Important mechanism

Fever
Fever is an increase in body temperature due to vasoconstriction in response to a cytokine induced
increase in thalamic set point.
Stimuli: exogenous pyrogens, bacterial endotoxin, virus, immune reactions, hormone, drugs

Host defense: recruitment of neutrophil, macrophage. Release pyrogen IL 1, IL6, TNF alpha and increase
synthesis of PGE2 by activating Arachidonic Acid Pathway

Effect: PGE2 reset the thermostat in anterior thermostat. Increase threshold

The person who is developing the fever has a cold sensation, and an increase in heart rate, muscle tone
and shivering attempt to counteract the perceived hypothermia, vasoconstriction. increase core
temperature To Meet the threshold of the thermostat new set point.

Tx: Aspirin (COX inhibitor) Decrease prostaglandin

Micturition
Is a spinal reflex (sacral micturition center), mediated by parasym nervous system, partially under
voluntary ctrl.
Sensory: stretch receptor (dense at trigone)
Facilitary area: pons
Inhibitory area: midbrain& cerebral cortex
Afferent nerve- pelvic nerve
Integrating center -sacral micturition centre (S234)
Efferent nerve – pelvic nerve
Effector organ: detrusor muscle and internal sphincter
When stimulus, conscious inhibition is removed
relaxation of pelvis floor muscles, pulls detrusor muscle to initiate contraction.
Intra-abdominal pressure is increased by straining.
External urethral sphincter relaxed. (compressor urethrae)
In women emptying of urethra is by gravity
in men it’s by contraction of bulbocavernosus.

Defeacation
1)Peristalsis empty sigmoid contents into rectum
2)Tension & stretch signaled to the brain through pelvic splanchnic nerve
Gastrocolic, gastroileal reflex results in mass movement 3-4 times/day
3)Rectal wall tension leads to further reflex contraction of sigmoid colon
4)Inhibition of both anal sphincters
5)Reflexes reinforced as contents are expelled thru the sphincters and tactile stimulation usually external
sphincter because skin…
6)Forced expiration, descent of diaphragm and contraction of abdominal muscle assist in the action
7)Levator ani contracts to straighten the anorectal angle

Coughing reflex
i. Where is the location of cough receptors? Trachea and bigger bronchi
ii. afferent pathway: cough receptor at trachea and bigger bronchus cough centre in
medulla
iii. efferent pathway
recurrent laryngeal nerve(vagus) –glottis
phrenic nerve – diaphragm
spinal nerve – intercostal, lattismus dorsi
iv. Describe cough reflex
Irritant trigger cough reflex.
 Deep inspiration, epiglottis close
Abdominal wall contract forcefully to push against diaphragm, strong contraction builds up
intrapulmonary pressure.
Forced expiration against the closed glottis due to increase pressure
Glottis sudden open, Air is expel together with the foreign particle

Vomiting reflex
Stimulus:
-GIT contents; mechanical stimulation of pharynx; nauseating sight, odour, taste; severe visceral pain
-Impulse send to vomiting center in reticular formation of medulla thru sensory vagus& sympathetic
afferent
-Motor efferent on CN 5 (trigem-mastication), 7 ( facial –salivary gland), 9(glosso-aff and eff of gag
reflex), 10 ( vagus- efferent of gag) , 12 (hypoglossal- extrinsic muscle of tounge)
-Pytalinism ( hypersecretion of saliva)
-Antiperistalsis & sphincter relaxation
-Inspiratory movement, closure of glottis, abdom muscle contract with retching (characteristic jerk)

Swallowing
1. 3 phases of swallowing: oral phase(voluntary), pharyngeal phase, oesophageal phase
2. Which phase of swallowing will cause respiration to stop? pharyngeal