to the break of Lexus, I'm looking for professionalism. Just not gonna mention them. The one I know is not be teams don't come of bruises on those of the subdivision of the break of plexus and then muscular with the tell no branches. I just remember as mammary kind of because it kind of sounds like no mom you from novel. But Mom, you is how I remember you guys remember in your own way. So the nerves, the revision tips I'm going give you is just know the plexus. It's formed by the anterior ray my of the cervical, cervical spinal nerves C five to see eight and then the thoracic spinal nerve t one. Remember? I said, C seven and C eight come off from the same vertebra. That's that's just another thing, you know. Just just know the names of the five nerve branches from lateral to medial. I just know the functions and clinical relevance again, a very busy slide. I just put this on here for you guys in your revision later on. But certain things I want to focus on the key points on clinical relevance is with the exhilarating. It can get injured from a surgical neck fracture of the humerus. This'll can cause loss of abduction because the deltoid and tear tears mine has lost innovation. You can also get this loss of sensation in this area called the Regimental Badge Area and I don't if you can see my camera, I don't if he gets and see me. But the regiment imaginary is just there's area. If you thought about something, the arm, it's kind of here you can get lost sensation there, So if you're moving on, you can get a lot of damage. Damage of this can cause a clot hand lives due to the paralysis off the lumbrical. You probably had a lot about this, but the one thing I want oh highlight is that the older nerve innovates the medial half of the flex. It is sore and profundis on why I was having this most flexes in the anterior compartment, uh, innovated by the median nerve. But this one muscle have to be difficult it and it's the all of that innovates, the medial half about flaccid. It's storing profundis radio love. You get this thing called restaurant when there's damage to it, basically because the radio love radial of innovates a lot of the posterior compartment of the forearm on. When you get loss of innovation, you get this opposing action, and so the flex of muscles cause the rest of look like it's dropped, moving on once again, the median nerve You can get two types of compacted out profession or damage get carpal tunnel syndrome, which is what you can see. They're pretty sure you've had a lot about this number on. You also get this damage of the elbow with the median nerve called the median nerve palsy on. This causes weakness in the urination of the full. On is another note obviously coming in from before the median nerve as much as it innovates a lot of the anterior compartment muscles in the forearm. It also innovates the lateral half. So remember the medial half is by the only left lateral half of the flex It insurance fund us by the median nerve again moving on sensory, you get sensory elevation of the hand. It's important to know what nerve supplies where. I'm pretty sure you've had a lot about this on. Do you see in this diagram? Quite a bit. I think the things that I want to focus on is that the all the nerve provides the medial one and provide sensation to the medial 1.5 digits. The median of provides a natural 3.5 digits but this is Palmer Surface. Um, for the radio, love provides thie sense of the century innovation off the lateral 3.5 digits, a dorsal. It's on the back of the hand and you can see that on the diagram. And then just know that the median nerve also provides the fingertips in the dorsal side. The Iranian nerve doesn't hurt. Just a note. Radogno doesn't provide motor innovation to the hand. It's just purely sensory again. I'll let you guys go through that in your own time arteries. I'm gonna I'm gonna have to move on, because again, as I said, arteries, I just said, like to me something. But I just don't think I could just scream at you. I think you have to take the time, and I understand it in your own way. I will. I will say this though. So, um, arteries in the upper limb coming from the heart. The one thing you need to note is that the right to play be and set the right subclavian steps stems off the break of cephalic of the aortic arch, whereas the left comes off the aortic arch on, you see, then diagrams And that was one thing You know, the subclavian changes there, and celery at the lateral border of the first rib, the auxiliary turns into the brachial artery. In a day inferior border of the terrorist major. On the brake, you'll artery splits off into the radio on older in a cubicle foster, you also get the stems the second human circumplex humeral artery and the deep brachial artery a second. See on then you also get this middle middle connection called the common Intracisternal you that it just connects the radial ulnar. We'll have to move on. And just, I think what is most important. But a second See, remember, oriented yourself well, So this is the right. This is This is the right side. Being the lateral collateral side is the left side is where the radial artery would be. The medial side being well, the other would be Just remember your intake yourself. Is it other things to say the venous system a little bit more simpler. Just cephalic brain basilic vein. The one thing engineer need to know is the medial cubital vein is a common site off. Very puncture. So that's one thing you need to know that is, it's It's near the cubital fossa that I showed