8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
1/27
MOQJLMI LGEEKNK GO HKMESH (MLH)
@AA\ ZKMQ 1, \K@K\SKQ
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
2/27
TMSHGEGNZ (@GICMZ)
Sh& &!! m' &!! ;?#2
\SQ%LS%QK MIC O%ILSJGI GO LKEE LG@TGIKIS\>
Iulekus Shk iulekus js lg`pgskc prjiljpmeey go
ckgxyrjagiulekjl mljc (CIM) ji lg`ajimtjgi wjth m
prgtkji (hjstgik) wjthji m nrguic suastmilk. Shk
iulekjl mljc `mtkrjme (lhrg`mtji) stmjis wkee wjth
amsjl cyks sulh ms hmk`mtgxyeji mic `kthyekik aeuk, mic
CIM lmi ak stmjikc spkljojlmeey ay thk Okuenki
tklhijuk. !hrg`mtji pmttkris "mry org` lkee tg lkee.
Shk pems`m lkee, ogr kxm`pek, hms m cjstjiltj"k
#lmrtwhkke# pmttkri. Sh& ?!&?*js skpmrmtkc org` thk
lytgpems` ay m cguaek `k`armik $ thk iulekmr ki"kegpk $
lgitmjijin ljrluemr hgeks %& tg '& i` ji cjm`ktkr $
iulekmr pgrks. Shk pgrks, whjlh mrk usumeey lrgsskc ay
m cjoousk `k`armik, prgamaey rkprkskit thk sjtks go
jitkrlhmink aktwkki iulekus mic lytgpems`.
O?t* 4 th& ?!&?*2
. kpejlmtjgi go CIM
*. +rgcultjgi go `ksskinkr IM
. -yithksjs go sg`k iulekmr prgtkjis Iulekgeus Shk
iulekus igr`meey lgitmjis gik gr `grk s`mee amsgphjejl
strulturks iulekgej, lg`pgskc go m ckisk iktwgr
(iulekgegik`m) kilegsjin pmekr mrkms (thk pmrs
m`grphm). Shk nrmiueks go thk iulekgegik`m mrk thgunht
tg rkprkskit ikwey$syithksj/kc rjagsg`k suauijts whjlh
pmss gut go thk iulekus megin wjth `ksskinkr IM mic
cjrklt thk syithksjs go spkljojl prgtkjis ji thklytgpems`. !ytgpems` !ytgsge cjookrs org` kxtrmlkeeuemr
oeujc ji hm"jin m hjnh lgilkitrmtjgi go pgtmssju`,
`mniksju` mic phgsphmtk. -gcju` js mltj"key kxleuckc ay
thk MS+$ckpkickit #sgcju`$pu`p# mlrgss thk lkee
`k`armik. 4miy ouiltjgis rksjck ji thk lytgsge gr
lytgpems`jl `mtrjx, im`key=
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
3/27
. 1eylgeysjs
*. -g`k rkmltjgis ji neulgikgnkiksjs
. Mltj"mtjgi mic syithksjs go sg`k m`jig mljcs
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
4/27
thk rgunh ? js usumeey ogr kxpgrt "jm thk 1genj
mppmrmtus. jagsg`ks mrk amsgphjejl sg thmt thk
lytgpems` go lkees lmpmaek go rmpjc prgtkji syithksjs
stmjis wkee wjth hmk`mtgxyeji gr pyrgiji. ?xm`peks go
lkees shgwjin sulh lytgpems`jl amsgphjejm mrk pems`m
lkees, kxglrjik lkees go thk pmilrkms, mic hkpmtglytks.
Shk s`ggth ? js lgilkrikc wjth syithksjs go
trjneylkrjcks org` orkk omtty mljcs, crun `ktmagejs`
mic cktgxjojlmtjgi, neylgnki syithksjs, mic thk
syithksjs go stkrgjc hgr`giks. !kees rjlh ji s`ggth ?
(ms wkee ms `jtglhgicrjm) shgw m nrkmtkr moojijty ogr
mljcjl cyks sulh ms kgsji mic mljc oulhsji.
Sh& N!" m88mmt?*2Shk 1genj mppmrmtus js m skrjks go
`k`armik em`keemk, `k`armik aguic "mlugeks mic s`mee"ksjleks, akst skki ji sklrktmry lkees sulh ms thgsk go
thk kxglrjik pmilrkms, ngaekt lkees, mic thk masgrptj"k
lkees go thk nut. Shk 1genj js thgunht tg pmlmnk
sklrktjgis whjlh rkmlh jt thrgunh thk ljstkrimk go thk
?. Shk sklrktjgi nrmiueks thki auc goo mic `jnrmtk tg
thk mpkx go thk lkee. 4jlrgojem`kits 4jlrgojem`kits mrk
thji ojem`kits wjth mi m"krmnk cjm`ktkr go 3 i`
lg`pgskc go pgey`krj/kc mltji. Shky mrk usumeey oguic
ji auiceks wjthji m iktwgr mic mrk j`pgrtmit ji
rktmjijin thk shmpk go lkees mic ji lkee `gtjejty.
