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Poslední úprava: MVDr. Olga Vajnerová, Ph.D. (23.08.2017)
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Poslední úprava: MVDr. Olga Vajnerová, Ph.D. (23.08.2017)
Understand the basic physiological functions of organs, organisms and their parts. Regulatory mechanisms to maintain homeostasis.
To get acquainted with cell physiology, physiological expressions and regulatory mechanisms at the cellular level.
To get acquainted with the physiological differences of functions during the development of an individual.
Learn to respond to the stress. Physiological mechanisms for maintaining the integrity of the organism. |
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Poslední úprava: Ing. Marcela Minaříková (11.05.2020)
Successful completion of the course in both semesters and oral exam.
The rules for the Physiology exam
The Physiology exam will be carried out in the personal and online forms. The form of the exam will be marked in SIS for each term. The online exams are exclusively for the students who are outside the Czech Republic now and who can not attend the exam, i.e., mainly foreign students.
Other students can apply for an online exam only because of severe reasons like illness. In such a case, you need to bring the document from your GP. Your request for the online exam will be thoroughly evaluated. Then you will receive email notification whether your application was accepted or rejected. Also, the cancelling of the exam date to which the student has subscribed is allowed only due to severe reasons.
Each student will be notified about the exact time of the exam by email to avoid the risk of a gathering of a high number of persons at the same time.
For the online exam and to select exam questions, we will use a random number generator. The use of supporting materials or any written notes is not allowed for both personal or online exam, respectively. The online exam will be recorded and archived. |
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Poslední úprava: HABET (23.01.2014)
Ward, J. P. T.: Physiology at a glance : Wiley & Blackwell, 2008 (B) Guyton, A. C.: Guyton & Hall textbook of medical physiology : Saunders Elsevier, 2011 (B), (avaible as ebook) |
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Poslední úprava: Ing. Marcela Minaříková (02.10.2020)
Exam topics 1. Osmosis, diffusion, oncotic pressure 2. Causes of uneven distribution of ions on the two sides of plasma membrane 3. Transport of substances across plasma membrane 4. Body fluids compartments. Composition and measurement. 5. Generation of action potentials 6. Muscle contraction mechanics. isotonic and isometric contraction. 7. Contraction of smooth muscle 8. Action potentials in the heart 9. Pacemaker cells in the heart. Heart rate regulation. 10. ECG curve and its measurement 11. Cardiac and skeletal muscle contraction comparison 12. Excitation-contraction coupling in cardiac and skeletal muscles 13. Autoregulation of myocardial contraction (homeometric, heterometric) 14. Cardiac cycle: meaning of all parts of the PV loop 15. Cardiac output 16. Relation between blood pressure and blood flow 17. Blood pressure regulation 18. Long-term regulation of blood pressure by the kidneys 19. Neural regulation of cardiac output distribution 20. Local regulation of blood flow (metabolic, myogenic) 21. Coronary blood flow 22. Circulatory system response to physical exercise 23. Tissue fluid, circulation of lymph, regional differences in production of tissue fluid, Starling equation, capillary equilibrium 24. Factors determining composition of alveolar air and arterial blood. Effect of dead space. 25. Respiration mechanics. Respiratory muscles. 26. Factors determining lung compliance and airway resistance. 27. Respiratory work 28. Factors affecting ventilation/perfusion ratio. Consequences. 29. Diffusion of O2 and CO2 across the alveolar-capillary membrane. Limits of perfusion and diffusion. 30. Oxygen-haemoglobin dissociation curve 31. Transport of gasses by blood and factors affecting it 32. Chemical regulation of breathing 33. Neural regulation of breathing 34. Functional differences between systemic and pulmonary circulation 35. Types of hypoxia 36. Spirometry: principle of measurement. Static and dynamic parameters of the lungs 37. Renal blood flow. Its regulation and relationship to glomerular filtration. 