 Good evening everyone am I audible am I audible to you all yes sir yes we have done blood have you any doubt in blood you can say blood part or digestive system part have you any doubt in blood or digestive system that you people want to ask now let us see let us see let us do a question one question is there question number one everyone question number one a person with blood group a can donate donate blood to and receive blood from you just think this is this is a option a and this is option b donate blood is option a and receive blood from option a options your options are a is person with blood group a b a b and b is person with any blood do so second one a is person with blood group a or a b b is blood groups ok your third option is a is person with person with blood group b or a b and b is b or o blood group fourth option is person with any blood group b is o blood group only please solve everyone what I told you all can solve it ok don't over try ok or try to do it too fast please think and then answer anybody having doubt in this question or not able to solve can ask me ok I think you people can do it easily now one important thing is blood clotting one important thing is blood clotting let's see blood clotting what is blood clotting do you people know what is blood clotting actually what happens actually what happens blood clotting yes blood clotting it is the formation of clot after any injury you people can observe easily that once injury is there you can say to a person he or she starts bleeding and after some time bleeding is going to a store you can say a stop on its own ok no other intervention is needed and that phenomena is known as blood clotting it involves 13 clotting factors yes or no it involves 13 clotting factors that are there factor 1 is fibrenogen factor 2 is pro thrombin factor 3 is thromboplasty factor 4 is calcium ion Ca plus 2 this is very important this is very important you can say factor 4 is factor 5 is pro axillary ok factor 6 is not isolated yet but it is there factor 7 serum pro thrombin conversion accelerator now you see factor 8 is known as anti hemophilic factor but anti hemophilic factor means deficiency of factor 8 is going to cause a disease known as hemophilia yes or no I am writing over here deficiency of factor 8 will cause hemophilia and that also hemophilia A if somebody will ask you because hemophilia is of many types hemophilia is a bleeding disorder in which blood clotting do not take place easily yes or no factor 9 is known as Christmas factor and factor 10 is S2 word power factor or thrombokinase this also you people need to remember thrombokinase factor 11 factor 12 is Hageman factor factor 13 is Fibrene stabilizing factor you will ask me sir what all use are there actually blood clotting having two pathway one is known as extrinsic pathway one is known as intrinsic pathway try to understand my point extrinsic pathway and intrinsic pathway yes or no have you people heard about these things earlier or have you any doubt in this let us see you people know the meaning of extrinsic factor or intrinsic factor no extrinsic means coming from outside intrinsic means coming from inside yes or no now see this is your blood vessel this is your blood vessel you got some injury okay you got some injury here you first say this is blood vessel okay injury will be there in this area in the tissue and that will start extrinsic pathway means injury is from tissue trauma not from blood vessel now if impact is there it is going to damage the wall of blood vessel also in that case it will start from inside and that will be known as intrinsic pathway yes or no so intrinsic pathway starts from inside the blood vessel and extrinsic pathway starts from outside the blood vessel due to tissue trauma yes or no please let me know have you people understood meaning of extrinsic or intrinsic pathway everyone clear with it yes let us see now now clotting of blood is not a single reaction clotting of blood is not a single reaction rather rather it involves or you can say series of reaction yes or no it involves a series of reaction yes or no series of reaction is like try to understand my point whenever you are having trauma from the blood vessel you try to understand my point this is your blood vessel this is the outer wall and here is epithelium here is epithelium yes or no epithelium if and in this what outer wall coalescent fibers are there what are you what are there coalescent fibers are there try to understand my point now if injury will be there injury will be there over here let's see for say here is injury in that case blood will contact this wall now tell me yes or no if injury will be there on the you can say in the inner lining of blood vessel in that case blood vessel will contact the wall now in which coalescent fiber is there yes or no or a yes or no yes or here and is saying yes anybody else see this is going to help you people a lot so intrinsic pathway starts factor 12 is activated by factor 11 you guys factor 12 is activated due to this injury factor 12 is going to activate factor 11 factor 11 which will be activating factor 9 so factor 12 11 9 is activated now 9 with the help of factor 8 factor 4 this is factor 4 C A plus plus and 10 will be activated to factor 10 a factor 11 with the help of factor you can say 8 getting my point and factor 4 will activate factor 10 so what happened factor 12 then 11 then 9 then 8 then 10 this is the sequencer in intrinsic pathway agreed everyone what is factor 10 what is factor 10 thrombokinase agreed what is factor 10 is it thrombokinase or not factor 12 then 11 then 9 then 8 then 10 yes or no and what is the name of factor 10 please tell me what is the name of factor 10 in your NCRT and all you will find it by this name yes or no it is thrombokinase now thrombokinase is why why you are saying so that numbering mistake is there 6 is you can say 6 is not there that is why you are saying 6 is actually I have told that 6 is not isolated actually okay that is why it is not written this you can say table is taken from a book of medical physiology gyton and hall it is quite correct completely correct don't worry okay I have not made this so chance of human error is not there I have just taken that because I have cut that table and pasted over here okay so you see what I have told thrombokinase is activated now till here any any you can say doubt is there any doubt is there till here no not at all now one thing I will say over here see here now how extensive pathways are starting some injury and the you can say on the outer side of the blood vessel injuries there so what happened tissue trauma and that lead to tissue factor activation factor 3 factor 7 and that has also activated factor 10 yes or no so you people can see from both the part pathways what happened eventually eventually factor 10 got activated yes or no