@t?:?!&*24jlrgtuaueks mrk igi$lgitrmltjek
strulturks, magut *% i` ji cjm`ktkr, mic go "mrjmaek
ekinth. Shky mrk lg`pgskc go suauijts (cj`krs) go
tuaueji whjlh lmi ak rmpjcey rk$mssk`aekc thus
prg"jcjin m cyim`jl lytgskektgi, mic mrk oguic ji
ljejm mic oemnkeem ms wkee ms ogr`jin `jtgtjl spjiceks
mic lkitrjgeks ji mee typks go lkees. 4jlrgtuaueks mrk
ji"ge"kc ji=
. 4mjitmjijin thk lytgskektgi
*. 4jtgtjl cj"jsjgi
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
5/27
. Srmispgrt pmthwmys ogr sklrktjgis mic gthkr
grnmikeeks
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
6/27
wjth prj`mry eysgsg`ks. Cjnkstjgi prglkkcs ji thk
sklgicmry eysgsg`ks sg$ogr`kc mic prgcults cjoousk gut
tg ak rk$utjejskc ay thk lkee. 2icjnkstkc `mtkrjme lmi
ji sg`k jistmilks ak kxpkeekc ay kxglytgsjs, gthkrwjsk
jt rk`mjis ji thk lkee ms m rksjcume ckisk agcy.
?xm`peks go prgtkjis tmki jitg lkees mic cjnkstkc
wjthji eysgsg`ks mrk=
. :mk`gnegaji
*. Imtj"k j``uignegaueji mic j``uik lg`pekxks
. Ckimturkc prgtkjis
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
7/27
hycrgphgajl ejpjc `gjktjks jitkrimejskc mic thk
prgtkjis (mic neylgprgtkjis) prkskit ms=
. ;itknrme `k`armik prgtkjis $ negauemr prgtkjis
jitkrlmemtkc tg "mryjin ckpths wjthji thk ajemykr mic
ji sg`k jistmilks lg`pektkey spmiijin thk `k`armik.
;itknrmtkc neylgprgtkjis mrk mewmys mrrminkc sg thmt
thkjr lmraghycrmtk `gjktjks mrk kxpgskc mt thk lkee
suromlk whkrk thky mlt ms spkljojl rklkptgr `geklueks.
5hjest sg`k jitknrme prgtkjis mrk lmpmaek go emtkrme
`g"k`kit wjthji thk ejpjc ajemykr (thus metkrjin thk
`gekluemr pmttkri prkskitkc mt thk suromlk) gthkrs
mppkmr tg ak mttmlhkc tg `jlrgtuaueks mic
`jlrgojem`kits mic `kcjmtk #trmis`k`armik lytgskektme
lgitrge#
*. +krjphkrme `k`armik prgtkjis $ mrk igt ksskitjme tg
strulturme jitknrjty mic mrk aguic tg jitknrme prgtkjis
gr neylgejpjcs ay jgijl agics. Shk lkee `k`armik hms m
iu`akr go j`pgrtmit ouiltjgis=
. ;itmk go kxgnkigus `mtkrjme ay phmnglytgsjs,
pjiglytgsjs gr `jlrgpjiglytgsjs
*. -kekltj"k pkr`kmajejty
. Shk MS+$mssgljmtkc sgcju`$pu`p whjlh mltj"key shjots
sgcju` jgis mlrgss thk `k`armik gut go thk lytgpems`
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
8/27
'. klgnijtjgi $ thk lmpmljty tg rklgnijsk ogrkjni
mitjnkis mic metkrkc gr kooktk hgst lkees, rksjcks mt
thk lk `k`armik mic js `kcjmtkc ay lkee$aguic
mitjagcjks gr mitjagcy$ejk `geklueks
9. klkptgr sjtks ogr stj`uemtgry hgr`giks, lytgjiks
mic gthkr lhk`jlme `kcjmtgrs.
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
9/27
@KCJLME \SMSJ\SJL\ (S%K\CMZ)
Jt'?t2
-tmtjstjls js thk sljkilk go lgeekltjin, su``mrj/jin,
prkskitjin mic jitkrprktjin cmtm, mic go usjin thk` tgkstj`mtk thk `mnijtuck go mssgljmtjgis mic tkst
hypgthksks. ;t hms m lkitrme rgek ji `kcjlme
ji"kstjnmtjgis. Igt giey cgks jt prg"jck m wmy go
grnmij/jin jiogr`mtjgi gi m wjckr mic `grk ogr`me amsjs
thmi rkeyjin gi thk kxlhmink go miklcgtks mic pkrsgime
kxpkrjkilk, jt tmks jitg mllguit thk jitrjisjl
"mrjmtjgi jihkrkit ji `gst ajgegnjlme prglkssks.
Ogr kxm`pek, igt giey cgks aeggc prkssurk cjookr org`
pkrsgi tg pkrsgi, aut ji thk sm`k pkrsgi jt mesg "mrjks
org` cmy tg cmy mic org` hgur tg hgur. ;t js thk
jitkrprktmtjgi go cmtm ji thk prkskilk go sulh
"mrjmajejty thmt ejks mt thk hkmrt go stmtjstjls.
-tmtjstjls js uskc tg k"meumtk thk mssgljmtjgi aktwkki
mi kxpgsurk "mrjmaek mic thk gutlg`k go jitkrkst. 4grk
spkljojlmeey, jt js uskc tg `kmsurk thjs mssgljmtjgi ji
thk cmtm lgeekltkc org` thk pmrtjluemr sm`pek go
jicj"jcumes ji gur stucy mic tg `mk jiokrkilks magut
jts ejkey sj/k mic strkinth ji thk pgpuemtjgi org`
whjlh thk sm`pek wms ckrj"kc.
OJICJIN SHK QJNHS \SMSJ\SJLME @KSHGC2
Shk mpprgprjmtk stmtjstjlme `kthgcs tg usk ckpkic gi
thk imturk go thk gutlg`k "mrjmaek go jitkrkst. thky
`my ak ksskitjmeey gik go thrkk typks=
. Iu`krjlme gutlg`ks, sulh ms ajrth wkjnht gr
lhgekstkrge ek"ke.
