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Fyziologie

Předmět na 2. lékařská fakulta |
DA0103337

Tento text není v aktuálním jazyce dostupný. Zobrazuje se verze "en".Sylabus

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 i

Tento text není v aktuálním jazyce dostupný. Zobrazuje se verze "en".Anotace

The subject is conceived as part of the basic professional subjects for the Master's degree program. During the course the students learn about the function and regulatory mechanisms of the human organism, organs and their parts.