before and they the cephalic reinvested being come into the absolute vein. And then that goes to play. And it stopped giving us the heart. Nothing you need to note deep veins like internal to the fascia, usually pad on day. Travel alongside the incumbent artery so you can get you get deep veins. The radial artery is the libido. Vein the vein. You'll get the break of break off and they they usually in pairs. On they leave they like, quite deep. But these this's the superficial system. Quick s p A. I don't I think I'm not going to run this one. I'll. I'll read it out to you and I'll let you know. I met a visits the local GP. After a fracture in the midst after his right humerus, the GP observed that America has obvious risk drop in his right, right, right wrist, which is flowing nerves of most likely damaged. It is the radio again. Something you have? No, the clinical presentation wrist drop because the radio no damage. Right muscles. This will be really quick because muscles was something I was really? I don't know. What did you guys have a hard time? You guys. So I'm gonna give it Leave you guys with a bit of gift. I made a table of all the muscles. What they bought group of region. They belong to the innovation on but the action and origin insertion. The reason I'm leaving you with it is because this is again so something you have to know. But I'll tell you what is most of water. I'm gonna leave you with the whole thing. So this is from my notes and a Z concede that they're all there. The first thing I want to tell you guys is yes. You could take away your time learning all of this. But in the end, the most that what the most, for example is important. That you need to focus on is what is What is the muscle? Where is it? Can you identify it And then what is it? What is it? Blood supply. Because blood supplies, you should general to a compartment our region. And then you could learn the actions of each individual muscles. But a tip from me better. Better than that. Learn the muscles then learned a group that they belong to on group tend to have a similar action. So if you just done the common action, it would just be easier to learn for cardio stressors. Re important thing. Rotator cuff muscles. You need to know the Forteo cough muscles. You need to know the origin insertion on innovation on That's just something for goddess rooms. I'm pretty sure other students if you want to learn it. Girlfriend, but just a quick tip for exams. You need to know the rotator cuff muscles, the other ones. You don't really need to know the origin and in session for. But as I said, it's all there on. I only does read that in your own time and hope that gift suffices for not going through the muscles specifically. So probably the end guys. Now that one trick I want to leave you with innovation have I think we've all been taught this. The other nerves that supply all intrinsic muscles of hand except low on both is supplied by the median nerve, and the boy is low know of his natural lumbar calls off upon opponents pollicis abductor, politics, progress and the flexor pollicis brother's again to something you know, A little trick just know is supplied by the median nerve. And so I'm going to end up with two questions. I will do these two persons just because I want to get the interaction from you guys just to know that I haven't snooze you guys off. So it's a hard, uh, would you be able to open the pool for this one? There's two quick questions just to know that you guys have engaged with me. So the first question is I can't see my months. You have you ask for your superior to take blood sample of an 85 year old gentleman using your knowledge of the vasculature of the upper limb. What is the most common blood vessel to draw blood from on? I'm very happy to see a lot of years getting the right answer. And so just just the time sake us up. You guys are getting my answer. You guys did engage with me. I'm very happy to see Get a few more seconds on the pool there. Lot of us when he and the answer is immediate Medio the medial medium cubital vein the side. I told you about the most common side to take your blood from moving on. Last question. Lots of little one. We get the pool again. Sorry, Santa, a 50 54 year old male presents with today GP with inability to flex their middle finger index finger and some basically symptoms. Which structure could be damaged? Yeah. Good, Good, good. I'm seeing a lot of right answer is very nice. Very nice city. And so give a few more saying that because all the little engaging, very less assertive, that will end it There people went for see on the right Answer is the median nerve. Very well done. And so, guys, that these just references I want to have a huge thank you for you guys were sticking with me. Here we go. Please. We fill out the feedback form. Uh, that's all I have. That's all from me. As I said, Really important thing next week. I was We have the part to off this basic little science is one we're going to covering. Ah, whole different set off topics there a limp or of the peace? Yes, and basically clinical sciences. So please do come for that now, to see a lot of us there. Thank you for sticking with me on. I hope this was beneficial for you guys. I hope there's a lot more focus on specific things that you need. Look up for the exam on day. Thank you. Ended there a guy. Just reiterate this is not really a replacement for your lectures. Anything. This is just what we think as students haven't been gone through this stuff, and you need, we think, is the most.