factor 10 got activated yes or no everyone yes now what happens after activation of factor 10 see over here what factor 10 is doing see in this diagram you have to see few things only factor 10 got activated now see over here it will be converting pro thrombin into thrombin it will be converting factor pro thrombin into thrombin yes or no factor 10 is converting flow thrombin into thrombin yes or no pro thrombin into what can I write over here thrombokinase yes or no yes or no after activation of factor 10 what happened pro thrombin got converted into thrombin yes or no agreed now this thrombin is going to convert fibrinogen into fibrin threads like fibrin fibrinogen were like this that got converted into fibrin threads like this a mess work is formed and in this mess work cells got trapped cells got trapped yes or no in this mess work cells got trapped yes or no agreed you must have observed the clot that is formed earlier or in the early part of blood clotting that is very soft yes or no that is very soft even if you will touch it it will start bleeding again yes or no please reply after that only I can move I told the clot that is formed due to this fibrin clot and the blood cells that got trapped inside it that is very soft in earlier part okay even if you will touch it touch it with you can have your finger it will start bleeding again have you felt this thing yes so what happens after that you will see some yellowish yellowish fluid start oozing out from here yellowish fluid start oozing out from here what's that what's that no that is not past year that is serum that is serum now you see all the clotting factor were exhausted yes or no all the clotting factor were exhausted during clotting yes or no please reply yes or not yes only Gayatri is saying yes now do you think any clotting factor is there in the serum do you think any clotting factor left in the serum no so blood plasma without clotting factor is known as serum a important definition over here so actually serum cannot clot serum cannot clot agreed just a minute yes yes so serum is plasma without clotting factor yes or no everyone blood having two components one is cell one is plasma so now from now you can say from this we are going to take a very important you can say inference from here plasma can clot but serum cannot yes or no because serum lacks clotting factor yes or no serum is plasma without clotting factor agreed agreed everyone others can also answer okay as I have told you you people yes yes we will be discussing we will be discussing first solve a question over here there is a question there is a question blood clotting involves blood clotting involves blood clotting involves the conversion of first pro thrombin to thrombolastin second thrombolastin to thrombin fibrinogen to fibrin and fibrin to fibrinogen fibrinogen please answer please answer take your time please answer thromboplasty new people can see from here third factor is known as thromboplasty so what do you think agreed what do you think what should be the answer what do you think answer should be is it like that no issue now have you seen this one have you seen this one have you gone for a blood test have you seen this kind of you see what is written over here edta is it written edta tell me dear edta is written yes do you know what is the full form of urethia it is ethylene diamine tetra acetic acid it what will it do if you are going to put blood try to understand if you have to perform blood investigation if you have to perform blood investigation in that case what will you do blood should be in the uncogulated form or incogulated form if you have to do it properly if you have to do blood you can say blood investigation properly blood should be in coagulated form or uncogulated if it will be coagulated you will not be able to perform any of the investigation that you people require so blood should be in uncogulated form it should not coagulate till investigation is performed so what they do they have lined this tube with the help of edta yes or no they are going to line this tube with the help of edta and that edta will combine with all the ca plus 2 and in that case what will happen blood blood will not coagulate agreed in that case blood will not coagulate agreed everyone and it will reach the lab in uncogulated form because you people know now the ca plus 2 is required for coagulation if edta will consume all the ca plus 2 in that case plotting can take place in that case plotting can take place or not tell me no so that is why it is lined by edta now one question that I think aditya has asked that sir what is the role of what is the role of platelet in in coagulation see actually platelet helps in aggregation and one is bone willibrand factor and that is going to help in attachment that factor is beyond your scope that is why I have not discussed okay so platelet is going to help you with aggregation yes or no if platelet will not be there the aggregation of cells and all can not take place yes or no yes or no anybody who has not understood adit have you got this thing tell me platelet help with aggregation of cells tell me aggregation means all the cells are coming together all the cells are coming together okay okay now which vitamin is needed vitamin needed for vitamin needed for what coagulation it is vitamin k okay in absence of vitamin k disease can be there yes or no in absence of vitamin k disease can be there many disease can be there you can say coagulation disorder will be there agreed everyone yes it has stopped I am sharing again I am sharing again I am sharing again so that's all with blood part okay now we will be talking about heart we will be talking about human heart let's see human heart what do you understand for what purpose heart is there heart is just like a pump heart is just like a pump yes or no try to understand what happens in simple organism simple organism what happens in them all the cells cells are in contact with what all these all the cells are in contact with environment environment so so they can directly exchange they can directly exchange things but when you will talk about complex organism like human okay deep seated cells are there yes or no deep seated cells are there everyone they can not directly exchange with you can say environment so there is a need for a system which supplies nutrition which removes you can say nutrition and oxygen and which removes waste and carbon dioxide both are required in this case yes or no both are required in this case agreed everyone everyone now for that circulatory system is there okay it is just like a supply line that is there in that blood we have done now we will be talking about heart yes or no heart is there what is the location of heart we will talk about that this is your lung okay and here you see in the this is right lung this is left lung and you people