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Human Physiology: Summary Notes & Self-Test Questions (Essentials of Medical Physiology) for USMLE 2024/2025 – Tested & Approved

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Human Physiology: Summary Notes & Self-Test Questions (Essentials of Medical Physiology) for USMLE 2024/2025 – Tested & Approved" is an expertly crafted study aid designed specifically for students preparing for the exams. The document is divided into well-organized sections, each focusing on a key area of cellular physiology: Volume and Composition of Body Fluids – Gain a deep understanding of the different body fluids, their composition, and how they interact in maintaining homeostasis. The section simplifies fluid balance concepts, making it easy to grasp fluid compartments and electrolytes. Action Potentials – Explore the mechanisms behind action potentials, the essential electrical signals that regulate muscle contractions and nerve impulses. The section includes clear explanations of ion channels, depolarization, repolarization, and the refractory period. Skeletal Muscle Physiology – Dive into the fascinating world of skeletal muscle contraction. This section provides an in-depth look at the sliding filament theory, muscle fibers, motor units, and neuromuscular junctions, explaining how the body translates electrical signals into physical movement. Smooth Muscle Physiology – Understand the differences between skeletal and smooth muscle physiology, including the mechanisms of contraction and regulation in smooth muscle tissues, vital for the function of organs like the heart, blood vessels, and digestive tract. The document is structured for ease of use, with the following key features: Concise, Clear Notes: Each topic is broken down into concise, bullet-pointed notes that highlight key concepts, processes, and physiological principles. The content is kept straightforward, ideal for quick revision and reinforcing foundational knowledge. Self-Test Questions: After each section, you’ll find a series of self-test questions designed to challenge your understanding of the material. These questions mimic the style of the USMLE, allowing you to test your knowledge and assess your preparation.

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CELLULAR PHYSIOLOGY

Volume and Composition of Body Fluids

Distribution of Body Water:

❖ Total body water makes up 50%-70% of body weight, varying with body fat.
Leaner individuals and males typically have higher water content.
❖ Water is distributed between Intracellular Fluid (ICF) and Extracellular
Fluid (ECF).
○ ICF: Makes up two-thirds of total body water and exists within cells.
○ ECF: Comprises one-third of total body water, divided into plasma (in blood
vessels) and interstitial fluid (surrounding cells).

Composition Differences:

❖ ICF and ECF have distinct solute compositions:
➢ ICF: High in potassium (K⁺) and magnesium (Mg²⁺) with proteins and organic
phosphates as anions.
➢ ECF: Dominated by sodium (Na⁺), chloride (Cl⁻), and bicarbonate (HCO₃⁻).
❖ Electroneutrality is maintained within each compartment, balancing positive and
negative charges.
❖ pH and osmolarity are regulated, with pH lower in ICF than ECF.

Concentration Maintenance:

❖ Concentration gradients across cell membranes are sustained by active transport
mechanisms, primarily:
○ Na⁺-K⁺ ATPase pump: Maintains Na⁺ outside and K⁺ inside cells.
○ Ca²⁺ ATPase: Regulates intracellular Ca²⁺.
❖ These gradients are vital for physiological functions, including nerve/muscle cell action
potentials and nutrient absorption.

Importance of Gradients:

❖ Concentration gradients across cell membranes are essential for critical functions:
○ Resting membrane potential relies on K⁺ gradient.
○ Action potential upstroke depends on Na⁺ gradient.
○ Excitation-contraction coupling in muscles requires Ca²⁺ gradient.
○ Nutrient absorption (e.g., glucose) depends on Na⁺ gradient across
membranes.

,Concentration Differences Between Plasma and Interstitial Fluids

1. Protein Distribution:
▪ Plasma contains proteins (e.g., albumin) that are mostly excluded from
interstitial fluid due to their large size, creating a key compositional difference
between the two.

2. Gibbs-Donnan Equilibrium:
▪ The presence of negatively charged plasma proteins leads to a slight
redistribution of small ions across the capillary wall to maintain
electroneutrality.
▪ This effect causes plasma to have a slightly lower concentration of small anions
(e.g., Cl⁻) and a slightly higher concentration of small cations (e.g., Na⁺, K⁺)
compared to interstitial fluid.
3. Gibbs-Donnan Ratio:
▪ This ratio quantifies the minor concentration differences for permeant ions: for
example, the Cl⁻ concentration in plasma is 95% of that in interstitial fluid.

▪ Though these differences are present, they are often negligible in clinical
considerations.




Test yourself
❖ How does the distribution of total body water relate to body composition, and what
implications does this have for hydration needs in individuals with varying body fat
percentages?

❖ In what ways do the unique solute compositions of intracellular fluid (ICF) and
extracellular fluid (ECF) contribute to critical physiological functions within the body?

❖ How does the presence of plasma proteins, such as albumin, affect the distribution of
ions between plasma and interstitial fluid, and what role does the Gibbs-Donnan
equilibrium play in this process?

❖ Why is the Na⁺-K⁺ ATPase pump essential for maintaining concentration gradients
across cell membranes, and how do these gradients support cellular functions like
nerve signaling and muscle contraction?

❖ How do concentration differences between ICF and ECF influence the osmolarity of
body fluids, and how does the body restore osmolarity balance when it shifts?

, ❖ What mechanisms allow the body to maintain macroscopic electroneutrality in each
fluid compartment, and why is this balance crucial for normal physiological processes?

❖ In what ways might the differences in Ca²⁺ concentrations between ICF and ECF
impact cellular processes, particularly in muscle and nerve cells?

❖ How do selective permeabilities of cell membranes prevent the dissipation of
concentration gradients, and what might happen if cell membranes were permeable
to all substances?

❖ How does pH regulation in body fluids differ between intracellular and extracellular
compartments, and what are the physiological consequences of these differences?



❖ What are some examples of physiological processes that depend on the
concentration gradients established by the Na⁺-K⁺ pump, and how might disruptions
in this pump affect overall body function?




Composition of Cell Membranes

❖ Cell membranes consist mainly of lipids and proteins.
❖ The lipid component includes phospholipids, cholesterol, and glycolipids, which
create a selective barrier.
❖ This barrier allows lipid-soluble substances (e.g., carbon dioxide, oxygen, fatty acids)
to pass freely, while water-soluble substances (e.g., ions, glucose) are restricted.
❖ The membrane proteins include transporters, enzymes, hormone receptors, ion
channels, and cell-surface antigens, which serve various roles in cellular function and
communication.

Phospholipid Structure
Phospholipids are amphipathic molecules, meaning they have both hydrophilic (water-
attracting) heads and hydrophobic (water-repelling) tails.
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