38. Factors determining glomerular filtration 39. Glomerular filtration measurement. Renal blood flow measurement. 40. Tubular transport measurement 41. Proximal tubule transport mechanisms 42. Renin-angiotensin-aldosterone system 43. Renal secretion of potassium 44. Renal secretion of urea. Ammonia metabolism in renal tubules. 45. Creation of concentrated and diluted urine. Regulation of water intake. 46. Kidney role in acid-base balance 47. Factors determining acid-base balance 48. Skeletal muscle tone regulation. Gamma system. 49. Contraction of skeletal muscles. 50. Red blood cells. Erythropoiesis, function, and ontogenesis. 51. Blood types. Rh incompatibility between the baby's and mother's blood. 52. Haemostasis and hemocoagulation. Factors. 53. Swallowing: oesophageal motility, secretion of saliva, regulation 54. Regulation of gastric motility 55. Regulation of intestinal motility - small intestine 56. Regulation of intestinal motility - large intestine. Defecation. 57. Regulation of gastric juice secretion 58. Regulation of pancreatic juice secretion 59. Bile 60. Regulation of intestinal juice secretion 61. Digestion and absorption of water, nutrients, ions, and vitamins 62. Metabolism of iron, phosphates, and calcium. Calcemia regulation. 63. Thermoregulation. Heat loss. Ontogenesis of thermoregulation. 64. Function of hormones 65. Pituitary hormones and their importance for the development of an individual. 66. Thyroid gland function 67. Glucocorticoids 68. Adrenocorticoids 69. Endocrine function of the testes 70. Endocrine function of the ovaries. Menstrual cycle. 71. Endocrine function of the adipose tissue 72. Hormonal changes during pregnancy. Placenta. Delivery. 73. Changes in circulatory and respiratory systems at birth 74. Hormones and trophic changes during postnatal ontogenesis 75. Endocrine function of the pancreas. Regulation of glycemia. Clinical measurement. 76. Neuronal action potential. Function of myelin sheath. 77. Axon conductivity and nerve fibre typology 78. Neurotransmission. Metabotropic and ionotropic receptors. 79. Excitatory neurotransmitter systems 80. Inhibitory neurotransmitter systems 81. Blood-brain barrier. Glia cells. Extracellular milieu. 82. Brain ventricles. Cerebrospinal fluid: generation, composition, importance. Intracranial pressure. 83. Cerebral blood flow. Its regulation and metabolism of neurones. 84. Reflexes: mechanism and classification. 85. Spinal cord function 86. Voluntary control of movement 87. Role of basal ganglia in motor control 88. Role of the cerebellum in motor control 89. Regulation of gait and balance 90. Autonomic nervous system 91. EEG and evoked potentials 92. Reticular formation of the brainstem. Modulatory systems. 93. Sleep and wakefulness 94. Limbic system. Motivation and emotion. 95. Forms of memory 96. Memory trace formation 97. Speech and its disorders 98. Eye 99. Function of the retina 100. Ear. Auditory transduction. 101. Statokinetic system. Nystagmus. 102. Olfactory and gustatory systems 103. Somatosensory system, proprioception, pain |
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Poslední úprava: Ing. Marcela Minaříková (05.10.2020)
1. Heart
1.1. Electrical activity of the heart
Rhythmicity of heartbeats and its origin, regulation of heart rate Action potential (AP) at various parts of the conductive system, the causes of their shape variations, involvement of various ion channels, cardiac pacemaker, timing of the action potential spreading through the conductive heart system, factors affecting heart rate - sympathetic effect, vagal control, receptors, effect. Action potential and its spread through cardiac muscles The shape of the AP myocardial curve, the contributing ion channels, the timing of their action potentiation, the principle of "plateau" and its implication, intercellular propagation, absolute and relative refractory phases, the effect of changes in the composition of the internal environment on AP myocardium. ECG (the recording principle, basic description) Types of connections, registration principle, Einthoven's triangle, principle of recording from leads, heart vector and axis, factors that affect them, basic description of the ECG curve elements - intervals, waves, interpretation.