can see there is a notch present in the left lung that is known as cardiac notch what cardiac notch so the heart is present between the lung okay in a notch present inside left lung known as cardiac notch yes or no known as cardiac notch getting my point see over here this cavity is known as media astenum this cavity is known as media astenum agreed everyone the cavity in which heart is present is known as what media astenum no issues what is the size of heart we will talk about the size it is the size of a cleansed fist okay have you understood meaning of cleansed fist tell me here have you understood that yes it is the size like that only okay some standardized techniques were there in this it is the size of cleansed fist now a structure if you will talk about covering of heart you see over here the the inner covering of heart is known as is known as visceral pericardium and this outer covering is known as parietal the parietal word is known as for outer one and and the visceral is for inner so inner covering is visceral outer covering is parietal agreed everyone between them there is a space that is known as pericardial cavity there is a space that is known as pericardial cavity agreed everyone please tell me agreed no so pericardial cavity is there it is filled with pericardial fluid what is the function of pericardial fluid if you will see they are they are going to protect the heart from shock like you are jumping it will protect the heart from getting a shock that is transferred due to your jumping walking etc and it also prevent friction yes or no otherwise your heart is going to rub from the body wall yes or no agreed yes two things are there now if you will talk about wall of heart the outer most wall you can say outer most layer of the wall is going to be known as is going to be known as hippie cardium it is the outer most layer then the middle layer that is myocardium then the middle layer that is myocardium agreed then the middle layer that is myocardium let us see it is made up it is the middle layer and it is made up of cardiac muscle cardiac muscle then comes endocardium it is the inner most layer agreed now the question is which layer of heart wall is made up of cardiac muscle cardiac muscle one is hippie cardium the second is myocardium the third is endocardium fourth is parietal lura what do you think what should be the answer what do you think what should be the answer yes Radha it is myocardium okay it is made up of cardiac muscle see now as far as the structure of human heart is concerned as far as the structure of human heart is concerned let us see first I am going to rub few things after that we will be discussing in detail first up I will like to rub few things now see what is there as far as your heart is concerned getting my point your heart is going to be formed getting my point your heart is going to be formed of four chambered four chambers yes or no it depends between first two layers you told about and the third layer you just explained because they both are covering the what are you trying to ask tell me dear that I have not understood first two layers hippie cardium and myocardium sir yes sir the visceral pericardium and the parietal pericardium I didn't understand the difference of like where they are actually present because they are actually they both of them are present outside heart yes or no getting my point you take anything you cover it by one you can say anything you can say you take foil paper or anything you leave some space and you put you can say second foil paper getting my point something like that heart is there it is wrapped you can say from outside first by visceral pericardium and then by parietal pericardium yes or no yes sir did you get it heart is covered by two membranes agreed do you people know what is the role of peritonium do you people know what is the role of peritonium leave it what I have told just try to understand over here heart is going to have two coverings one is the visceral pericardium another is parietal pericardium and there is a little space present between them that is known as pericardial cavity or pericardial space in that pericardial fluid is present now you people agree sada you understood no yes sir got it yes anybody else having doubt adit you are saying no sir for what and the three layers you just explained because they are both are coming see you have also asked about this sada the pericardium myocardium and endocardium no sir I got confused between the the the two sets of layers you just explained I thought all them all of them are the same so now I got to know what they are no no one is the covering of heart and one these three are there in the wall of heart actually this one and this one both are pused only okay okay sir yes now if we will talk your heart is going to be formed of four chambers two atria and two ventricle do you people know you keep on listening atria or oracle is the atria and oracle are same is the atria and oracle are same or not are they same everyone I want from you people what is the difference between atria and oracle please respond is the atria and oracle are same no they are not same actually what happens over here what happens over here if you will see in this diagram they have not mentioned about oracle actually I am going to explain to you people what is about oracle is there oracle are not the main chamber rather that is a accessory chamber chamber of atria what is this they are the accessory chamber of atria yes or no main chamber is atria and it is present getting my point it is present to assist atria only when more blood has to be accommodated in that case this chamber will be used saying atria or oracle is wrong you see here they have written see this a small structure is oracle agreed everyone you got it now yes let's see so two atria and two ventricles are there let's see what is this this is inter atrial septum inter atrial septum that is the septum present between two atria it separates two atrial chambers agreed now if I will talk like you can say from this point of view this is what what is this interventricular septum between the two ventricle this is right atrium this is right ventricle this is left atrium this is left ventricle yes or no everyone please note it everyone no issues now you see over here now you see over here between the left atria and the ventricle atrio ventricular septum is there atrio ventricular septum is there that separates atria and ventricle yes or no yes or no everyone no issues now here between atria and ventricle there are valves present let's see if I will like to let's see here a valve is present between atria and ventricle there is atrio ventricular septum but you you you can say you people understand that there have to be some communication and that communication is guarded by some valves name of this valve is by cuspid valve what