Download Vice-Rector for education normal physiology department

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„CONFIRMED”
Vice-Rector for education
____________ Prof. Guminsky Y.I.
"___" ____________ 2012
THEMATIC PLAN OF LECTURES
normal physiology department
Vinnitcia medical N. Pirogov’s university
on 3 semester of 2012-2013 academic year
for the students of 2 course
medical faculty (for foreign students).
40 h for the lectures.
MODULE 1
1. OBJECT AND TASKS OF PHYSIOLOGY. EXCITATIVE TISSUES. BIOPOTENTIALS.
Physiology as scientific basis of medicine about the functions of organism, ways of health saving
and capacity. Value of physiology in before-clinical doctor’s preparation. Connection of physiology
with the other nature sciences (physics, chemistry, anatomy, cybernetics and others).
Functions of cells, tissues, organs, physiological systems of organism. Homeostasis and
homeokinesis. Excitation as universal display of vital functions. Concept of the excitative tissues.
Stimulation as factor of external environment influencing on an organism and reflex adaptation on
principle of the functional system. Excitability. Threshold as a measure of excitability. Electric
phenomena in excitative tissues. Modern methods of biopotentials studying in physiology and
medicine. Membrane potential of the rest. Action potential.
LECTURE DEMONSTRATIONS: demonstration of modern electro-physiology apparatus.
Demonstration of movie is a "microelectrode technique".
2. ELECTRO-GENESISES IN EXCITATIVE TISSUES. LAWS OF EXCITATIVE TISSUES
STIMULATION. PHYSIOLOGY OF MUSCLES
Modern pictures of mechanism of biological potentials origin - membrane potential of rest and
action potential (Kouel, Kartis, Huxley, Hogkin, Katz). Local potential. Critical level of
depolarization. Sodium activation and inactivation. Phases of excitability: absolute and relative
refractory, supernormal phase. Ionic channels functioning, their role in estimation of medicines
action (B.І.Chodorov, P.G. Коstjuk). sodium-potassium pump.
Action of electric current on excitative tissues. Correlation between strength of stimulation and
strength of the reaction. Physical and physiological electro-tone. The law of polarity. Cathodal
depression. Accommodation. Lability. Correlation between the minimal strength and duration of
stimulation. Reobaze. Utilization time. Chronaxia. Importance of stimulation laws for physiotherapy
and electrodiagnostic.
Mechanism of muscular contraction. Types of skeletal muscles contraction: isometric, isotonic,
auxotonic. Regimes of skeletal muscles contractions. Single and tetanic contractions as a result of
superposition of single muscular contractions. (Helmgoltz). Vvedensky’ theory of the optimum and
pessimum of stimulation strength and frequency. Rhythmic contractions of muscles in the human
organism. Concept of absolute and maximal strength of muscle. Work of muscles. Static and
dynamic activity of man, capacity. Importance of І.M. Sechenov’ and J.V. Folbort’ works about
fatigue and renewal of functions. Sechenov’ active rest theory.
3. GENERAL PRINCIPLES OF FUNCTIONS REGULATION AND SELF-REGULATION.
NERVOUS REGULATION. REFLEX PRINCIPLE OF THE CNS ACTIVITY.
FUNCTIONAL SYSTEM AS UNIVERSAL PRINCIPLE OF REGULATION.
EXCITATORY SYNAPSES.
Biological regulation. Types of function regulation in an organism. Contours of the biological
regulation. Regulated parameters. Nervous and humoral regulation of functions in an organism.
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Reflex as elementary reaction of organism. Reflex arc; its functional and structural organization
in obedience to a neuron theory.
Functional system as universal principle of management (P.К. Anokhin). Reverse afferentation as
system-making principle. Laws of conducting of excitation on nervous fibres.
Synapses an organ and neuronal. Role of the mediators (L’jovi.,.V О. Kib’achov). Mediators of
excitation and inhibition (acetylcholin, norepinephrin, dopamine, glycine, GABA, glutamate,
serotonin, oxide of nitrogen and the other), neuro-modulators (neuro-peptides). Features of
excitation conducting in the synapses.
4. EXCITATION AND INHIBITION IN CNS. COORDINATION OF REFLCTORY
ACTIVITY.