*. 7jimry gutlg`ks, su``mrj/kc ms prgpgrtjgis, rjss gr
gccs, sulh ms thk prg$ pgrtjgi go lhjecrki cjmnigskc
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
10/27
wjth msth`m, thk prgpgrtjgi go pmtjkits ji kmlh
trkmt`kit nrgup whg mrk ig eginkr hypkrtkisj"k, gr thk
rjs go cyjin ji thk ojrst ykmr go ejok.
. mtks go `grtmejty, `grajcjty gr sur"j"me `kmsurkc
eginjtucjimeey g"kr tj`k, sulh ms thk sur"j"me rmtks
ogeegwjin cjookrkit trkmt`kits ogr arkmst lmilkr, gr
thk iu`akr go kpjsgcks go cjmrrhgkm pkr pkrsgi pkr ykmr
m`gin M;C- pmtjkits.
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
11/27
TMSHGEGNZ (^KCIK\CMZ)
TQGSKGEZ\J\ MIC TQGSKJI OGECJIN2
5hjek jt js skeo k"jckit thmt rmpjc mic koojljkit
prgtkgeysjs js lkitrme tg thk prgpkr ouiltjgijin go thk
lkee, jt js giey rklkitey thmt thk `klhmijs`slgitrgeejin prgtkgeysjs hm"k aknui tg ak uickrstggc.
Ogr jistmilk, thkrk js m "kry legsk lgiikltjgi aktwkki
prgtkgeysjs mic lgitrge go thk lkee lylek. ;ickkc m
sjinek prgtkji, lyleji 7, whjlh mllu`uemtks curjin thk
1j mic - phmsks `ust ak cknrmckc ogr lkees tg kxjt
`jtgsjs.
6ik go thk `m0gr omltgrs ji thk rknuemtjgi go sulh
cknrmcmtjgi js thk prgtkji uajujtji. Ms jts im`k
j`pejks, thjs prgtkji js hjnhey lgiskr"kc thrgunhgut
kumrygtks, mic js uijuk ji jts majejty tg aklg`k
rk"krsjaey lrgss$ejikc tg gthkr prgtkjis. ;i cgjin sg
jt js ejkey thmt uajujtji skr"ks ms m `g"maek ajicjin
sjtk ogr prgtkjis thmt cg igt hm"k lg`pek`kitmry
strulturks mic ay arjinjin sulh prgtkjis jitg legsk
mssgljmtjgi js mi ksskitjme lg`pgikit go `miy j`pgrtmit
prgtkgeytjl pmthwmys. Shk prgpkr ouiltjgijin go ikwey
syithksjskc prgtkjis js ckpkickit upgi thk` mttmjijin
thk lgrrklt thrkk cj`kisjgime lgiojnurmtjgi.
Shk lg`pekx ogecjin go pgeypkptjcks ji"ge"kc ji thjs
prglkss js lgitrgeekc ay gthkr prgtkjis whjlh mrk
kjthkr ki/y`ks prg`gtjin cjsuephjck ogr`mtjgi mic
jsg`krjsmtjgi, gr `k`akrs go m om`jey go prgtkjis whjlh
stmajejsk uiogeckc mic pmrtjmeey ogeckc strulturks mic
prk"kit thk ck"kegp`kit go jimpprgprjmtk jitrm$ mic
jitkr$lhmji agics. Shky mlhjk"k thjs wjthgut thk`ske"ks
aklg`jin jilgrpgrmtkc jitg thk strulturk. Shksk
prgtkjis mrk tkr`kc lhmpkrgiks mic mrk "jtme tg thklgrrklt trmiseglmtjgi, mssk`aey, cjsmssk`aey mic
trmispgrt go pgeypkptjcks mic prgtkji gejng`krs. Shk
prgtkjis ojrst lm`k tg igtjlk whki oguic ji kxlkssj"k
m`guits ms pmrt go thk lkeeuemr rkspgisk tg hjnh
tk`pkrmturk, hkilk thk im`k #hkmt$shgl# prgtkjis. Igw
thmt jt js mpprkljmtkc thmt thky mrk ksskitjme tg
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
12/27
igr`me ouiltjgi mic jilrkmskc ji `miy ogr`s go ji0ury
thky mrk tkr`kc strkss prgtkjis mic lhmpkrgik.
LKEE 6 LKEE MCHK\JGI2
. Duiltjgime `klhmijs`s
(j) Cks`gsg`ks $ jitkrlkeeuemr 0uiltjgis ejikc tg thk
jitkr`kcjmtk ojem`kits go thk lytgskektgi. Shky mrk
lg`pgskc go m skrjks go trmis`k`armik neylgprgtkjis mic
prgtkjis tkr`kc cks`gnekjis mic cks`gpemjis
(jj) Mchkrkis 0uiltjgis whjlh lgitmji cjookrkit ogr`s
go trmis`k`armik mchksjgi `geklueks, thk `mji `k`akrs
akjin thk lmchkrji om`jey. Shksk `geklueks mrk
rkspgisjaek ogr lmelju` ckpkickit jitkrlkeeuemr
mchksjgi. 6thkr 0uiltjgis aktwkki lkees, im`key nmp mictjnht 0uiltjgis, mrk igt mchksj"k strulturks. Shkjr
ouiltjgi js tg meegw thk pmssmnk go s`mee `geklueks
jitg, gr aktwkki, lkees.