by cuspid valve so if somebody will ask you this is left atrium this is right atrium if somebody will ask you like this the question is which valve valve is present in the left inter you can say atrial septum tell me which valve should be there what is the name of this that valve here it is vicar cuspid valve and in the right side it is tri cuspid valve agreed everyone everyone from the right side it is yes it is inter atrial septum this complete structure is inter atrial septum but there is a opening present and that opening has to be guarded by a valve it will let the blood come from atrium to ventricle but will not let it flow back agreed agreed here tell me sorry what have I written oh sorry you are right it is atrio ventricular septum only I have written it mistakenly let us see it is atrio ventricular septum yes you are all you can you can say damn right let us see you got it are here and you got it are you are right of course yes yes I have made a mistake over here so which valve is present this is in atrio ventricular septum only now here it is tri cuspid valve agreed now everyone will try to understand everyone will try to understand this is inferior vena keva and here is superior vena keva here is superior vena keva what is there vena keva blood deoxygenated blood means blood without oxygen from the lower part of the body returns to right atrium via which blood vessel from the lower part of body it returns via which blood vessel you can say collect blood from the lower part of the body and deliver it inside the right atrium yes or no everyone everyone done and from the superior part of the body blood is connected collected and is put inside right atrium by superior vena keva so what are you can say vena keva is meant for what is the function of vena keva here it is the collection of deoxygenated blood deoxygenated blood and returning it to the right atrium agreed everyone everyone your heart is four chambered what in other organisms like amphibia before that pisces or fishes reptiles and mammals what do you think how many chambers are there in the heart of fishes i am going to explain it to you dear give me two minutes open two chambered heart open circulatory system i am going to discuss with you people fishes here two chambered heart is there in amphibia it is three chambered in reptiles it is three three or you can say incomplete four chamber because interventricular septum starts forming exception is what is the exception for reptiles exception is crocodile exception is crocodile yes or no because crocodile is having four chambered heart mammals having four chambered as well as here crocodile is also there everyone do you have any doubt in this now the question is now the question is let's see let's see question is the heart of amphibian is is usually first two chambered second is three chambered third is four chambered fourth is three and a half chamber what do you people think yes it is three chambered do you know it was asked in kbpy as a 2016 it was it is asked in that only agreed everyone now few more important things we will like to let's see what i want to tell you all few more things i want to tell you people see when pressure increases inside ventricle what is the chance okay let's see what i have told over here if pressure increases inside the ventricle what is the chance there is chance this valve will get inverted getting up and inverted like over c over here like valve will open this way and the blood will start flowing from ventricle to atria that should not happen to prove to prevent that there are cords that are there there are cords that are there which connects the valve from papillary muscles these valve are known as koda tendinine what koda tendinine i am making another diagram so that you people can clear you can say see this thing clearly so what do you think what is the function of koda tendinine it is preventing the version of valve this way when when the ventricle is contracting yes or no tell me dear everyone have yes so see this question if koda tendinine of left side is cut then what will happen you can see this you can say these options and answer agreed agreed everyone no issues this question is done if you are going to cut this koda tendinine in that case during contraction blood will flow back agreed now how your heart is going to contract for that some for that some tissues are responsible for that some tissues are responsible and what is the name of those tissue they are known as nodal tissue nodal tissue what are they they are modified they are modified cardiac muscle yes or no they are modified cardiac muscle they are not nerves they are not nerves they are modified cardiac muscle yes or no nodal tissue agreed everyone and they are responsible for contraction of your heart and they are responsible for contraction of your heart so contraction of your heart is taking due to a muscle or a nerve what I have told I have told nodal tissues are responsible for contraction of heart of your heart getting my point getting my point nodal tissues are there so here if you will see they are cardiac muscles so for contraction of your heart muscle is responsible or nerve is responsible everyone hariyaran is saying muscle sardai is saying muscle anybody else please please everyone muscle only hariyaran and sardai is saying nobody else having any idea about this or nothing to say you should answer then only I will move ahead I have told for your heart contraction what is responsible a nerve or muscle aditya kinsukh is saying muscle anybody else aditya is saying muscle I think sir I have written muscle is there gaitri is saying muscle anybody else anybody else ritu sasvat samu c s a n sino arterial node is the part of uh so I am not able to message you anybody else see that is muscle getting my point you are saying s a n sino arterial node that is also part of nodal tissue only getting my point so human heart is myogenic the heart the heart that is going to get its try to understand my the heart that is getting its you can say impulse or stimulus from the muscle that kind of heart is known as myogenic heart okay but heart of lower organism or neurogenic they require like in earthworm and all they require nerves to fire nerves to fire that is known as neurogenic heart so human heart is myogenic or neurogenic tell me myogenic agreed everyone that nodal tissue having these kind of things see over here this is assay node this is ab node connected by inter nodal fibers connected by inter nodal fibers then ab bundle is running through the inter ventricular septum and you can see from the end small fibers are getting originated yes or no know that is known as perkinje fiber together they are going to be known as bundle of his against the name of its discoverer sir will have his junior he was a swiss cardiologist yes or no yes or no have you people understood assay