1.2. Mechanical properties of the cardiac action
Comparison of cardiac muscle fiber, skeletal and smooth muscle contraction Involvement of contractile apparatus components, energy consumption, tetanic contraction, relaxation. Comparison of the excitation and contraction coupling in cardiac and skeletal muscles Principles of muscle cell excitation, signal transduction, pathways resulting in the activation of the contractile apparatus, the role of calcium Mechanisms regulating the force of cardiac contraction Homeometric, heterometric, contractility, factors affecting it, influence of calcium concentration, effect of vegetative control, Frank-Starling's law, principle, consequences, preload, afterload, factors affecting them, central venous pressure, their significance for cardiac contraction strength and cardiac output. Cardiac cycle, cardiography, changes of essential points and segments of the curve Systolic and diastolic cycles, causes and consequences of pressure / volume changes, Laplace's law Cardiac minute output Calculation, Fick's principle, dilution method, echocardiographic estimation, its setting, affecting factors, the influence of changes on the heart rate on its systolic and diastolic durations, the relationship between heart work and oxygen consumption Ventricular function measurements Cardiac output, ejection fraction, interpretation, relation to end-diastolic filling, end-systolic pressure and volume, cardiac index, ergometry, influence of the load on the volume of the cardiac output, cardiac work, oxygen consumption and blood pressure
2. Circulation
2.1 General principles
Relationship between pressure and blood flow Measurement methods, factors affecting the pressure and the flow, elasticity, laminar and turbulent flow, determining factors and thier significance, closing pressure, what determines it and its significance for organ perfusion, parallel and series connection and significance for pressure-flow values
2.2. The pressure-flow relationship at different sections of the vascular bed and its regulation
Factors determining blood pressure, its importance, measurement High-pressure and low-pressure system, significance, capacitive and resistant flow, flow rate and its relationship to pressure at different flow intervals and phases of cardiac cycle, measurement of blood pressure, mean arterial pressure, significance, influence of body position, relation to capillary filtration Time factor in blood pressure regulation and involvement of individual regulatory mechanisms Mechanisms of long-term maintenance of blood pressure stability, the importance of the kidneys, RAAS Neuroregulation of blood flow distribution, baroreceptors, baroreflex, resetting. Local regulation of blood flow, autoregulation of blood flow by organs (metabolic, myogenic, vasoconstrictive, vasodilatory factor).
2.3. Local specifics of blood flow, pressure / flow changes at rest and during exercise
Coronary blood flow Oxygen consumption by the heart muscles at rest and during exercise, coronary reserve, influence of Laplace's law, subepicardial and subendocardial blood flow. Other specific organs blood flow brain (HEB), liver, splanchnicus, kidneys Circulatory changes after birth Circulatory changes during exercise Static, dynamic load, differences 3. Blood and hematogenous gas transport
Transport of gases via the blood, affecting factors Total blood transport capacity and modifying factors, solubility of gases in the liquids, partial pressure, transport in plasma, hemoglobin role in gas transportation and its affecting factors, hemoglobin saturation, Astrup - predictive value, limitations. Hemoglobin dissociation curve Types of hemoglobin and its O2 and CO2 affinity and its affecting factors, consequences. Explanation of the sigmoidal character of the curve, shifts of the dissociation curve, factors causing it, Bohr effect, Halden effect. Blood groups, Rh maternal-fetal incompatibility Antigenic definition of individual types, determination of blood groups, consequences of incompatibility - transfusion, mother / fetus, preventive methods. Hemostasis, hemocoagulation, anticoagulant factors, their interaction, coagulation tests Vasoconstriction and its factors, platelet reaction, hemocoagulation, binding of individual factors, calcium, vitamin K, formation of definitive thrombus, interaction of coagulation and anticoagulation mechanisms within the coagulation cascade, Quick test, APTT, INR, their significance Hematological tests Hemoglobin, hematocrit, mean erythrocyte volume, erythrocyte count, leukocytes, platelets, erythrocyte color intensity, blood count, FW
4. Breathing
4.1. Ventilation and respiratory mechanics
Factors determining the composition of alveolar air, the effect of dead space size Alveolar ventilation versus tidal volume, effective alveolar ventilation, anatomical and functional dead space, partial pressures of gases in the respiratory system, composition of exhaled air during breathing, affecting factors, hypoventilation, hyperventilation, influence on gases partial pressure within alveolar air and blood , calculations. Mechanism of inhalation and exhalation, respiratory muscles, respiratory pattern Barometric, interpleural, alveolar pressure, measurements, their values when breathing is stopped, relation to inspiration and expiration and their changes, its relation to the respiratory rate, inspiratory and expiratory muscles, their activity, management. Factors determining pulmonary compliance and airway resistance, respiratory work Relationship of the volume change versus the pressure change, tissue elasticity and surface tension and their affecting factors, surfactant, lung compliance curve, shape interpretation, airway flow resistance and its indicating factors, regulation of bronchial lumen, static, dynamic work, measurement Examination of lung function Spirometry: TLC, VC, TV, IRV, ERV, RV, FRC, flow-volume curve: FVC, PEF, resting versus forced expiration, plethysmography, lung and airway resistance.
