Syllabus
Lectures
Prof. Zuzana Červinková, M.D., Ph.D.
Prof. Milan Holeček, M.D., D.Sc.
Assoc. Prof. Otto Kučera, M.D., Ph.D.
Assoc. Prof. Halka Lotková, M.D., Ph.D.
Introduction to physiology. Functional organization of human body and control of the internal environment. Regulation of body functions. Body fluid compartments (composition, volume, principles of measurement).
Functions and parameters of the blood. Red blood cells (count, metabolism, function). Hematocrit. Sedimentation. Hemolysis. Hemoglobin (concentration, function, types, derivatives).
White blood cells. General characteristics of leukocytes.
Regulation of red blood cell production - the role of erythropoietin. Essential substances required for erythropoiesis. Destruction of red blood cells. Regulation of white blood cell production.
Plasma. Plasma proteins. Serum. Regulation of acid-base balance. Function of acid-base buffers.
Hemostasis (vasoconstriction, function of platelets, hemocoagulation, inhibition of hemocoagulation, fibrinolysis).
Immunology I - introduction. Classification of immune mechanisms (nonspecific defense mechanisms, specific immune mechanisms - humoral and cell-mediated).
Immunology II - Interactions between nonspecific and specific immune mechanisms. Ontogenesis of immunity. Vaccination and passive immunity. Inflammation, allergy, auto-immunity.
Blood groups (ABO system, Rh factor, other blood group systems). Blood typing. Transfusion. Hemolytic disease of newborn.
Transport of ions and molecules across cell membrane.
Resting membrane potential. Action potential.
Characters of stimulus. Threshold for initiation of action potential. All-or-nothing principle. Chronaxie. Propagation of action potential. Recording membrane potential and action potentials. Nerve degeneration and regeneration. Properties of mixed nerves. Compound action potentials. Nerve fibers types and function.
Synaptic transmission. Excitatory and inhibitory post-synaptic potentials. Presynaptic inhibition and facilitation.
Summation and occlusion. Classification of neurotransmitters.
Contraction of skeletal muscle. Neuromuscular junction of skeletal muscle. Energy source and metabolism of muscle contraction. Heat production in muscle. Excitation - contraction coupling. Muscle fatigue.
Contraction and excitation of smooth muscle. Neuromuscular junctions of smooth muscle. Neural and hormonal control of smooth muscle contraction.
Regulation of visceral functions - the role of spinal cord, medulla oblongata, hypothalamus and limbic system in control of vegetative functions (vital centres, vomiting, hunger, thirst, sexual reactions, body temperature). Relation of hypothalamus to pituitary gland.
Spinal cord reflexes - proprioceptive stretch and tendon reflexes, exteroceptive reflexes, the role of muscle spindle and of gamma system, reciprocal innervation, flexor and extensor reflexes, and the crossed extensor reflex.
Control of posture and movement - motor functions of spinal cord, cerebellum, basal ganglia, descendent part of reticular formation and brain cortex.
The reticular activating system, spontaneous and evoked electric brain activity (EEG and evoked potentials).
Higher nervous functions, unconditioned and conditioned reflexes, dynamic stereotype, learning memory, second signal system, physiology of language, hemispheric dominance, frontal lobes, experimental neurosis, types of higher nervous activity.
Blood - brain barrier cerebrospinal fluid. Metabolism of the brain.
The autonomic nervous system - general organization, transmitters, basic characteristics of sympathetic and parasympathetic functions, receptor substances of the effector organs – cholinergic and adrenergic receptors.
Biorythms. Sleep and wakefulness.
Action potential in cardiac muscle. Electrical and mechanical properties of cardiac muscle. Prepotential.
The specialized excitatory and conductive system of the heart. Origin and spread of cardiac excitation. Contraction of cardiac muscle. Excitation-contraction coupling.
The heart as a pump. The cardiac cycle. The main hemodynamic events associated with the cardiac cycle. Heart sounds. Electrocardiogram. Bipolar and unipolar leads. Cardiac vector. Arrhythmias.
Cardiac output - method of measurement. Factors controlling cardiac output. Coronary blood flow. Oxygen consumption of the heart.
Dynamics of blood flow. Flow, pressure, and resistance. Laminar and turbulent flow. Poiseuille-Hagen formula. Critical closing pressure. Law of Laplace.
Arterial and arteriolar circulation. Arterial pressure. Capillary circulation. Lymphatic circulation and interstitial fluid volume. Venous circulation, venous return.
Local and systemic cardiovascular regulatory mechanisms. Cardiac innervation. The reflex mechanisms for maintaining normal arterial pressure.
Circulation through special regions (cerebral circulation, splanchnic circulation, circulation of the skin, placental and fetal circulation).
