Physiology

Oral exam 2017

Opracowali: Tomasz Błaszczyszyn, Remigiusz Dzień, Aleksandra Kamińska, Monika

Karcz, Dominik Łukasiak, Patryk Martynowicz, Aleksandra Miękina, Hubert Mikosza,
Anna Opadczuk, Bernadetta Socha, Hugo Szczuraszek, Łucja Świca
 I. Neurohormonal regulation of body functions.

1. Physiology as a science. The concept of function. Methods physiological research:

Physiology is the science about the regularities of organisms‘ vital activity in connection with
the external environment.

a) Observation
This is the method in which the scientists don‘t mix in course of vital processes. They only
make use of vision and description of all changes. On the base of this changes they make
conclusions.

b) Experiment
There are two kinds of experiments: acute and chronic. Acute experiment was doing with the
helps of anesthesia. It may be accompanied by cut off the nerves, introduction the different
substances. The chronic experiment was doing in vital animals, for example, after the acute
experiment scientists can used the observation.

c) Examination
This is the method of examine the patient with different diseases, for example, with using the
different apparatuses.

d) Simulation
We can simulation different processes as a laboratory simulation or realistic simulation, for
example, apparatus of artificial kidney or apparatus of artificial circulation. It may be the
simulation the different processes by means of computers.

2. The formation and development of physiology in the nineteenth century.

From 19 century to our days physiology separated of anatomy and became the independent
science. Majandi studied the physiology of nerves system. Bernar studied the physiology
mechanisms of development of digestive juice and their digestion properties, the role of liver
in supporting the sugar level in blood, meaning of constant of pupils‘ internal surrounding.
Yung worked out the three component theory of color perception. Gelmgolths developed this
theory and creation the theory of hear perception. Phylomaphytsky worked out the theory of
cyclic functioning of nerves system.

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 3. Contribution work I.M.Syechenova, I.P.Pavlova, PC Anohin, P.H.Kostyuka to the
world of physiology.

a. M. Sechenov's - problems of physiology and biophysics of respiration closely followed

the problems of central nervous system and psychology in the scientist's creative work. The
principle of resumed vacuum is shown to have major significance for extraction of the blood
gases and invention of absorptiometer underlying further modifications of the model. I. M.
Sechenov's studies in binding of CO2 by different blood components and saline solutions, in
interrelationship of oxygen binding by erythrocytes and output of carbonic acid, in solubility of
carbonic acid in water.

b. Pavlov contributed to many areas of physiology and neurological sciences. Most of his
work involved research in temperament, conditioning and involuntary reflex actions.Further
work on reflex actions involved involuntary reactions to stress and pain. Pavlov extended the
definitions of the four temperament types under study at the time: phlegmatic, choleric,
sanguine, and melancholic, updating the names to "the strong and impetuous type, the strong
equilibrated and quiet type, the strong equilibrated and lively type, and the weak type."

4. Ukrainian physiological school.

Standing of physiology in Ukraine (In year 1593 was opened the first high medical school near
Lviv – Zamoiska academy. In year 1594 this school became the university and it has given the
doctor degree. In 1661 was opened the Lviv University with the medical faculty. In 1805 was
opened the Charkiv University with the medical faculty. On this the medical faculty studied
Danilevsky, who published the important work about the influence of brain on blood circulation
and breathing, the text-book from physiology, he was the one science in the world, who register
bioelectrical phenomenon of dogs‘ brain.

Resting 5. Potential calm the nerve cell mechanisms of formation, size, physiological role.
→ -

The formation of resting potential depends on:

• Concentration difference of K+ across the membrane
• Permeability of Na+ and K+ during the resting state
• Na+-K+ pump

Ions and the Resting Potential

Ions are electrically-charged molecules e.g. sodium (Na+), potassium (K+), chloride (Cl-).
The resting potential exists because ions are concentrated on different sides of the membrane.
• Na+ and Cl- outside the cell.
• K+ and organic anions inside the cell.

3
 • Resting membrane potential of most cells ranges from - 65 to – 85 mV.
• In most neurons the resting potential has a value of approximately −70 mV.

Concept of Resting Potential:

A potential difference across the cell membrane at the rest stage or when the cell is not
stimulated.

a. Function:
The resting potential is mostly determined by the concentrations of the ions in the fluids on both
sides of the cell membrane and the ion transport proteins that are in the cell membrane.

b. Maintaining the Resting Potential

• Na+ ions are actively transported (this uses energy) to maintain the resting potential.
• The sodium-potassium pump (a membrane protein) exchanges three Na+ ions for two
K+ ions. ↳ outside
→
inside
6. The action potential of nerve cells, the mechanisms of formation, size, physiological
role.