4.2. Blood-alveolar air gas exchange
Causes and consequences of pulmonary ventilation-perfusion mismatch disproportion and their ratio Rahn-Fenn scheme, alveolar dead space, venous admixture, O2 and CO2 partial pressures alveolar and arterial Gas transport across the alveolo-capillary membrane, perfusion and diffusion limitations Diffusion surface, diffusion path, concentration gradient, gases solubility and membrane diffusion, flow rate, diffusion capacity, measurement, A-V difference Functional differences between systemic and pulmonary circulation Pulmonary and systemic bed triggered hypoxic reaction, hypoxic pulmonary vasoconstriction, mechanism, consequences for oxygen saturation, circulation
4.3. Respiratory regulation
Mechanisms of chemical regulation Central, peripheral, localization, response to change in O2 and CO2, mechanism, adaptation Neuroregulation of respiration Defensive reflexes of respiration, origin of respiratory rhythm, inspiratory and expiratory neurons, activity, lung receptors, peripheral receptors of the thorax and respiratory muscles, peripheral receptors of the limbs, baroreceptors, thermoreceptors, pain.
4.4. Hypoxia - causes and implications
Types of hypoxia Hypoxic, ischemic, anemic, histotoxic, causes, consequences for oxygen transport to tissues, hemoglobin saturation, arterial and venous pO2 and pCO2, dissociation curve in these designated conditions. Hyperbaria, hypobaria Influence on gas transport, respiratory center reactions, dissociation curve shift, ABR shift, effect on hematocrit, effect on pulmonary perfusion Respiratory quotient
5. Kidneys
5.1. Glomerular function
Renal blood flow. Regulation, relation to glomerular filtration. Flow autoregulation, cortical and medullary flow, differences, significance, blood flow myogenic and tubuloglomerular feedback regulation, changes in vas afferens and vas efferens resistance, relation to GF size, influence of RAAS system, ANP, prostaglandins, sympathetic, effective flow Factors determining glomerular filtration Differences in hydrostatic pressures, their causes and consequences, oncotic pressure, permeability of the glomerular membrane and factors influencing it, composition and osmolarity of primary urine, Measurement of glomerular filtration rate and renal blood flow Clearance, principle, calculation, creatinine, insulin, advantages, disadvantages, cystatin C, flow measurement using the PAH clearance method.
5.2. Tubular function
Measurement of tubular transport, fractional excretion of solutes and water Fractional excretion, tubular resorption, calculations, significance, osmolar fractional excretion, osmolality deficit, osmolar clearance, solute-free water clearance Transport mechanisms and their importance in the proximal tubule Na +, glc, K +, HCO3-, H +, urea, amino acids Renin-angiotensin-aldosterone system Juxtaglomerular apparatus and macula densa, principle of function, effects of ANG and aldosterone Potassium excretion in the kidneys Localization, importance for maintaining potassium and other factors of the internal environment Renal excretion of urea and ammonia metabolism in renal tubules Correlation of the ABR maintenance Formation of concentrated and diluted urine Osmolarity of tubular fluid during flow through the tubular system, Henle loop function, osmotic startification of the marrow, significance, maintenance principle, influence of aldosterone and ADH on urine volume regulation, principle of action
5.3 Urination Mechanism, control, testing
6. ABR (Acid-Base Regulation)
6.1. Basic factors determining acid-base balance in the body
Acid production in the body, buffers ABR structure Respiratory and metabolic component Values detecting the ABR status Buffer base, base excess, anion gap
6.2. Deviations and regulation of acid-base balance
Acidosis causes, consequences Respiratory, metabolic Alkalosis, causes, consequences Respiratory, metabolic Respiratory compensation The role of the kidneys Urine acidification, principle, localization, acidification tests, titratable acidity, relation to HCO3- transport 7. General physiology
7.1. Thermoregulation and its ontogenetic development
Regulatory functions of the hypothalamus, thyroid hormones, sympathetic nervous system (vasomotor activity of cutaneous vessels, sweat glands, brown fat, uncoupling), tremor. Specificities of thermoregulation in the neonatal period.