Features of conducting of excitation on a reflex arc: one-side conducting, synaptic delay (time of
reflex), summation of excitation, after-tetanic potentiation, transformation of rhythm, after-action,
fatigue, sensitiveness to the neuro-tropic matters, damage influencing of drugs.
Postsynaptic and presynaptic inhibition, inhibitory mediators (Eccls, Shmidt, P.G. Kostjuk).
Central inhibition (І.М.Sechenov, Golts), its kinds (the direct, passing ahead, reciprocal inhibition
right behind excitation, recurrent inhibition, lateral). Divergence and convergence are structurallyfunctional pre-conditions of coordination. Irradiation and generalisation of excitation.
Concept of the reflectory activity coordination. Divergence and convergence is structurallyfunctional precondition for coordination. Irradiation and generalization of excitation.
Reflexes are: antagonistic, allied, sinergic, chain. Principle of general eventual way; facilitation,
occlusion (N.Vvedensky, Ch. Sherrington). Principle of dominant (О.О.Ukhtomsky), its property,
stages. Importance of dominant as working principle of brain. Modern pictures of integrative
activity of the brain. Plasticity in the nervous system.
LECTURE DEMONSTRATIONS: irradiation and generalization of excitation in a spinal frog.
5. FUNCTIONS OF SPINAL CORD, HIND AND MIDDLE BRAIN STEM AND
CEREBELLUM.
Functions of spinal cord. Role of anterior (ventral) and posterior (dorsal) spinal nerves roots
(the Bell-Majandi law). Reflex and conduction functions of spinal cord. Clinically important
reflexes. Role of spinal cord in regulation of muscular length and muscular tone. Physiology
description of the proprio-receptors. Functioning of gamma-loop. Functions of the tendon receptors
Golji. Activating of - and -motoneurons by supraspinal mtor centers. Functional possibilities of
the isolated spinal cord. The spinal animal. Spinal shock. Explorer function of spinal cord, its
development in ontogenesis.
Vitally important centres of brain stem. Role of hind brain in support and redistribution of
muscle tone. Decerebrate rigidity. Functional description of middle brain (nuclei of 3-4 pair of
cranial nerves, red nuclei, black substation, tectum, dark blue spot).
Functionally-structural organization of cerebellum. Associations of cerebellum and other
departments CNS as pre-condition of providing of its functions. Functional organization of
cerebellum cortex. Cooperation of the cortex and cerebellum, intracerebellar and vestibular nuclei.
Role of cerebellum in programming, initiation and control of movements.
Adaptation-tropic function of cerebellum (L.Оrbeli). Results of deletion and damage of
cerebellum in a man.
6. FUNCTION OF THALAMUS, BASAL GANGLIONS, RETICULAR FORMATION.
Specific (commuting and associative), motor, unspecific nuclei of thalamus. Their participation in
forming of pain.
Functional description of specific (commuting and associative), unspecific nuclei of the thalamus.
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Functional organization of basal ganglions. There is a role in regulation of muscular tone,
difficult motive acts, vegetative functions. Neuro-mediators in the system of basal ganglions, their
physiology role. Clinical displays of basal ganglions damage, their physiology mechanisms.
Ascending and descending parts of the reticular formation. Works of Megun and Morucci
Conception of the center-encephalic system (Penfild, Jasper, Gasto) and its correction.
7. PHYSIOLOGY OF THE VEGETATIVE NERVOUS SYSTEM. UNITY OF
REGULATION SOMATIC AND AUTONOMIC FUNCTIONS. LIMBIC SYSTEM OF THE
BRAIN.
Anatomic-physiology features of the sympathetic and parasympathetic system. Mediators in
vegetative synapses. Basic kinds of receptive substances. Metasympathetic nervous system
(O.D.Nozdrachev).
Interoreceptors, their importance (V.M.Chernigivs’ky). Role of large hemispheres’s cortex in
adjusting of internal organs activity (К.М.Bikov). Word of a doctor, as factor of influencing on the
state of the man health. Comparative description of the sympathetic and parasympathetic parts of
nervous system; relative antagonism of their influencing.