node ab node then ab bundle and these smaller fibers are known as perkinje fiber together they will be known as bundle of his sir will have his junior agreed yes sino arterial node is known as pacemaker and situated in the upper right corner of right atrium ab node is known as paceter situated at the lower left corner of right atrium everyone agree with this agree with this so this is that only that we have discussed already now one important thing what is going to be the pathway what is going to be the pathway let's see one important thing let's see what do you people say about the pathway why i am asking that let's see have you heard about single circulation double circulation and incomplete double circulation have you heard about that tell me what's that what's that let's see actually if you will talk about blood vascular system it is open type and close type in open type capillary system is not present what is a capillary system let's see this is your organ blood vessel will enter your organ will break into capillaries and will leave like a way no point of time the blood vessel is moving out of its you can say blood vessel no point of time the blood vessel is moving out of its you can say blood vessel blood is not moving out of it always remaining inside it only exchange is going to take place this is known as capillary so actually capillary system is absent in the open circulation and it is present in the if it is closed by blood vascular system it is having three pathways one is single circulation one is one is incomplete double circulation another is complete double circulation yes or no please let me know complete double circulation incomplete double circulation and single circulation yes or no everyone say let's see in single circulation heart is two chambered atria and ventricle blood is flowing into ventricle from atria from atria it is going to go into gills here it will get oxygen and becomes oxygenated it will go into the organ supply the oxygen becomes a deoxygenated blood and it is coming to atria here it is deoxygenated in the ventricle also it is deoxygenated and from the ventricle it is leaving like a deoxygenated blood yes or no anybody having any doubt in this have you any doubt tell me dear tell me dear now tell me one more thing it is important at any point of time the heart is receiving oxygenated blood at any point of time the heart is receiving oxygenated blood tell me dear no so if somebody will ask you in which type of circulation heart denote or heart at all not receiving the oxygenated blood what will you say which type of circulation is there single circulation yes it is there in the fissures now incomplete double circulation it is having two atria and only one ventricle it is having two atria and only one ventricle let us see agreed let us see the atria is two and ventricle is one now from here blood is coming and from here also blood is coming left side of atria is receiving oxygenated blood which kind of blood blood with oxygen and right atrium is receiving deoxygenated blood yes or no any doubt in that any doubt in that no tell me dear both kind of blood is getting mixed into it both kind of blood is getting mixed into ventricle so from ventricle here also mixed blood is coming and here also mixed blood is coming so gills lungs or a skin they are they are receiving mixed blood as well as the body is receiving the mixed blood yes or no mixing of blood is here two pathways are formed but they got mixed inside ventricle yes or no tell me tell me dear yes this kind of circulation is there in amphibia reptilia except crocodile except crocodile now the most important one the complete double circulation the complete double circulation part heart is four chambered crocodile apes and mammalia sea over here from the left ventricle originating oxygenated blood through otta through otta it is going to the body here oxygen is supplied and from the body the blood that is you can say moving out is tell me from the body the blood which is going out is deoxygenated blood and it is entering the right atrium through vena cava yes or no it is entering the right atrium through vena cava yes or no everyone everyone should reply dear if you are not getting these things these things are very important you will end up in problem in you can say after that do you people agree hariharan and saddha is agreeing anybody else clear aditya is saying clear anybody else anybody else yes let's see let's see what i am saying dear here here from the right atrium the blood from the right atrium the blood is moving out through pulmonary artery through which artery pulmonary artery agreed so what do you think which kind of blood is there in pulmonary artery oxygenated or deoxygenated what kind of blood is being carried by deoxygenated rest other rest other artery in your body is going to carry oxygenated blood now from here it will go into lung from lung originating pulmonary vein after getting oxygen it will become oxygenated which kind of blood is flowing into pulmonary vein which kind of blood is flowing into pulmonary vein oxygenated agreed oxygenated blood is flowing inside in rest of the vein deoxygenated blood is going to be there everyone agree for this yes or no now one question is there the pulmonary artery carries first deoxygenated blood to the lung second oxygenated blood to brain third oxygenated blood to to the lung fourth deoxygenated blood to the kidney tell me dear what is there anybody having doubt in this this question were asked in kbpy assay 2014 tell me dear any doubt in this any doubt in this others can also answer some of you are just not responding at all please respond I have a habit of that okay usually in my class 70 to 80 students are sitting okay even then I allow them to respond otherwise I do not feel like you can say communication is proper if you are getting you let me know if you are not getting you please say sir I have not understood so that I can do something in time okay understood this question dear if somebody is not able to solve please let me know everyone so have you people understood about these things now some disease of circulatory system some disease of circulatory system let us see disease of heart that is there disease of heart disorders do you people know what all disorders are there that is there that is related to heart let us see let us see dear here is a blood vessel known as coronary artery coronary artery is going to supply blood to the heart wall do you people understand this thing even the blood just give me a minute let me make it suitable for you all first yes yes let us see do you people know heart muscle wall also need some heart muscle wall also need some oxygen because they are living cell too they are also living cells you know tell me dear isn't it for so if I will talk like that if they are living cell in that case are they