*. Igi$0uiltjgime `klhmijs`s ;itkrlkeeuemr mchksjgi js
mesg omljejtmtkc ay `k`armik$aguic lkee mchksjgi
`geklueks (!M4s). -g`k !M4s mrk spkljojl tg lkrtmji
tjssuks whkrkms gthkrs, ogr kxm`pek sg$lmeekc ej"kr
lkee mchksjgi `gekluek (8$!M4), mrk wjckey cjstrjautkc
ji kpjthkejme mic gthkr tjssuks. Shk kxjstkilk go igi$spkljojl mchksjgi `geklueks `kmis thmt giey m s`mee
rkpkrtgjrk go sulh `geklueks js rkujrkc ogr mchksjgi
aktwkki m `uetjpejljty go lkee typks.
LKEE 6 @MSQJ5 MCHK\JGI2
. Duiltjgime `klhmijs`s
(j) :k`jcks`gsg`ks ajic lkees tg thkjr suastrmtu`
(jj) Oglme lgitmlts
*. Igi$0uiltjgime `klhmijs`s Shk lkee suromlk js
kujppkc wjth m "mrjkty go rklkptgrs ogr kxtrmlkeeuemr
`mtrjx `geklueks sulh ms ojargikltji mic em`jiji. Shk
`m0gr rklkptgrs mrk `k`akrs go thk jitknrji om`jey.
eitknrjis mrk hktkrgcj`krs thmt rklgnijsk mic ajic tg m
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
13/27
spkljojl m`jig$mljc skukilk ji thk `mtrjx `gekluek.
Shky mrk trmis`k`armik prgtkjis whgsk lytgpems`jl
cg`mjis jitkrmlt thrgunh jitkr`kcjmtk prgtkjis sulh ms
"jilueji gr tmeji tg ajic tg mltji `jlrgojem`kits. Shus
jitknrjis mlt ms mi j`pgrtmit arjcnk aktwkki amsk`kit
`k`armik gr lgiikltj"k tjssuk `mtrjx prgtkjis mic
jitrm$lytgpems`jl `jlrgojem`kits mic pkr`jt milhgrmnk
go lkees tg `mtrjx lg`pgikits.
SHK LKEE LZLEK MIC LKEE QKTQGC%LSJGI2
Motkr cj"jsjgi (`jtgsjs) thk lkee kitkrs thk ojrst
rkstjin phmsk $ 1j (1mp ). Shjs phmsk js "mrjmaek mic
ji sg`k lkees `my ak sg prgeginkc thmt thky mrk
kookltj"key gut go lylek (1g). Shky `my rkturi tg thklylek gr aklg`k oueey cjookrkitjmtkc #kic$lkees#
jilmpmaek go cj"jsjgi. -$phmsk js lgilkrikc wjth thk
syithksjs go CIM mic hjstgiks tmjin thk lkee up tg m
tktrmpegjc stmtk.
Mt thk sm`k tj`k thkrk js pmrmeeke syithksjs go IM mic
prgtkjis. Shk lkee thki kitkrs m sklgic, arjko rkstjin
phmsk $ 1* (1mp *) whjlh js ogeegwkc ay `jtgsjs. ;o
agth #cmunhtkr# lkees kitkr thk rkpejlmtj"k lylek thki
thk tgtme iu`akr go lkees wjee cguaek wjth kmlhnkikrmtjgi mic thk pgpuemtjgi wjee nrgw kxpgikitjmeey.
5hjest thjs cgks gllur ji thk kmrey stmnks go k`arygijl
ejok, emtkr ji ck"kegp`kit thk lkees cg igt j``kcjmtkey
kitkr thk lylek sg thmt cguaejin tj`ks mrk prgeginkc.
Swg lmtkngrjks go cj"jcjin lkees mrk rklgnijskc, stk`
lkees mic prgnkiy lkees=
. -tk` lkees mrk lmpmaek go prgculjin cjookrkit ogr`s
go prgnkiy lkee. 5hki thky cj"jck thky nj"k rjsk tg gik
rkpemlk`kit stk` lkee mic gik cj"jcjin prgnkiy lkee.
*. +rgnkiy lkees cj"jck aut mesg cjookrkitjmtk jitg gik
gr `grk typks go spkljmejskc lkees. Shus, thk prgnkiy
lkee pgge nrmcumeey cj"krnks ji ogr` mic ouiltjgi mic
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
14/27
js giey rkikwkc ay jiput org` thk stk` lkees. Shk rmtk
go nrgwth go m tjssuk js m ouiltjgi go thk orkukily
wjth whjlh stk` lkees rkprgculk mic suppey thk prgnkiy
pgge mic thk iu`akr go #m`pejoyjin# cj"jsjgis uickrngik
ay thk prgnkiy lkees curjin thkjr ejoktj`k. Sh& ?/:&
4 *?h m/8!4#" '0** * /'4&' :#2
. Shk spmtjme cjstrjautjgi go lkees wjthji m tjssuk
*. -uromlk mttmlh`kits
. !ytgjiks mic thkjr rklkptgrs
LZSGFJIK\2
!ytgjiks mrk m om`jey go neylgsyemtkc gr igi
neylgsyemtkc pgeypkptjcks mic prgtkjis sklrktkc ay
lkees ji rkspgisk tg m stj`ueus whjlh `gcuemtks thkakhm"jgur go tmrnkt lkees. Shky kxkrt thkjr kooklts ji
thrkk wmys=
(j) Shky mlt gi thk lkee prgculjin thk` $ mi mutglrjik
kooklt
(jj) Shky mlt gi lkees ji thk "jljijty go thk prgculjin
lkee $ m pmrmlrjik kooklt
(jjj) Shky mlt systk`jlmeey gi cjstmit sjtks $ mi
kicglrjik kooklt.
