Charles University Second Medical School

DEPARTMENT OF PHYSIOLOGY

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SYLLABUS FOR FOREIGN STUDENTS

Cellular membrane physiology
     Ion distribution in the cell membrane
     Transmembrane transport mechanisms
     Ion membrane channels
     Ion transport in excitatory cells

Mechanisms of membrane transport
     Ion distribution in epithelial cells
     Transport mechanisms in epithelial cells
     Mechanisms of secretion in epithelial cells

Physiology of body fluids
     Definition of water and solutes intake and output
     Body fluid compartments
     Development of body fluid compartments
     Measurement of body fluid compartments
     Regulation of body fluids
           composition
           volume
     Thirst

Renal physiology
     Functional morphology of nefron
     Renal blood flow
           measurement
           regulation
     Glomerular filtration
           functional properties of glomerular membrane
                 factors determining transport
           glomerular filtrate
                 composition
                 volume
           glomerular filtration rate
           measurement of GFR
           filtration fraction

     Tubular transport mechanisms
           Proximal tubule
           Distal tubule
           transport of solutes
           transport of urea
           transport of amino acids
           transport of glucose
           measurement of tubular transport mechanisms
           regulation of tubular transport mechanisms

     Glomerulotubular balance

     Concentration of urine
           function of loop of Henle
           concentration gradient in medulla
           function of the collecting duct
           regulation of concentration and dilution mechanisms
           measurements

     Urine
           composition
           diuresis

     Kidney and regulation of body fluids

     Role of kidney in regulation of acid base status
           tubular mechanism of transport of
                 proton
                 bicarbonate
           buffer mechanisms in urine

     Function of urinary bladder
           transport of urine in the urethra
           intrinsic mechanism of regulation of SM in urinary bladder
           neural control of urinary bladder
           mechanism and regulation of micturition

Circulation
     Transport function of circulation
     Physical basis of blood flow

     Function of the heart
           Mechanism of heart contraction
                 isometric, isotonic contraction
                 series and parallel elasticity
                 homeometric, heterometric regulation

                 preload, afterload
                 pressure volume diagram
                 volume ‑ velocity curve, dP/dt
           Mechanism of heart excitation
                 action potential in the heart muscle
                       ion fluxes, channels
                 sinus potential
                       ion fluxes
                       generation of rhythm
                 spreading of stimulus
                       relative and absolute refractory period
                 heart rate
                       regulation
           ECG ‑ origins
                 measurement

           Cardiac output
                 regulation
                 measurement
                       Fick principle
                       dilution methods
                       electromagnetic flowmeter

           Heart sounds

           Heart work

           Heart metabolism
                 utilization of oxygen
                 factors determining oxygen delivery
                 coronary blood flow

     Peripheral blood vessels
           Physical concept of resistance
                 blood viscosity
           resistance ‑ blood flow ‑ pressure
           concept of closing pressure
           compliance of vessels
           arteriole
                 regulation
                       autoregulation
                       shear stress of endothelium
                       nerves
                       local factors
                       endothelial cells
                 local blood flow and metabolic needs

     Blood pressure
           systolic, diastolic, mean
                 determining factors
                 pressure curves
           driving, intravascular and transmural pressures
           effect of hydrostatic pressure
                 syphon effect
                 function of veins
           measurement of blood pressure, catheterization

     Capillaries
           regulation of blood flow through capillaries
           transport of solutes
           balance between the capillary and interstitium
           edema
           lymph flow

Regulation of blood pressure (Prof. Herget)
     Blood pressure and regional distribution of blood flow
     volume of fluid compartments and
           blood pressure
           cardiac output
                 concept of Guyton
     kidney ‑ fluid balance ‑ blood pressure
     ANF
     renin ‑ angiotensin ‑ aldosterone
     baroreceptors
     blood pressure and vascular morphology

Lung function
     Lung ventilation
           partial pressure of gas
                 measurement
           gradients of respiratory gases
           concept of alveolar ventilation
                 composition of alveolar air
           dead spaces
           Bohr equation

     Lung volumes
           spirometer
           measurement of FRC

     Mechanism of inspiration and expiration
           interpleural pressure
           lung compliance
                 pressure volume diagram
                 surfactant
                 concept of measurement
           compliance of thorax wall
           lung resistance
                 alveolar pressure
                 bronchial resistance
                       mucus secretion
                       regulation of bronchial smooth muscle
                             nerves
                             local factors
                 larynx
                 concept of measurement of lung resistance
                 resistance of thorax

     Regional pulmonary resistance and compliance
           distribution of inspired gas
                       measurement
           regional lung blood flow
           matching the blood flow and ventilation
                 hypoxic pulmonary vasoconstriction
           concept of alveolar dead space and venous admixture
           Fehn and Rahn diagram
           regional lung distribution of V/Q
                 effect of gravity

Function of pulmonary capillary
           lung diffusion of gases
                 transfer factor
           relation of lung diffusion and V/Q
                 limitation of diffusion
                 limitation perfusion
           metabolic function of pulmonary capillary
           ion and water transport in lungs

Control of breathing
           Neural
                 origin of rhythmicity
                 regulation of inspiration and expiration
                 feedback from the lung tissue
                 feedback from the chest wall
                 cortical influences
                       speech
           Chemical
                 carotid and aortic bodies
                 mechanism of oxygen sensing
                 effect of hypoxia on lung ventilation
                                   on lung volumes
                 central chemoreceptors
                 mechanism of CO2 sensing in central  chemoreceptors
                 interaction of CO2 and O2 in control of breathing
                 breathing and acid base status
                 breathing in sleep
                 breathing in exercise
                 breathing at high altitude
                 voluntary apnoe
                 diving

