By CL Ghai
Contents
General Introduction xvii
SECTION ONE: HEMATOLOGY
1-1 The Compound Microscope 2
1-2 The Study of Common Objects 13
1-3 Collection of Blood Samples 14
1-4 Hemocytometry (Cell Counting)
The Diluting Pipettes 23
1-5 Hemocytometry (Cell Counting)
The Counting Chamber 28
1-6 Examination of Fresh Blood:
A. Drop Preparation
B. Preparing a Peripheral Blood Film 31
1-7 Estimation of Hemoglobin 34
1-8 The Red Cell Count 45
1-9 Determination of Hematocrit (Hct)
(Packed Cell Volume; PCV) 53
1-10 Normal Blood Standards (Absolute Corpuscular Values and Indices) 57
1-11 The Total Leukocyte Count (TLC)
White Cell Count (WCC) 60
1-12 Staining a Peripheral Blood Film
The Differential Leukocyte Count (DLC) 69
1-13 The Cooke-Arneth Count (Arneth Count) 85
1-14 Absolute Eosinophil Count 87
1-15 Study of Morphology of Red Blood Cells 89
1-16 The Reticulocyte Count 90
1-17 Erythrocyte Sedimentation Rate (ESR) 93
1-18 Blood Grouping (Syn: Blood Typing) 98
1-19 Tests for Hemostasis
(Bleeding time; Coagulation time; Platelet count; and other tests) 111
1-20 Osmotic Fragility of Red Blood Cells
(Syn: Osmotic Resistance of Red Blood Corpuscles) 128
1-21 Specific Gravity of Blood and Plasma
(Copper Sulphate Falling Drop Method of Philips and van Slyke) 132
1-22 Determination of Viscosity of Blood 136
SECTION TWO: HUMAN EXPERIMENTS
Unit I: Respiratory System
2-1 Stethography: Recording of Normal and Modified Movements of Respiration 139
2-2 Determination of Breath Holding Time (BHT) 145
2-3 Spirometry (Determination of Vital Capacity, Peak Expiratory
Flow Rate, and Lung Volumes and Capacities) 146
2-4 Pulmonary Function Tests (PFTs) 157
2-5 Cardiopulmonary Resuscitation (CPR)
(Cardiopulmonary-Cerebral Resuscitation (CPCR)) 160
Unit II: Cardiovascular System
2-6 Recording of Systemic Arterial Blood Pressure 167
2-7 Effect of Posture, Gravity and Muscular Exercise on
Blood Pressure and Heart Rate 182
2-8 Cardiac Efficiency Tests (Exercise Tolerance Tests) 186
2-9 Demonstration of Carotid Sinus Reflex 187
2-10 Demonstration of Venous Blood Flow 188
2-11 Recording of Venous Pressure 189
2-12 Demonstration of Triple Response 190
2-13 Electrocardiography (ECG) 191
2-14 Experiments on Student Physiography 197
Unit III: Special Sensations
2-15 Perimetry (Charting the Field of Vision) 200
2-16 Mechanical Stimulation of the Eye 205
2-17 Physiological Blind Spot 205
2-18 Near Point and Near Response 206
2-19 Sanson Images 206
2-20 Demonstration of Stereoscopic Vision 207
2-21 Dominance of the Eye 207
2-22 Subjective Visual Sensations 208
2-23 Visual Acuity 208
2-24 Color Vision 211
2-25 Tuning-Fork Tests of Hearing 213
2-26 Localization of Sounds 218
2-27 Masking of Sounds 218
2-28 Sensation of Taste 219
2-29 Sensation of Smell 220
Unit IV: Nervous System, Nerve and Muscle
2-30 Electroencephalography (EEG) 222
2-31 Electroneurodiagnostic Tests, Nerve Conduction Studies,
Motor Nerve Conduction in Median Nerve 226
2-32 Electroneurodiagnostic Tests
Sensory Nerve Conduction in Ulnar Nerve 230
2-33 Electroneurodiagnostic Tests Electromyography (EMG) 231
2-34 Electroneurodiagnostic Tests Evoked Potentials Brainstem Auditory,
Visual, Somatosensory and Motor Evoked Potentials 234
2-35 Electroneurodiagnostic Tests
The Hoffmann’s Reflex (H-Reflex ) 236
2-36 Study of Human Fatigue Mosso’s Ergograph and Hand-Grip Dynamometer 237
2-37 Autonomic Nervous System (ANS) Tests
(Autonomic Function Tests; AFTs) 240
Unit V: Reproductive System
2-38 Semen Analysis 245
2-39 Pregnancy Diagnostic Tests 248
2-40 Birth Control Methods 250
SECTION THREE: CLINICAL EXAMINATION
3-1 Outline for History Taking and General Physical Examination 255
3-2 Clinical Examination of the Respiratory System 258
3-3 Clinical Examination of the Cardiovascular System 263
3-4 Clinical Examination of the Gastrointestinal Tract (GIT) and Abdomen 272
3-5 Clinical Examination of the Nervous System 276