L!m**&* 4 #t3&*>
. 1rgwth omltgrs
*. !gegiy stj`uemtjin omltgrs
. ;itkrekujis
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
15/27
Nth 4mt*>Shksk mrk s`mee pgeypkptjcks prgculkc
ay "mrjgus lkees. Shky hm"k m iu`akr go mltjgis, thk
`gst j`pgrtmit go whjlh mrk thk lgitrge go lkee
prgejokrmtjgi mic cjookrkitjmtjgi..
(j) ?pjckr`me nrgwth omltgr om`jey m. ?pjckr`me nrgwth
omltgr a. Srmisogr`jin nrgwth omltgr (x l. M`phjrknueji
Shksk 1Os mrk prgculkc ay `miy lkee typks. Shky
jitkrmlt wjth thk kra$7 om`jey go rklkptgrs mic mrk
j`pgrtmit ji kpjthkejme lkee prgejokrmtjgi mic
cjookrkitjmtjgi
(jj) +emtkekt ckrj"kc nrgwth omltgr (+C1O) Cj`krs go
twg suauijts +C1O$M mic +C1O$7 prgculkc ay pemtkekts,
kicgthkejme lkees, mltj"mtkc `mlrgphmnks ktl.,
j`pgrtmit ji tjssuk rkpmjr mic lhrgijl jioem``mtgryprglkssks
(jjj) Srmisogr`jin nrgwth omltgr & om`jey
m. S1O+$ (`m0gr mltjgis $ nrgwth rknuemtjgi,
lgiikltj"k tjssuk syithksjs )
a. 74+*M, *7 mic (agik `grphgnkiksjs)
l. ;ihjajis M mic 7 (rknuemtjgi go pjtujtmry ngimc
mxjs)
c. Mltj"ji M mic M7 (mitmngijs` go jihjajis mltjgis) k.
4ueekrjmi jihjajtgry suastmilk (ck"kegp`kit go `mek
rkprgcultj"k systk`)(j") Ojargaemst nrgwth omltgr (O1O)
m. Mljcjl O1O
a. 7msjl O1O
l. jit *
c. O1O%
k. hst
Shksk 1Os mrk pgtkit stj`uemtgry omltgrs ogr
ikurgkltgckr`me lkees, kicgthkejme lkees, ojargaemsts
ktl., mic pemy m `m0gr rgek ji k`arygnkiksjs
(") ;isueji$ejk nrgwth omltgr
m. Sypk ;
a. Sypk 4kcjmtk mltjgi go hgr`giks sulh ms nrgwth
hgr`gik
("j) Ikr"k nrgwth omltgrs
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
16/27
m. Ikr"k nrgwth omltgr
a. Ikurgekuji Ikurgtrgpjl omltgrs ogr ikurme tjssuks
whjlh pemy m rgek ji wguic hkmejin
1$ L!# *t/?!mt" 4mt*>
knuemtk thk prgejokrmtjgi mic cjookrkitjmtjgi go
hmk`mtgpgjktjl lkees.
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
17/27
@KCJLME \SMSJ\SJL\ (SH%Q\CMZ)
Jt'?t2
-tmtjstjls js thk sljkilk go lgeekltjin, su``mrj/jin,
prkskitjin mic jitkrprktjin cmtm, mic go usjin thk` tgkstj`mtk thk `mnijtuck go mssgljmtjgis mic tkst
hypgthksks. ;t hms m lkitrme rgek ji `kcjlme
ji"kstjnmtjgis. Igt giey cgks jt prg"jck m wmy go
grnmij/jin jiogr`mtjgi gi m wjckr mic `grk ogr`me amsjs
thmi rkeyjin gi thk kxlhmink go miklcgtks mic pkrsgime
kxpkrjkilk, jt tmks jitg mllguit thk jitrjisjl
"mrjmtjgi jihkrkit ji `gst ajgegnjlme prglkssks.
Ogr kxm`pek, igt giey cgks aeggc prkssurk cjookr org`
pkrsgi tg pkrsgi, aut ji thk sm`k pkrsgi jt mesg "mrjks
org` cmy tg cmy mic org` hgur tg hgur. ;t js thk
jitkrprktmtjgi go cmtm ji thk prkskilk go sulh
"mrjmajejty thmt ejks mt thk hkmrt go stmtjstjls.
-tmtjstjls js uskc tg k"meumtk thk mssgljmtjgi aktwkki
mi kxpgsurk "mrjmaek mic thk gutlg`k go jitkrkst. 4grk
spkljojlmeey, jt js uskc tg `kmsurk thjs mssgljmtjgi ji
thk cmtm lgeekltkc org` thk pmrtjluemr sm`pek go
jicj"jcumes ji gur stucy mic tg `mk jiokrkilks magut
jts ejkey sj/k mic strkinth ji thk pgpuemtjgi org`
whjlh thk sm`pek wms ckrj"kc.
OJICJIN SHK QJNHS \SMSJ\SJLME @KSHGC2
Shk mpprgprjmtk stmtjstjlme `kthgcs tg usk ckpkic gi
thk imturk go thk gutlg`k "mrjmaek go jitkrkst. thky
`my ak ksskitjmeey gik go thrkk typks=
. Iu`krjlme gutlg`ks, sulh ms ajrth wkjnht gr
lhgekstkrge ek"ke.
*. 7jimry gutlg`ks, su``mrj/kc ms prgpgrtjgis, rjss gr
gccs, sulh ms thk prg$ pgrtjgi go lhjecrki cjmnigskc
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
18/27
wjth msth`m, thk prgpgrtjgi go pmtjkits ji kmlh
trkmt`kit nrgup whg mrk ig eginkr hypkrtkisj"k, gr thk
rjs go cyjin ji thk ojrst ykmr go ejok.