Introduction to respiration (anatomy of the lungs, properties of gases). Pulmonary ventilation (inspiration and expiration, intrapleural pressure, intraalveolar pressure, dead space, surface tension in alveoli, resistance to airflow, effects of gravity, work of breathing).
The external manifestations of pulmonary ventilation (respiratory movements, breath sounds). The pulmonary volumes and capacities, forced expiratory vital capacity.
Diffusion of oxygen and carbon dioxide through the respiratory membrane, pulmonary circulation. Transport of oxygen and carbon dioxide between the lungs and tissues.
Control of pulmonary ventilation. Hypoxia, hypercapnia, oxygen therapy, effect of increased barometric pressure.
Practical courses & seminars
Lecturers
Prof. Michaela Adamcová, M.D., Ph.D.
Prof. Zuzana Červinková, M.D., Ph.D.
Prof. Milan Holeček, M.D., D.Sc.
Assoc. Prof. Otto Kučera, M.D., Ph.D.
Assoc. Prof. Halka Lotková, M.D., Ph.D.
Moustafa Elkalaf, MBBCh, Ph.D.
Pavla Staňková, M.S., Ph.D.
Václav Šafka, M.D, Ph.D.
MUDr. Kristián Lux
Seminars
Test (MCQ) and seminar - hematology.
Test (MCQ) and seminar - immunology.
Test (MCQ) and seminar - general neurophysiology and myology.
Test (MCQ) and seminar - central nervous system.
Practical courses
Introduction to practical laboratories. Rules of safety work in laboratories. Rules of blood handling and blood sampling.
Counting of red blood cells. Packed cell volume (PCV - Hematocrit). Red blood cell sedimentation.
Summary - RBC – number, calculation of red blood cell indices.
Hemolysis. Testing of fragility of red blood cells. Hemoglobin derivatives.
Summary – Hemoglobin, hemolysis.
(Investigation of capillary resistance.) Investigation of bleeding time. Determination of clotting time (Lee-White, APTT, prothrombin time).
Summary - Hemostasis
How to gain scientific information.
Testing for blood group and Rh factor. Preparation of blood smear.
Test (MCQ) and seminar - hematology.
Summary - WBC, blood groups and Rh factor.
Test (MCQ) and seminar - immunology.
Action potential (theory, case).
Neuromuscular transmission (theory, case).
Test (MCQ) and seminar - general neurophysiology and myology.
Basic neurological examination - proprioceptive and exteroceptive reflexes.
Test (MCQ) and seminar - central nervous system.
Recording and evaluation of ECG I.
Physical examination of cardiovascular system. Determination of arterial blood pressure.
Recording and evaluation of ECG II.
Practical class at Simulation center.
Demonstration of regulation of the isolated heart.
Harvard step test.
Evaluation of ECG - conclusion. TEST ECG.
Credit. 2nd correction tests.
Annotation
The aim of Physiology I is to gain good knowledge about the functions of the human body in health. The subject Physiology I is taught in the form of lectures, practical classes and seminars. Emphasis is mainly focesed on functional organization, on the mechanisms controlling the internal environment of the organism, interrelationships among the control of individual functions and on the coordination and integration of functions. Lectures: concept of homeostasis, body fluid compartments, blood and its functions (hemostasis, blood groups), introduction to immunology (innate and adaptive immunity), general neurophysiology (ion transport across the membrane, resting and action membrane potential, synapses), myology (skeletal and smooth muscle), central nervous system (spinal reflexes, regulation of posture and movement, reticular formation, autonomic nervous system, function of different parts of the CNS, CNS metabolism, wakefulness and sleep, lower and higher nervous activity, speech), cardiovascular system (cardiac muscle, conductive system of the heart, cardiac cycle, ECG, cardiac output and its regulation, blood flow, functional classification of the circulatory system, microcirculation, regulation of CVS activity) and respiratory system (ventilation, diffusion, transport of respiratory gases by blood, pulmonary circulation, regulation of breathing). Practical classes: selected methods and examinations used in clinical practice (basic hematological examinations with an emphasis on hemocoagulation tests, blood group tests, WBC count, basic principles of neurological examination, ECG recording and evaluation, blood pressure measurement, cardiac stress tests). Entry requirements: prerequisites: completed Anatomy II Outcomes:
1. the student acquires basic theoretical knowledge about the function of the blood, the immune system, general neurophysiology and myology, the central nervous system and the cardiovascular system
2. the student acquires practical skills related to important clinical and laboratory examinations and learns to interpret the obtained results
3. the student gets to know the basic ways of obtaining scientific information
4. the student is capable of basic medical thinking based on model case studies.