Description of influencing of stimulation of the sympathetic and parasympathetic fibres on the
function of different organs. Adaptation-trophic function of the sympathetic nervous system
(L.А.Оrbeli, А.G.Ginetsinsky). Vegetative reflexes which have clinical-diagnostic importance.
The limbic system and its functions. Emotions as basis of integral behaviour reactions, their
biological role (P.V.Simonov).
Limbic system, its organization and functions. Leading role of hypothalamus in adjusting of
vegetative functions. Structural-functional features of the hypothalamus: neuro-reception, neurosecretion. Role of the hypothalamus in the integration of somatic, autonomous and endocrine
functions, formation of motivations, emotions, biological rhythms, unspecific adaptation of
organism.
8. HUMORAL ADJUSTING OF AUTONOMOUS FUNCTIONS. ROLE OF ENDOCRINE
GLANDS IN ADJUSTING OF PROCESSES OF GROWTH AND DEVELOPMENT.
Factors of the humoral adjusting, their description and classification (ions, metabolites, peptides,
hormones). Contour of the humoral adjusting, role of feed-back in adjusting. Interconnection of the
nervous and humoral regulation.
Properties and functions of hormones. Basic mechanisms of hormones action. Receptors of
membranes and intracellular receptors, second mediators, G-proteins, their role. Adjusting of
hormones action. Hypothalamo-hypophysis system. Neurosecrets of hypothalamus, role of liberins
and statins. Functional connection of hypothalamus and hypophysis. Hormones of a front and back
particles of hypophysis.
9. ROLE OF ENDOCRINE GLANDS IN REGULATION OF PROCESSES GROWTH,
DEVELOPMENT, HOMEOSTASIS AND UNSPECIFIC ADAPTATION OF ORGANISM.
Endocrine function of pancreas. Insulin (Sobol’ev, Banting), glucagon.
Parathyroid gland.
Thyroid gland. Functions of hormones (thyroxin, thyrocalcitonin). Hyper and hypo- function of
thyroid gland.
Adrenal glands. Functions of cerebral matter. Hormones of cork matter (mineral-corticoids,
glucocorticoids).
Role of hormones in adjusting of specific and unspecific adaptation. Role of hormones at action
of stressing factors.
10. ROLE OF ENDOCRINE GLANDS IN REGULATION OF HOMEOSTASIS AND
UNSPECIFIC ADAPTATION OF ORGANISM.
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Adrenal glands. Functions of cerebral matter. Hormones of cork matter (mineral-corticoids,
glucocorticoids).
Role of hormones in adjusting of specific and unspecific adaptation. Role of hormones at action
of stressing factors.
Endocrine function of sex glands. Male and female sex hormones. Menstrual cycle. Endocrine
function of placenta. Hormones of the entherine system. Tissue hormones.
Thymus gland, its functions, importance in child's age. Epiphysis, its hormones, their functions.
MODULE2
1. INTERNAL MEDIUM OF ORGANISM, AS MEAN OF PROVIDING OF UNITY
ORGANISM AND ENVIRONMENT. GENERAL DESCRIPTION OF THE SYSTEM OF
BLOOD. PHYSIOLOGY OF ERYTHROCYTES.
Liquid media of organism. Concept of the internal medium of organism. Homeostasis and its
regulation.
Concept of the system of blood. Basic functions of blood. Blood as system of transport. Amount
and composition of blood. Hematocrit index. Physiological description of elements of blood.
Functions of erythrocytes. Haemoglobin and its properties. Forms in early ontogenesis. Compounds
of haemoglobin. Myoglobin. Role of haemoglobin in providing of respiratory function of blood.
Oxygen capacity of blood. Differential blood count. Functions of leucocytes; Т- and Вlymphocytes.
Plasma of blood, its composition. Osmotic pressure and its role. Solutions: iso-, hypo- and
hypertonic. Osmotic fragility of erythrocytes. Haemolysis. Oncotic pressure and its role in water
exchange. Erythrocyte sedimentation rate (ЕSR). Active reaction of blood (PH).. Acidosis and
alkalosis. Buffer systems of blood.