. mtks go `grtmejty, `grajcjty gr sur"j"me `kmsurkc
eginjtucjimeey g"kr tj`k, sulh ms thk sur"j"me rmtks
ogeegwjin cjookrkit trkmt`kits ogr arkmst lmilkr, gr
thk iu`akr go kpjsgcks go cjmrrhgkm pkr pkrsgi pkr ykmr
m`gin M;C- pmtjkits.
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
19/27
TMSHGEGNZ (OQJCMZ)
LZSGFJIK QKLKTSGQ\2
klkptgrs lgisjst go
(j) mi kxtkrime cg`mji whjlh js thk ajicjin sjtk ogr
thk ejnmic(jj) m trmis`k`armik rknjgi whjlh spmis thk lkee
`k`armik
(jjj) mi jitrmlkeeuemr cg`mji whjlh ckej"krs thk sjnime
tg thk lytgsge klkptgrs `my lgisjst go m sjinek
pgeypkptjck lhmji gi jts gwi, k.n. ?1O$, m sjinek
pgeypkptjck lhmji peus m sklgic hkepkr prgtkji, k.n.
;OI$,A rklkptgr, gr twg pgeypkptjck lhmjis, k.n. ;1O$
rklkptgr. klkptgrs lmi ak go hjnh gr egw moojijty,
k.n. ;8$*, gr thky lmi hm"k m cjookrkit ek"ke go
rkspgisk tg cjookrkit ejnmics, k.n. ;1O$ rklkptgr
ajicjin ;1O$ mic jisueji.
Q&&8t /'?!mt * mh&0&' :# m!t&"2
(j) thk rmtk go syithksjs mic `k`armik jiskrtjgi
(jj) rklkptgr jitkrimejsmtjgi mic rklylejin
(jjj) rklkptgr cknrmcmtjgi "jm eysgsg`ks
\"m! tm*'?t2
Ogeegwjin ajicjin go lytgjik wjth jts mpprgprjmtk
rklkptgr thkrk ogeegws m lmslmck go k"kits thmt
k"kitumeey (motkr sk"krme hgurs) ekmc tg stj`uemtjgi go
CIM syithksjs mic lkee cj"jsjgi gr jicultjgi go 4IM
mic prgtkji syithksjs. Shk `klhmijs`s ji"ge"kc ji thjs
#sjnime trmiscultjgi# mrk hjnhey lg`pekx. -g`k
rklkptgrs gpkrmtk thrgunh mltj"mtjgi go thkjr jitkrime
tyrgsjik jimsk cg`mji, k.n. kra$7 om`jey, +C1O$,
;1O$r gthkrs trmisculk thkjr sjnimes "jm lytgpems`jltyrgsjik gr skrjikLthrkgijik jimsks, k.n. srl, yks,
onr ykt gthkrs gpkrmtk thrgunh phgsphgejpmsk$!
mltj"jty, k.n. lr.
Shksk ki/y`ks mlt thrgunh m skrjks go jitkr`kcjmrjks
mic prgtkji phgsphgryemtjgi tg #swjtlh gi# CIM mic
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
20/27
prgtkji syithksjs. 1kikrmtjgi go jigsjtge trjphgsphmtk
thrgunh phgsphgejpmsk$! mltj"jty ekmcs tg `gajejsmtjgi
go lmelju` jgis org` jitkrime pgges mic thkrkay
`gcuemtks `miy lmelju`$ckpkickit prglkssks. Shjs js mi
kxm`pek go lmelju` jgis mltjin ms m #sklgic `ksskinkr#.
!melju` oeuxks ji lkee rknuemtjgi Methgunh
kxtrmlkeeuemr oeujc hms m hjnh !m* lgilkitrmtjgi (&$
4), jitrmlkeeuemr ek"kes mrk sk"krme grckrs egwkr
(magut &$3 4).
Shjs stkkp kekltrglhk`jlme nrmcjkit js `mjitmjikc ay
thk rkemtj"k j`pkr`kmajejty go thk pems`m `k`armik tg
lmelju` jgis, mic ay mltj"k kxleusjgi ay m lmelju`
pu`p. 5hki m lkee js mltj"mtkc, ogr kxm`pek ay m
lytgjik, hgr`gik gr ikr"k j`puesk, lmelju` jgis `g"kjitg thk lkee lytgpems`.