7.2. Body fluid compartmentalization, their composition, measurement and regulation
Molarity, osmolarity, electroneutrality. Composition of intracellular and extracellular fluid. Plasma-interstitial fluid gradient differences, Gibbs-Donnan equilibrium. Principle of measuring the volume of body fluid compartments by dissolving the indicator. How changes in fluid intake and expenditure affect the distribution of fluids in the body.
7.3. Tissue fluid production, lymphatic circulation, regional peculiarities in tissue fluid production
Fluid passage through the capillary wall, Starling's equation (hydrostatic and oncotic pressure). Description of the lymphatic system and structural peculiarities of lymphatic vessels. The role of the lymphatic system in fat absorption, reabsorption of fluids from the interstitium and removal of large proteins from the interstitial space. Specificities of the pulmonary microcirculation.
7.4. Ion distribution across cell membranes, significance
Forms of transport of substances across the cell membrane Diffusion, facilitated diffusion, secondary active transport, primary active transport. Factors determining the molecular size of diffusion. Carriers, the most important ATPases, symport and antiport. Distribution of ions on the cell membrane, its derive, influence on the setting of membrane tension Ion channels and selective permeability of the cell membrane, electrochemical gradient. Equilibrium potentials for K +, Na + and Cl-, Nernst equation. Resting membrane potential. Action potential, mechanism of origin, factors that influence it Voltage-dependent Na + and K + channel, changes in membrane conductivity for Na + and K +, graph of voltage course during AP (depolarization, threshold value, repolarization to positive values, repolarization, hyperpolarization). Absolute and relative refractory period and AP propagation.
8. Endocrine system
8.1. General principles of hormonal regulation, mechanisms of action of hormones
Negative feedback simple and complex, positive feedback. Number of receptors and their hormone affinity (down-regulation, up-regulation). Membrane receptors associated with second messenger, membrane receptors associated with catalytic activity, steroid and thyroid hormones receptors.
8.2. Pituitary hormones, their importance in individual development
Relationship between hypothalamus and pituitary gland Relation of adenohypophyseal hormones secretion to the hypothalamic function, connection of hypothalamus and neurohypophysis, overview of neurohypophyseal hormones and their function. Tropical pituitary hormones Overview and their functions, connectivity at the levels of the relevant peripheral gland. Hormones important for growth and development of an individual Growth hormone, prolactin, function, significance.
8.3 Hormonal function of the thyroid gland and parathyroid glands
Release, transport, activation Regulation of thyroid hormone production and secretion, plasma thyroid hormone binding, T4 activation in target tissues, tissue receptor. The effects of thyroid hormones, including their importance for the development Prenatal and postanatal metabolic, circulatory effects, for the development and functioning of NS. Functions of parathyroid glands in calcium regulation.
8.4. Adrenal hormones
Glucocorticoids, stress response Regulation of glucocorticoid excretion, pulsatile secretion, circadian course. Effects of glucocorticoids and the importance of glucocorticoid secretion under stress Adrenal marrow hormones, reaction to stress Biological consequences of adrenal medulla activation. Target organs and tissues according to receptor subtypes and the nature of individual types of response. The importance of catecholamine secretion in stress.
8.5. Endocrine function of the pancreas, regulation of glycemia (growth hormone, corticoids…)
Regulation of insulin secretion in pancreatic β cells. Mechanism of insulin action in target cells, main effects of insulin. Glucagon - regulation of secretion and effects. Pancreatic somatostatin. General overview of glycemic control.