2. DEFENSIVE FUNCTIONS OF BLOOD. BLOOD GROUPS.
System which supports the liquid aggregate state of blood. Prevention of blood coagulation in
the normal vascular system. The intravascular anticoagulants. Fibrinolysis. Dialectical relation
between the mechanisms which support the liquid aggregate state of a blood. Thrombocytes, their
structure and functions.
Coagulation of blood. Formation of the platet plug. Coagulative hemostasis, its stages,
mechanisms, importance. Characteristic of the factors, which take part in coagulative hemostasis (of
plasma, of thrombocytes, of leukocytes, of tissues). Anticoagulants, their importance.
Blood groups ABO, CDE and other (Jansky). Studies about specificity of albumens of
plasma and their role in blood transfusion. Methods of blood groups determination. Rhesus blood
factor (Rh) (Landsteiner and Vinner). Its importance for the normal development of fetus. Rules of
blood transfusion.
LECTURE DEMONSTRATIONS: demonstration of video-film: "Formation of the platelet plug".
3. BREATHING SYSTEM. PHYSIOLOGY MECHANISMS OF BREATHING STAGES.
Functions of the breathing system. Breathing stages. Role of the external breathing. Physiological
description of respiratory tracts.
Biomechanics of inspiration and expiration. Pressure in a pleura cavity, its appearance in
ontogenesis. Elastic properties of lungs and walls of thorax. Elastic traction of lungs. Role of
surfactants. Breathing features in fetus and baby. Static and dynamic indexes of lungs ventilation.
Classification of respiratory volumes. Vital capacity of lungs. Spirometry. Spirography.
Pneumotahography. Pikflowmetry. Pulmonary ventilation and factors responsible for it. Remaining
volume. Anatomic and physiology „dead space”.
4. TRANSPORT OF GASES BY A BLOOD.
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Exchange of gases in lungs. Composition of inspired, expired and alveolar air; importance of
their measuring. Partial pressure and tension of gases in alveolar air, in a blood and in tissues.
Exchange of gases between alveolar air and blood.
Transport of gases (O2 and CO2) by blood. Table of contents О2 and СО2 in an arterial and vein
blood. Oxygen capacity of blood. Coefficient of oxygen utilization. Fastening and transference by
the blood О2. Curve of HbO2 dissociation. Factors which influence on dissociation of HbO2.
Connection and dissociation of HbCO2 and bicarbonates. Importance of carboanhydrase. Gases
exchange between blood and tissues.
5. CONTROL OF BREATHING.
Breathing regulation. Medulla oblongata’s respiratory center (Mtslavsky’, Lumsden). Role
of the tension СО2, О2 and other humoral factors in adjusting of breathing. Reflexes adjusting of
breathing. Central and peripheral chemoreceptors, their importance in providing of gas homeostasis.
Changes of lungs ventilation at hypercapnia and hypoxia. Receptors of lungs tension, their role in
control of breathing. The Heringe-Breer’s reflexes. Role other types of receptors in adjusting of
breathing: irritante, j-receptors, proprio-receptors.
Mechanism of the first inhalation in the newborns.
6. SYSTEM OF BLOOD CIRCULATION. PHYSIOLOGY PROPERTIES AND FEATURES
OF THE HEART.
Morpho-functional description of the system of circulation of blood, its role in an organism.
Heart, its structurally-functional features. Automatism of the heart. Action potential of atypic
cardiomyocytes as the pacemaker of the heart rhythm (synoatrial node). Conducting system of heart,
its functional features, speed of excitation conducting on the structures of the heart. Blockades of
heart: transversal and longitudinal. Action potential of typical cardio-myocytes. Phases of
excitability. Mechanism of cardio-myocytes contraction. Analysis of correlation between the
excitation and excitability of cardiomyocyte and contraction of myocardium. Systolic and minute
volumes of heart as indexes of force and work of heart. Endocrine elements in a heart.
LECTURE DEMONSTRATIONS: movie "Isolated heart".
7. PUMP FUNCTION OF HEART. EXTERNAL DISPLAYS OF CARDIAC ACTIVITY.
Phase analysis of cardiac cycle, its clinical role. Age-old features of cardiac cycle. Pressure in the
cavities of heart and main vessels of pectoral cavity and work of valves in different phases of
cardiac cycle.