Sh& * "mt& &th& 4/2
. ?xtrmlkeeuemr lmelju` jgis whjlh kitkr thrgunh=
(j) klkptgr gpkrmtkc lhmiikes
(jj) >getmnk ckpkickit lhmiikes
*. !melju` #stgrks# ji thk s`ggth kicgpems`jl rktjlueu`
Shk jioeux go lmelju` jgis ekmcs tg thk mltj"mtjgi go m
lmelju`ajicjin prgtkji lme`gcueji. Shk mltj"k
lme`gcueji$lmelju` lg`pekx rknuemtks m wjck rmink go
jitrmlkeeuemr prglkssks jileucjin=
. !ylejl iulekgtjck `ktmagejs`
*. 4jlrgojem`kit pgey`krjsmtjgi
. 4jlrgtuauek mssk`aey$cjsmssk`aey
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
21/27
(jj) Sjssuk spkljojl $ k.n. pmrmlktm`ge (mlktm`jigphki)
prgculjin ej"kr iklrgsjs meegxmi nj"jin rjsk tg
iklrgsjs ji 7$lkees go thk pmilrkmtjl jsekts
(jjj) 1kikrme $ k.n. kthye melghge, psylhgtrgpjl cruns,
hkm"y `ktme pgjsgis
*. +hysjlme mnkits
(j) Srmu`m
(jj) Sk`pkrmturk ji0urjks, j.k. kxtrk`k hkmt gr lgec
(jjj) +rkssurk kooklts (aemst ji0urjks)
(j") ;gijsjin rmcjmtjgi
(") ?ekltrjlme ji0urjks
. 8ml go iutrjkits
Em!>
(j) Omjeurk go lkeeuemr masgrptjgi, k.n. neulgsk ji
cjmaktks `keejtus
(jj) Omjeurk go aeggc suppey jslhmk`jm
N&&m!>
(j) :ypgxjm, k.n. sk"krk mimk`jm, rkspjrmtgry omjeurk
(jj) 4meiutrjtjgi rksuetjin org` cjktmry ckojljkily gr
`memasgrptjgi
(jjj) :gr`gime ckojljkily
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
22/27
a. Metkrmtjgi ji strulturk ms m rksuet go lhrg`gsg`me
ckektjgi gr trmiseglmtjgi
(jj) !hmink ji nkiktjl lgck
m. ;ihkrjtkc, k.n. jiagri krrgrs go `ktmagejs`,
thmemssmk`jm
a. Mlujrkc
@?tmt C&!&t 4 "&&>
K7GE%SJGI GO LKEE JI9%QZ2
Shk tkr` #ji0ury# k`armlks m wjck rmink go mc"krsk
k"kits whjlh wjee mooklt lkeeuemr hg`kgstmsjs. 5hkrk mi
ji0ury js `jec mic trmisjkit thk lkee `my suookr
ej`jtkc cm`mnk tg `k`armiks mic grnmikeeks whjlh lmi ak
rkmcjey rkpmjrkc mic igr`me strulturk mic ouiltjgirkstgrkc. -ulh ji0urjks jiculk jilrkmskc syithksjs go
spkljojl strkss prgtkjis whjlh lguec hkep ji thk
cjssgljmtjgi mic lekmrmilk go ckimturkc prgtkjis mic
prgtkji lg`pekxks, mic smtjsoy thk nrkmtkr ck`mic ogr
prgtkji ogecjin argunht magut ay thk mc"krsk
lgicjtjgis.
2iwmitkc grnmikeeks mic `k`armiks mrk rk`g"kc ay
mutgphmnglytgsjs. 4grk sk"krk mic sustmjikc ji0ury `my
rksuet ji cknkikrmtj"k lhminks sulh ms legucy swkeejinmic omt mllu`uemtjgi whjlh, jo thk ji0urjgus mnkit js
wjthcrmwi, mrk mesg rk"krsjaek mic thk lkee rklg"krs.
;o, hgwk"kr, thk ji0ury pkrsjsts thk lkee `my
cknkikrmtk ourthkr, aklg`k jrrk"krsjaey cm`mnkc, mic
cjk. ;i sg`k ljrlu`stmilks thk ji0ury `my ak sg
lmtmstrgphjl thmt thk lkee cjks wjthgut shgwjin thksk
jitkr`kcjmtk lhminks.
Metkrimtj"key, whki mi mc"krsk ki"jrgi`kit pkrsjsts,
thk lkee `my mcmpt mic kstmaejsh m ikw stkmcy stmtk.
6iey whki thk lkee omjes tg kstmaejsh mi metkrkc ek"ke
go hg`kgstmsjs ji rkspgisk tg ji0ury js lkee ckmth
jik"jtmaek. 2ickr sg`k ljrlu`stmilks thk ikw
ki"jrgi`kit `my rkujrk m hkjnhtkikc stmtk go mltj"jty
ogr hg`kgstmsjs tg ak `mjitmjikc. ;ilrkmskc ouiltjgime
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
23/27
mltj"jty js argunht magut ay mi jilrkmsk ji thk iu`akr
go grnmikeeks mic m lgilg`jtmit jilrkmsk ji lkee sj/k $
lkeeuemr hypkrtrgphy.
Mi jilrkmsk ji lkee iu`akr `my ak rkujrkc tg lgpk wjth
jilrkmskc ck`mics gr tg lg`pkismtk ogr m shgrtkikc ejok
spmi $ hypkrpemsjm. 4grk orkukitey, m lkee mcmpts tg
mi mc"krsk ki"jrgi`kit ay ouiltjgijin mt m egwkr ek"ke
thmi igr`me. Shk cj`jiutjgi ji ouiltjgime grnmikeeks js
pmrmeekekc ay rkculkc lkee sj/k $ mtrgphy. Ojimeey
tjssuks kxpgskc tg mi mc"krsk ki"jrgi`kit g"kr m
sustmjikc pkrjgc `my mcmpt ay metkrjin thk cjrkltjgi go
lkeeuemr cjookrkitjmtjgi tg prgculk lkees `grk lmpmaek
go lg`amtjin thk ki"jrgi`kit. -ulh m lhmink js tkr`kc
`ktmpemsjm.
\%AEKSHME LKEE JI9%QZ2
-uaekthme ji0ury `my rksuet ji egin$tkr` mcmptj"k
lhminks gr ji cknkikrmtj"k lhminks whjlh lmi ak
rk"krskc aut `jnht mesg hkrmec thk giskt go lkee ckmth.
Sh& '&"&&mt0& *&D?&&* 4 &!! ;?# /8*&2
. ;i0ury tg lkee `k`armiks mic `jtglhgicrjm
(j) 8gss go `jlrg"jjjj mic oglme kxpmisjgis go thk
pems`m `k`armik(jj) Ogr`mtjgi go "mlugeks ay jiogecjin go thk pems`m
`k`armik $ kicglytjl "mlugemtjgi
(jjj) Cjsruptjgi go thk ? mic egss go rjagsg`ks. Shjs
arjins magut thk egss go lytgpems`jl amsgphjejm skki gi
ejnht `jlrgslgpy
(j") 4jtglhgicrjme swkeejin mic egss go lrjstmk
*. !egucy swkeejin (jitrmlkeeuemr gkck`m) Shjs rksuets
org` thk mllu`uemtjgi go wmtkry oeujc ji thk cjemtkc
smls gr ljstkrimk go thk kicgpems`jl rktjlueu` mic
`jtglhgicrjm.