require oxygen the heart muscle wall cells or muscle cells that are there they will require oxygen they will require oxygen tell me yes that oxygen is going to be supplied by coronary artery which artery is going to supply blood to heart heart muscle wall which artery is there which artery is going to supply coronary artery great now you see due to something that had happened due to something that had happened you see try to understand my point oh I have to make it what had happened try to understand one process is there that is known as atherosclerosis what atherosclerosis due to deposition of cholesterol and all the lumen of this blood vessel started getting narrow started getting narrow over here let us see it got narrowed down it got narrowed down like this here you people can feel it do you think that the muscle wall is going to get ample oxygen now after atherosclerosis no adherence saying no so atherosclerosis is deposition of cholesterol calcium fiber etc in coronary artery this will lead to decreased blood supply to heart muscle yes or no a few people agree after atherosclerosis the blood supply to the you can say heart muscle will you can say increase or decrease after it will decrease if it will not get ample you can say blood in that case it will not get ample oxygen this will lead to decrease decreased blood supply is known as ischemia and decreased oxygen supply to heart is known as hypoxia yes or no hypoxia agreed everyone atherosclerosis had happened atherosclerosis had happened after that is ischemia has taken place and after ischemia what had happened here hypoxia is there and in that case the patient will start feeling a pain inside the chest acute chest pain that is known as angina pectoris what is the name of that chest pain angina pectoris till now you people have understood or not yes hypoxia has decreased oxygen supply clear sasvati is saying clear now if i will try to treat the patient in that case the pain may be relieved if we are not able to relieve the pain in that case what will happen the heart muscle will die it will be dead and that condition is known as heart attack or myocardial infarction what is this what is this tell me dear what is this myocardial infarction or heart attack is irreversible damage to heart muscle in that case what you can do at that time if aspirin tablet is there you can give give 300 mg of aspirin to the patient okay agreed or a streptocyanase is there a streptocyanase is is a enzyme secreted from bacteria streptococcus yes or no it is clot buster it will dissolve the clot yes or no everyone myocardial infarction is there due to what due to that due to some clot or atherosclerosis so how we are going to treat it we will like try to treat it by blood thinning agent that is aspirin yes or no you may have seen that many of you agreed you may have seen that thing you can say oldest person in your house maybe you can say maybe one aspirin yes or no everyone tell me dear tell me have you understood till heart attack have you people understood till heart attack now what will happen after heart attack what will happen will the heart be able to yes aspirin is there if blood is going to be you can say thinned a bit getting more point you will get some time for surgery and all so that is the emergency treatment that we are going to give okay aspirin can be given in myocardial infarction as well as you can say streptokinase can be given okay at your level you try to understand like that only otherwise many other conditions are there that a doctor looks fully you can say look for agreed aspirin is a blood thinning agent only okay many of you can say old age person in your house maybe using it yes or no the grandfather and all agreed everyone say yes or no clear yes now I will say atherosclerosis has taken place ischemia after that hypoxia after that angina factor is after that if not treated in time myocardial infarction has taken place do you think any any pressure or any change is going to be there in the pumping activity of heart do you think it is going to happen is there any change in pumping a you can say capacity of if some part of heart is damaged some part of heart wall is damaged will the heart pump you can say blood like earlier or it will decrease it will decrease yes of course it will decrease so your body is going to get less amount of blood now so when do one fail as a student when we fail when we are not able to score that much which is required to pass the exam heart will fail when the heart will not be able to meet the demand of the body that will be what heart failure that will be what heart failure agreed everyone yes heart failure or cardiac failure so there is a difference between heart attack and heart failure once heart attack will be there after that heart failure will be you can say will take place and this condition can not continue for long after some time heart will say I am not going to beat anymore once heart will stop as you can say stop beating that condition will be known as cardiac arrest yes or no let's see what they will do they can perform angiography angiography by angiography what happens they are going to inject a radioactive dye that dye will make everything white but that let's see I have injected a radioactive dye and I am taking a photograph wherever the blood is flowing it will become white okay and the in area where blood is not flowing it will be black only okay if this kind of photo will be there that means in this area some constriction is there okay means in this area this lumen is narrowed down yes or no so by angiography you will get to know where the blockage is there agreed everyone radioactive dye will be injected in the blood wherever it will go it will look like it is white yes or no you can say radio and not radioactive actually that you can say radio opaque will be the right word okay it is the diagnostic I will say radio opaque let's see radio opaque okay so radio opaque dye will be injected and by angiography we will find out where the blockage is actually yes or no now what will I do I will insert a I will insert a with the help of camera and all we are we are going to insert it here I am going to make it swell over here that is like a balloon at this end balloon is there we are going to in plate that you can save that balloon it will push it outwards and I will leave a stent over here that is known as angioplasty getting my point you people try to think for two minutes I am just coming back give me a minute yes dear have you people understood this thing angiography and angioplasty what is the difference yes you are right that is dangerous there is chance of rupture of blood vessel getting my point there is chance of rupture of blood vessel usually this is done in the younger person angioplasty is done in younger person because their blood vessel is elastic that is not going to rupture