External displays of cardiac activity (electric, sound, mechanical), their origin, methods of
researching: cardiac shove, tones of heart, phono-cardiogram and others. Electrocardiography (ЕКГ)
(Einthoven, Samoilov)). Mechanism of forming of ECG elements. Electric axis of heart. Features of
alpha angle in teens. Role of electrocardiography in clinic. Concept of the dynamo-, balisto-,
mechano-,vector- and echo-cardiography.
LECTURE DEMONSTRATIONS: listening of phonogram of hearts of a healthy man.
8.
BLOOD
PRESSURE.
VELOCITY
OF
BLOOD
STREAM.
PULSE.
MICRICIRCULATION. VEIN CIRCULATION.
System circulation of blood. Classic (after Harvey) and functional (after Folkov) classification of
departments of vascular river-bed. Circulation of blood according to the laws of hydrodynamics.
Mechanism of vascular tone forming. Common peripheral resistance of vessels. Factors, which
responsible for the value of arterial pressure. Arterial pressure: systolic, diastolic, pulse, middle,
shock, lateral. Bloody pressure in different parts of the circulatory system. Age-old arterial pressure
fluctuations. Hypertension, hypotension. Physiology bases of measuring bloody pressure in the
experiment and clinic. Bloody depots and physiology mechanisms which regulate the redistribution
of blood in an organism (S.P. Botkin, L.D.Barkroft).
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Volume and linear rate of blood movement. Values of them in different parts of the circulatory
system and factors, influence on them. Time of blood circulation. Arterial pulse and its properties.
Sphygmogram, its estimation. Physiology description of capacity vessels. Factors which influence
on movement of blood in veins. Returning of blood to the heart. Vein pulse, flebogram, its
estimation.
Physiology of capillaries. Mechanism and role of microcirculation.
9. CONTROL OF CARDIAC ACTIVITY AND SYSTEM CIRCULATION OF BLOOD.
Adjusting of cardiac activity: myogenic, humoral, nervous. Intracellular and intra-cardiac
regulator mechanisms. Heterometric and homeometric regulation of heart functioning. The heart law
(Starling), its narrow-mindedness. Local reflexes, their role in adjusting of operation of the
transplanted heart. Pavlov’s classic works of the centrifugal nerves of heart; strengthening nerve of
heart, as illustration of trophic function of the nervous system. Reflex adjusting of cardiac activity
(reflexes from the carotide sinus receptors and arc of aorta, atriums and large veins). Conditionreflex adjusting of heart functioning, its role according to the positions of deontology. Humoral
regulation of heart operating (endocrine).
Regulation of hemodynamic system. Nerves vasoconstrictors and vasodilatators (the Val’ter and
Bernar’ experiments). Cardiovascular center, its localization, mechanisms of excitation. Influence of
the higher departments of CNS on the vascular tone. Humoral, metabolic, myogenic adjusting of
vascular tone.
10. SYSTEM OF DIGESTION. DIGESTION IN THE MOUTH CAVITY. ROLE OF THE
TASTE AND OLFACTORY SENSORY SYSTEMS. CONTROL OF SALIVATION.
DIGESTION IN A STOMACH. REGULATION OF SECRETORY AND MOTOR
FUNCTIONS OF THE STOMACH.
Digestion as functional system, that supports the constant level of nutrient matters in an
organism; its internal and external links. Digestive center. Physiological backgrounds of hunger and
satiation; their importance in the precautions of gastro-intestine tract diseases. Types of digestion
(cavity, membrane, intracellular).
Digestion in a mouth cavity. Mechanical and chemical development of meal. Saliva, its
composition. Physiological importance of its components. Regulation of salivation. Role of
parasympathetic and sympathetic secretory fibres.
Digestion in a stomach, its role. Composition of gastric juice. Importance of its components for
digestion. Role of hydrochloric acid in digestion. Role of gastric enzymes. Protective mechanisms
from the stomach mucus self-digestion. Role of the mucus. "Cephalic" (complex-reflex) and neurohumoral (gastric and intestinal) phases of gastric secretion. The matters which suppress, excite and
indifferent to the gastric secretion; hormones of the DES system.
Chief of the normal physiology
department
prof. Moroz V.M.