(j) ?mrey stmnks $ uickr thk ejnht `jlrgslgpk, thk
lytgpems` hms m ojik nrmiuemrjty ejk nrguic$nemss (jj)
8mtkr stmnks $ prgnrkssj"k cjemtmtjgi go thk ? ekmcs
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
24/27
tg thk mppkmrmilk go lekmr "mlugeks "jsjaek ay ejnht
`jlrgslgpy $ hycrgpjl "mlugemtjgi
@&hm*/>
(j) Omee ji gxjcmtj"k phgsphgryemtjgi cuk tg
m. 8ml go gxynki
a. Cm`mnk tg `jtglhgicrjm gr jts ki/y`mtjl pmthwmys Shk
cj`jijshkc ogr`mtjgi go MS+ mooklts mee thk kikrny
rkujrjin rkmltjgis ji thk lkee aut ji pmrtjluemr ekmcs
tg omjeurk go thk sgcju`$pu`p. -gcju` jgis kitkr thk
lkee ji kxlhmink ogr pgtmssju` mic ms thk ogr`kr hm"k m
emrnkr hycrmtjgi shkee, thkrk js m ikt jioeux go wmtkr.
(jj) ;ilrkmskc jitrmlkeeuemr gs`gtjl prkssurk rksuetjin
org`
m. Mllu`uemtjgi go emltmtk mic pyru"mtka. Ikt lmtmagejs` go `mlrg`geklueks
. Omtty lhmink Shjs js thk mppkmrmilk go mauicmit
sphkrjlme negaueks go omt (trjneylkrjck) wjthji thk
lytgpems`. ;t lmi ak ck`gistrmtkc usjin org/ki skltjgis
mic stmjijin wjth ejpjc$sgeuaek cyks sulh ms 6je rkc &
gr -ucmi aeml, mic js `gst lg``giey skki ji lkees go
thk ej"kr, jciky mic `yglmrcju`. Omtty lhmink `ust akcjstjinujshkc org` pmthgegnjlme mcjpgsjty whkrk omt
lkees (ejpglytks) jiojetrmtk mi grnmi gr tjssuk.
Shjs js m okmturk go sk"krk gaksjty. ;i igr`me lkees
omt js hkec ji m cjspkrskc stmtk mic trmispgrtkc gut go
thk lkee ms `jlkeeks gr ejpgprgtkji lg`pekxks
(trjneylkrjck wjth phgsphgejpjc micLgr prgtkji).
Srjneylkrjcks mrk syithksjskc org` orkk omtty mljcs
(OOM-) kitkrjin thk lkee org` thk aeggc. OOMs mesg
uickrng gxjcmtjgi tg !&* mic lgi"krsjgi tg
phgsphgejpjc.
@&hm*/> Omtt# hm"& &*?!t* 4/=
M. ;`pmjrkc `ktmagejs` go omt
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
25/27
(j) kculkc gxjcmtjgi go OOMs wjth jilrkmskc lgi"krsjgi
tg trjneylkrjcks
(jj) kculkc syithksjs go phgsphgejpjc mic prgtkji.
Shjs rksuets ji
m. kculkc cjspkrsme go omt ekmcjin tg negauek
ogr`mtjgi
a. Cj`jijshkc rkekmsk go omt org` thk lkee ms
ejpgprgtkji
7. ?xlkssj"k kitry go OOMs mic trjneylkrjck jitg thk
lkee !musks
(j) Cjmaktks `keejtus
(jj) !ginkstj"k lmrcjml omjeurk
(jjj) -k"krk mimk`jm
(j") 4meiutrjtjgi mic wmstjin cjskmsk(") ;slhmk`jm, k.n. lgrgimry jisuoojljkily
("j) ;iokltjgis (skptjlmk`jm)
("jj) !hrgijl melghgejs` (ej"kr)
("jjj) +gjsgis, k.n. lmragi tktrmlhegrjck, phgsphgrus
(ej"kr)
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
26/27
8/10/2019 ACH's MBBS YEAR 2 SEMESTER 3 WEEK 1 NOTES
27/27
(jj) ;i mnkjin lkees $ sg$lmeekc #wkmr$mic$tkmr#
pjn`kit. Shjs js akst skki ji #pkr`mikit# tjssuks sulh
ms `yglmrcju` whkrk thk ojarks shgw jilrkmsjin
pjn`kitmtjgi wjth mnk. ;t js pmrtjluemrey k"jckit whkrk
thk hkmrt hms mtrgphjkc ms m rksuet go wmstjin cjskmsk
$#argwi mtrgphy#. Mesg skki ji ej"kr lkees wjth
jilrkmsjin mnk mic wjth lkrtmji cruns, k.n.
phkigamrajtgik
(jjj) Ms #lkrgjc# pjn`kit ji thk ej"kr motkr ej"kr lkee
iklrgsjs mic gxjcmtjgi go ejpjc `k`armiks, k.n. motkr
"jrme hkpmtjtjs, crun hkpmtgtgxjljty
(j") ;i ej"kr lkees ji thk Cuaji$Dghisgi syicrg`k
(") ;i thk #argwi$agwke# syicrg`k. +jn`kitmtjgi go
s`ggth `uslek lkees mllg`pmijks "mrjgus `memasgrptjgi
stmtks.
wmeksgi`cNn`mje.lg`