that easily okay a person having you can say age around 40 years or so in much older individual open heart surgery is performed open heart surgery is performed yes or no tell me open heart surgery is performed everyone what they do in that they expose the heart getting my point they take a blood vessel which is not that useful okay from the body itself okay they will create a alternate pathway they will bypass this plot now blood is not flowing through this rather blood will flow through this and this is going to be known as bypass surgery agreed that is going to be known as bypass surgery have you people understood the meaning of what bypass tell me dear heart attack cardiac failure and cardiac rest yes I will surely explain earlier and I am going to explain it have you people understood what is angioplasty what is angiography and what is you can say you can say bypass surgery in bypass surgery actually we are bypassing it through this by connecting a artery across the clot or the you can say this thing now you are saying sir please explain between heart attack see what is heart attack when this muscle is not getting oxygen this muscle got damaged that is heart attack yes or no so irreversible damage to heart muscle or wall of heart is what heart attack yes or no tell me dear yes once this part of heart is damaged do you think that heart is going to pump the blood like before it is doing before is it like that yes or no no in that case will the heart be able to meet the demand of your body will the heart meet you you can say the demand of the body tell me when heart will not be able to meet the demand of your body yes not fully that is only heart failure and it if heart failure will be there after some time heart will start you can say you can say stop beating you can say when heart will stop beating that will be known as what that will be known as what tell me that will be known as heart no when heart will stop beating that will be known that will be known as heart failure or cardiac failure yes no no no please see to it I think I even I have explained it wrongly heart failure is when it is not meeting the demand of the body and cardiac arrest is when heart stops beating agreed cardiac arrest yes you are right so the cardiac failure is when the heart is not able to like see in an exam when do you fail you are not going to get that much you can say number which is required yes or no in that case you say that somebody has failed sardha yes or no yes same is there with heart also if heart is not able to meet the demand of the body in that case what will we say we will say that heart has failed and after many failures heart will stop beating that is arrest yes or no have you I think I am able to explain to you people all these things now one is a stroke one is a stroke what do you think what is a stroke what is a stroke tell me dear see what happens bit increasing is blood vessel elasticity okay blood vessel is no more elastic now I told blood vessel is no more elastic now in that case at times what happens a pressure will be there blood vessel will rupture agreed that can be known as stroke also agreed please think all these things for two minutes you people can think upon these things these are very important things agreed anybody having doubt anybody having doubt no you people have understood all these things fully can cardiac arrest be reversed using bypass no once heart see many things are there you must have seen in the you can say pictures after somebody as you can say fallen unconscious they are pressing the chest with some iron like thing yes or no have you seen that that can be done once cardiac arrest had happened no use of bypass surgery is there you are not going to get that time if for that much time blood is not flowing in that case things will be difficult okay no issues everyone everyone so this is there now if we will talk about these things one more thing I will like to tell you all all one is cardiac cycle what is their cardiac cycle agreed you people can do like this have you done like this before you people keep on doing like this no you are going to feel some thrust from inside yes or no you are going to feel some thrust from inside what is that that is actually contraction of ventricle that is known as systole and relaxation is known as diastole so all the series of event that is taking place between consecutive heartbeat is known as cardiac cycle all the series of event taking place between consecutive heartbeat is known as cardiac cycle yes or no everyone series of event taking place between consecutive heartbeat getting my point heart rate is 75 beats per minute agreed so what do you think what is the duration of one cardiac cycle in 60 seconds you are going to get 75 cycles so for one cycle it is around 0.8 second yes or no everyone here if you people are going to divide them into eight equal halves this is 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 like that only getting my point the contraction of atria is going to be there for 0.0 to 0.1 second okay and atria is going to relax for 0.1 to 0.8 second yes or no everyone everyone atria is going to contract for only 0.1 second and it will be relaxing for 0.7 second everyone no issues no issues tell me dear now if you will talk about ventricular event ventricle is you can say contracting between 0.1 to 0.4 second and for rest of the time it is relaxing so can you people see contraction is known as ventricular systole and rest is known as ventricular diastole yes or no now one thing I want to ask you all see from 0.4 to 0.8 second what is there from 0.4 to 0.2 you can say 8 second what is there which is there in the systole and which is there in the diastole complete diastole both are there in the diastole that is known as joint diastole when both atria and ventricular in diastole okay you people can read a bit about heart sounds and if you have any issues you can ask okay now one is excretory system what do you know about excretory system it is the excretion is elimination of metabolic waste do you people agree do you people agree excretion is excretion of metabolic waste no issues now if your food is carbohydrate its metabolic waste will be CO2 and H2O and if it is lipid it will be ketone bodies if it is protein it is NH3 ammonia and urea yes or no everyone getting my point have you people heard about hunger strike that you can say people used to do for protesting fast carbohydrate will be utilized then lipids will be utilized and after that muscle protein will be there that is going to be utilized to produce energy so first one or two days it will be all right after that once lipid will be a start you can say lipid will start breaking down it will convert into ketone bodies what yes or no yes or no and this ketone bodies will come into urea and that process is known as ketone urea yes or no so if somebody