SECTION FOUR: EXPERIMENTAL PHYSIOLOGY
(AMPHIBIAN AND MAMMALIAN EXPERIMENTS)
4-1 Study of Apparatus 310
4-2 Dissection of Gastrocnemius Muscle-Sciatic Nerve Preparation 316
4-3 Simple Muscle Twitch (Effect of a Single Stimulus) 317
4-4 Effect of Changing the Strength of Stimulus 322
4-5 Effect of Temperature on Muscle Contraction 324
4-6 Velocity of Nerve Impulse 326
4-7 Effect of Two Successive Stimuli 327
4-8 Genesis of Tetanus (Effect of Many Successive Stimuli) 329
4-9 Phenomenon of Fatigue and its Site (Effect of Continued Stimulation) 331
4-10 Effect of Load and Length on Muscle Contraction (Free- and After-Loading) 332
4-11 Exposure of Frog’s Heart and Normal Cardiogram 335
4-12 Effect of Temperature on Frog’s Heart 337
4-13 Effect of Adrenalin, Acetylcholine and Atropine on Heart 337
4-14 Effect of Stimulation of Vagosympathetic Trunk and Crescent;
Vagal Escape; Effect of Nicotine and Atropine 339
4-15 Properties of Cardiac Muscle (Stannius Ligatures) 341
4-16 Perfusion of Isolated Heart of Frog 343
4-17 Study of Reflexes in Spinal and Decerebrate Frogs 344
4-18 Experiments on Anesthetized Dog 345
SECTION FIVE: CHARTS
5-1 Jugular Venous Pulse Tracing 349
5-2 Cardiac Cycle 351
5-3 Oxygen Dissociation Curve 353
5-4 Strength-duration Curve 356
5-5 Action Potential in a Large, Myelinated Nerve Fiber 357
5-6 Action Potentials in Cardiac Muscle Fibers 360
5-7 Dye Dilution Curve 361
5-8 Oral Glucose Tolerance Test (OGTT) 364
SECTION SIX: CALCULATIONS
Calculations 369
Appendix 375
Index 379
Preface to the Eighth Edition
The first edition of this book was published over 25 years ago. During this period of evolution, the growth and development of the book has been an on-going process depending, as it does, on the feedback received from many teachers and students. They have been generous in their appreciation as well as in their criticism. I have tried to incorporate many of their suggestions in the present edition. I owe them my thanks and hope that I will continue to receive such help in the future as well.
The material included in this book conforms to the syllabi and courses laid down by the Medical and Dental Councils of India from time-to-time, courses that are mandatory and are followed by all colleges.
The 8th Edition has been extensively revised and updated by incorporating the latest concepts and developments in the subject. Figures and text that were not found to be helpful have been deleted/replaced and over twenty-five new Figures/Diagrams have been added.
Questions/Answers, at the end of most Experiments, have been particularly appreciated by junior teachers and students. They are not intended to replace the standard textbooks but only to obviate the necessity for the students to refer to textbooks again and again. They also act as bridges between theory and practical.
A new feature of the book is the introduction of OSPEs at the end of most Experiments—a tool that is being used widely for assessing the practical skills of the students during class tests and university examinations.
Most medical students are overawed and overwhelmed by the enormous amount of medical information available today. Besides, there is the language barrier. Every attempt has, therefore, been made to make the book easily-readable and understandable by our students who come from a wide spectrum of educational backgrounds.
It is a pleasure to acknowledge the valuable suggestions received from many sources. I am particularly indebted to Dr DK Soni, Dr AK Anand, Dr RS Sharma, Dr Ashok Kumar, Dr Parveen Gupta, Dr R Vijayalakshmy, Dr Mrs S Vasugi, Dr P Rajan, Dr Aruna Patel, Dr BS Malipatil, Dr Shailendra Chandar, Dr R Latha, Dr K Sarayu, among others.
I am thankful to Shri Jitendar P Vij (Chairman and Managing Director), M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India and his dedicated team for their enthusiasm in doing an excellent job.