Reflexes from the lungs
     caugh

Pulmonary circulation
     blood pressures
           measurement
     compliance of pulmonary blood vessels
     causes of low pulmonary vascular resistance
     critical closing pressure of lung vessels
     effect of gravity
     mechanical interaction of breathing and lung blood flow
     regulation of pulmonary vascular resistance

Foetal circulation
     reconstruction of circulation after the birth

Heart ‑ lung interactions

Physiology of Blood
     Red blood cells
           production
           formation of haemoglobin
           destruction of red blood cells
     Neutrophils and macrophages
           general characteristics
           defensive properties
                 adhesion, adhesive molecules
                 fagocytosis
                 mechanism of activation
                 production of
                       ROS
                       enzymes and cytotoxic factors
           physiology of inflammation

     Blood groups
           0 ‑ A ‑ B
           Rh
           transfusion

     Hemostasis and blood coagulation
           hemostasis
                 vasoconstriciton
                 formation of platelet plug
                 coagulation
                       conversion of prothrombin ‑ thrombin
                       conversion of fibrinogen ‑ fibrin
                       formation of prothrombin activator complex
                       lysis of blood cloth, plasmin
                       concept of procoagulation and  anticoagulation balance

Transport of blood gases
     Transport of oxygen
           amount of oxygen in blood
           function of hemoglobin
                 saturation, partial pressure
                 hemoglobin dissociation curve
                       adult
                       foetal
           factors influencing oxygen dissociation curve
           Types of hypoxia

     Transport of carbon dioxide
           Henderson ‑ Hasselbalch equation
           effects of carbonic anhydrase
           forms of CO2 transport in the blood

     Interaction of O2 and CO2 transport mechanisms

Endocrinology
     autocrine, paracrine and endocrine regulations
     hormones, types, structure
     physiology receptors for hormones

     Thyroid gland
           hormones
           iodine metabolism, trapping
           transport of thyroid hormones
           metabolism of thyroid hormones
           effect of thyroid hormones
                 ontogenesis
           regulation of thyroid secretion
     Pancreas
           insulin, secretion, metabolism
           blood transport
           receptors
           effects
           regulation
           glucagon
           effects
           regulation
     Endocrine regulation of carbohydrate metabolism

     Adrenal gland
           medulla
                 structure and metabolism of hormones
                 regulation of secretion
           cortex
                 structure and metabolism of hormones
                 transport
                 ACTH
                 effects of glucocortcoids
                       role in inflammation
                 effects of mineralocorticoids
           adrenalectomy
           concept of stress

     Regulation of calcium metabolism
           metabolism of Ca and P
           physiology of bone
           calcitonin
           parathormon
           regulation of secretion
           Vitamin D

     Pituitary gland (hypophysis)
           overview of pituitary hormones
           hormones of the middle lobe
           STH
                 structure, metabolism, regulation
                 receptors
                 somatomedins
           physiology of growth

     Gonads
           ontogenetic development
           puberty
           hypophysial gonadotropins

     System renin-angiotensin
     erythropoetin
     ANP
     epiphysis

Physiology of sexual activity
     function of male sexual organs
           regulation
     function of female sexual organs
           regulation
           menstruation
     central regulation of sexual behaviour
     physiology of coitus
     contraception

Physiology of energy metabolism and nutrition
     energy metabolism
     measurement, RQ
     energetic balance
     physiology of nutrition
     vitamins
     minerals

Physiology of gastrointestinal tract
     Mechanisms of digestion
     Regulation of gastrointestinal tract
           gastrointestinal hormones
           mechanism of swallowing
           function of the stomach
                 secretion of pepsin
                 secretion of HCl
                 motility
                 regulation of secretion and motility
           exocrine secretion of pancreas

           small intestine
                 secretion
                 regulation of secretion
                 types of motility
                 regulation of motility
           large intestine
                 resorption mechanisms
                 regulation of motility
                 defecation
           physiology of intestinal immunologic mechanisms

     Metabolic function of liver
     Bile function and secretion
           Metabolism and excretion of bilirubin
     Function and regulation of gallbladder

Neurophysiology
     Introduction to neurophysiology.
     Review of anatomical and histological principles of neurophysiology.

General neurophysiology
     The neuron and the glial cell; the blood‑brain barrier
     Metabolism and nutrition of the neural tissue
     Types of neurons (Golgi I and II) and neural circuits
     Basic functions of synapses
     Review of neurotransmitters and neuromodulators
     Ionotropic and metabotropic mechanisms of synaptic transmission
     G protein and second messengers
     Electrophysiology of the neuron
           The resting membrane potential: Ionic and electric gradients
           Action potentials: Properties of excitable membranes
                 The absolute and relative refractory periods
                 Myelinated nerves ‑ saltatory conduction
           Postsynaptic potentials, excitation and inhibition
           Generator potentials in receptors
           Accommodation of the nerve fibre and adaptation of the receptor
          Recording and stimulation of neural cells
     Electrical properties of a volume conductor, extracellular recording and stimulation.
           EEG, event related potentials, chronaxy, the Pflüger's law.
     Reflex and non‑reflex activity
     Learning and memory

Systemic neurophysiology
     General design of the nervous system
     The peripheral nervous system
     Organization of the central nervous system
     Principles of development of the central nervous system
     Functions of the spinal cord
     Physiology of the brain stem: the medulla, the pons, the mesencephalon
     Functions of the thalamus and physiology of pain
     Hypothalamus and the autonomic nervous system
     Motor functions: The cerebral cortex, the basal ganglia and the cerebellum. Pyramidal and extrapyramidal systems.
     The cerebral cortex and intellectual brain functions
     Sleep and wakefulness, modulatory systems of the brain.
     Motivation and emotions.
     Neurophysiology of vision and hearing.
     The chemical senses of taste and hearing


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