8.6. Endocrine function of the gonads
Endocrine function of the testes regulation of GnRH, FSH and LH secretion in men. Effects of androgens. Endocrine function of the ovaries, menstrual cycle Regulation of ovarian function (GnRH, FSH and LH), negative and positive feedback. Phases of the menstrual cycle and levels of LH, FSH, 17β-estradiol and progesterone. Effects of estrogens and progesterone on the target tissues. Hormonal changes in pregnancy, placenta, childbirth Events in the early phase of pregnancy (fertilization, implantation, HCG secretion). Overview of hormones in pregnancy. Synthesis of progesterone and estriol during pregnancy. The role of hormones in childbirth (oxytocin, prostaglandins, fetal cortisol and the estrogen / progesterone ratio). Regulation of milk secretion and ejection 9. GIT
9.1. General GIT functions
GIT motility and its control (general principles) Slow and fast waves, enteric NS, autonomic and hormonal control of motilities, inhibitory and excitatory GI neurotransmitters (noradrenalin, acetylcholine, CCK, VIP, histamine, somatostatin), effectors, GIT reflexes Secretion and function of regulatory substances Paracrine hormones (somatostatin, histamine, pepsin), neurocrine (Ach, VIP, subst P…); gastrointestinal; (gastrin, secretin, CCK, GIP)
9.2 Functional specifics of individual sections of the GIT
Oral cavity and esophagus Chewing and swallowing (function, nervous mechanisms), motility, regulation of saliva production and their function; significance of saliva secretion volume Stomach Main functions (storage, mixing, propulsion), chyme, regulation and importance of gastric secretion (HCL, mucus, enzymes, hormones); gastric emptying mechanism Digestion of chyme in the small intestine Motility, absorption and postabsorption phases, mechanism and regulation of intestinal juice secretion Exocrine pancreas, liver, gallbladder Hormonal control of pancreatic secretion, bile output, bile salt circulation The main function of the large intestine Propulsion, haustration, defecation, function of intestinal bacteria, resorption of ions, vitamins, water, calcium, iron.
9.3. Systems and substances affecting food intake
Influence of hypothalamus, adipose tissue, leptin, insulin, GLP-1, Ghrelin, peptide YY
10. Nervous system
10.1. General neurophysiology
Synapsis Neurotransmission (presynaptic part), postsynaptic receptors and potentials (ionotropic and metabotropic r.), EPSP and IPSP, neurotransmitters (overview, receptors, synthesis, reuptake), learning (synaptic scales, LTP, LTD) Neuron, glial cell Specifics of the function of individual parts of nerve cells, types of nerve fibers, the relationship between their thickness and myelination to the rate of signal transmission, glia function
10.2. Senses
Vision Retinal circuits, photoreceptors, receptive fields Hearing Mechanics, frequency coding, potassium circulation Vestibular system Function, nystagmus Smell Odorant effect, circuits in the olfactory bulb Taste The effect of five different tastes on receptor cells Somatosensory system Touch, pain, muscle elongation, tendon strain Visceral system Baroreceptors, osmoreceptors, chemoreceptors
10.3. Spinal cord and ANS
Reflex activity of the spinal cord Postural, defensive, monosynaptic, polysynaptic connections, crossed reflexes, reflex arc, gamma loop ANS Sympathetic, parasympathetic, effect on various organs
10.4. Brain
Brainstem centers Cerebellum Functions of its three main components (vermis, flocculus, hemispheres), involvement of mediators Hypothalamus Nerve functions, endocrine functions Basal ganglia Circuits involvement, expected role (behavior control, planning, skills learning) Cerebral cortex Primary cortical areas (sensory areas, motor cortex), higher order cortical areas (secondary, associative, premotor, frontal) Involvement of brain structures in the motor control Sleep Phases, sleep cycle, neurochemical nature of sleep and awakening, ARAS Memory Structures and mechanisms involved in memory track storage, short-term memory - long-term, declarative - non-declarative
10.5. Nervous system tests
EEG Principle, waves, meaning Evoked potentials |