will ask you in hunger strike what can be the sign that's you can say the person is sitting on hunger hunger strike what do you think what should be there is it ketone urea because for first one or two days the carbohydrate stored is going to provide you or provide that person with energy yes or no agreed and after that what will start breaking down tell me lipid and once lipid will break down what will be there in the body ketone bodies no and that ketone bodies will come into urea and that signifies that that person is sitting on hunger strike now talking about excretory system porifera, silentrata, tinofora and ikainodermata is there they do not have any excretory system you are aware about the phylumsina you people are aware about the phylumsina these names yes so these phylums do not have any excretory system in place fatty element is flame cells and protonapridia a scale menthys excretive tube with renate cell anelida napridia is there in arthropoda class insecta malpighian tibule crustacean the crown is there very delicious okay green gland and or you can say orantinal gland these are the names arachnids coxal gland in that a scorpion and spiders are there molusca cabers organ this is important amicodata proboscis gland invertebrates kidneys there yes or no so that is there to be mugged up point so you people can learn a bit now we will talk about human excretory system you see over here human excretory system is consisting of two kidneys ureter okay urinary bladder and urethra they are there you see this ureter is opening over here this ureter is opening over here and here is the opening of urethra is there you will connect to them you will form a triangle this is known as trigone yes or no everyone everyone this is known as trigone now can you observe this line and please be agree with me observe this tell me dear do you people agree see right kidney is on slightly on the lower side because on right side liver is there yes or no everyone yes right side liver is there now see urethra having two sphincter one is internal urethral sphincter one is external urethral sphincter now retroperitoneal organ is the kidney do you know what is the meaning of retroperitoneal see this is your anterior body wall towards stomach this is your posterior body wall towards your back you see one peritoneum is one peritoneum is going to line this another peritoneum is going to line this like this okay all your organ the esophagus the stomach the intestine the heart all are present in this space okay well covered by peritoneum and this peritoneum is only going to be known as pericardium in heart pleura in lung yes or no tell me dear everyone yes but it is slightly different in case of kidney it is situated over here behind the peritoneum yes or no and directly attached to the body wall peritoneum is above it so kidney is retro means behind situated behind the peritoneum everyone will talk about the structure of kidney it is divided into outer cortical part and inner medullary part medulla medulla of kidney is not continuous rather in the form of renal medullary pyramid here is the these are the medullary pyramids agreed everyone now you see this is this blue one is cortex this blue one is cortex this one this one is cortex now you see can you see cortex extending between can you see cortex extending between the medullary pyramid can you see that cortex is is extending between medullary pyramid or not everyone is yes sardai is saying yes rest are tired now not able to answer please dear is the Hariyaran is saying yes you know what is that known as that is known as that is known as renal column of botany part of renal cortex extending between renal medullary pyramid agreed is known as what extend you see now it should be till here only but it is not like that it is going down so part of cortex extending between renal medullary pyramid is known as renal cortex now you see this pyramid this pyramid is going to open into minor calyx from here okay few minor calyx are going to form major calyx these major calyx will form the renal pelvis and renal pelvis eventually opens into urator yes or no do you people agree with this yes or no tell me dear agreed now completely agreed completely agreed with this now you know that your kidney is going to be consists of nephron which is the structural and functional unit of kidney it is consisting of following parts nephron is consisting of glomerulus and renal tibule two segments are there renal tibule consisting of Bowman's capsule loop of Henley PCT and DCT Bowman's capsule loop of Henley PCT and DCT yes or no tell me tell me dear there is one definition that is of uriniferous tibule it consists of it includes collecting duct also it includes collecting duct also no issues so you see over here this part is glomerulus this part is glomerulus everyone this part is glomerulus this is Bowman's capsule this one this structure in tubular part this is PCT this is Henley's loop it is going down hence descending limb of Henley's loop this is going up hence ascending limb of Henley's loop yes or no this is DCT this is collecting duct yes or no try to understand my point try to understand my point why this word proximal is used proximal means close close to Bowman's capsule is proximal and away from Bowman's capsule is distor yes or no everyone glomerulus and Bowman's capsule together known as Malpigean body or renal corpuscles yes or no everyone Malpigean body or renal corpuscles one thing now one last thing that I will like to discuss with you all to you people know that descending limb of Henley's loop is permeable for water and ascending limb of Henley's loop is permeable for electrolyte do you people know that anyone of you know let us see see this is the descending limb now do you people know a structure of plasma membrane a structure of plasma membrane do you people see the you can say know that so yes you know that this part apart from head is hydrophobic hydrophobic means water cannot pass through this on its own yes agreed everyone agree let us see water cannot pass through this so for that one protein is there which comes from this side because I start from this side and reach till here through this only water can pass this is water channel what is there water channel this is known as aquaporins what porins agreed everyone this is known as aquaporins yes or no let us see let us see descending limb having those aquaporins because of that only this and descending limb is permeable for x2o x2o can come and go ascending limb do not have aquaporins hence it can know you can say move water across it yes or no so descending limb is permeable for what descending limb is permeable for what water and ascending limb is permeable for na plus k plus like electrolyte agreed so you people can see this thing rest you are we will be doing in the next class agreed good night everyone