• Polarization: a state in which membrane is polarized at rest, negative inside and positive
outside.
• Depolarization: the membrane potential becomes less negative than the resting potential
(close to zero).
• Action potentials: Rapid depolarization
When partial depolarization reaches the activation threshold, voltage-gated sodium ion
channels open.

1. Sodium ions rush in.

The membrane potential changes from -70mV to +40mV.
Stimulus causes depolarization to threshold.

2. Na+ channels open.

Electrochemical gradient inward.
+ feedback loop.
Rapid reversal in membrane potential from –70 to + 30 mV.
VG Na+ channels become inactivated.

3. K+ channels open.
Electrochemical gradient outward.
- feedback loop.
Restore original RMP.

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Concept:
Action potential is a rapid, reversible, and conductive change of the membrane potential after
the cell is stimulated.

Nerve signals are transmitted by action potentials.

Properties of the Action Potential;

• “All or none” phenomenon
• A threshold or suprathreshold stimulus applied to a single nerve fiber always initiate the
same action potential with constant amplitude, time course and propagation velocity.
• Propagation
• Transmitted in both direction in a nerve fiber

7. The critical level of depolarization.

* Local answer is
excitation that occurs
only wander
Threshold Potential: threshold stimuli

• Threshold potential plays a key role in the genesis of action potential.

• Threshold potential is a critical membrane potential level at which an action potential
can occur. Because of
+
Why can all the Na channel open at the threshold potential? It is dependent on the gating
property of the voltage-gated Na+ channels.
The value of threshold potential of most excitable cell membrane is about 15 to 20 mV less
negative than the resting potential.
The threshold stimulus is just strong enough to depolarize the membrane to the threshold
potential level, therefore it can cause an action potential.

8. Changes in the excitability of cells during stimulation. K+

inside
The various ions in the cytoplasm are maintained at a certain concentration, since the cell
membrane blocks unregulated ion penetration. For example, as shown in Figure 17-5A, the K+ that
concentration is maintained higher while Na+ is maintained lower inside animal cells, as outside
compared to extracellular fluids (biological fluids such as blood and lymph fluid). By
maintaining such concentration difference, cells can generate a potential difference (negative
charge at the cytoplasm side) of tens of millivolts across the cell membrane. This potential,
called resting membrane potential, is an equilibrium potential that results from the difference
in concentration and selective permeability of ions across the cell membrane.

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9. The laws and conditions of the excitation of nerve fibers.

a) Condition of carrying (1. Anatomic integrity of nerve‘s filament. 2. Physiological full

value.)
b) Laws of carrying (1. Double-sided conduction. 2. Isolated of conducting. 3. Conducting
of excitation without attenuation.) mode
C) Carrying in
myelinated nerves → from nodes of to next
ranvier

conductor of stimuli
d) Carrying in nonmyelinated nerves
- → uninterrupted
10. Mechanisms of excitation of nerve fibers.
Excitation is
by the propagation of X-P in
response to stimuli !
In myelin filaments conducting of excitation is done from node of Ranvier to node of Ranvier
In nonmyelin filaments con+ducting
• of excitation is done uninterrupted

11. Mechanisms of excitation transfer through the neuromuscular synapse.

Transmission from nerve to muscle resembles chemical synaptic transmission. The myoneural
junction, the specialized area where a motor nerve terminates on a skeletal muscle fiber, is the
site of a stereotyped transmission process. The contacts between autonomic neurons and smooth
and cardiac muscle are less specialized, and transmission is a more diffuse process.

12. Conjugation of excitation and contraction. Mechanisms of contraction and

relaxation of skeletal muscles.

1. Muscle activation: The motor nerve stimulates an action potential (impulse) to pass
down a neuron to the neuromuscular junction. This stimulates the sarcoplasmic reticulum to
release calcium into the muscle cell ↳ muscular endoplasmic
-
Cqht is released from E R
- . reticulum

2. Muscle contraction: Calcium floods into the muscle cell binding with troponin allowing
actin and myosin to bind. The actin and myosin cross bridges bind and contract using ATP as
energy (ATP is an energy compound that all cells use to fuel their activity – this is discussed in
greater detail in the energy system folder here at ptdirect). Ccitt troponin → actin + my sin
binding
-

→ actin + mysin bridge (+ ATP)

3. Recharging: ATP is re-synthesised allowing actin and myosin to maintain their strong
binding state.

4. Relaxation: Relaxation occurs when stimulation of the nerve stops. Calcium is then pumped
back into the sarcoplasmic reticulum breaking the link between actin and myosin. Actin and
myosin return to their unbound state causing the muscle to relax. Alternatively relaxation
(failure) will also occur when ATP is no longer available.
Actin 1- ✗ relaxation
Stnnlation stops mysin →
.
-
-

-
Cast removed -

actin +
mysin ✗ → ATP
depleted

13. Types of muscle contractions, single and tetanichni; isotonic and isometric
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 • An isometric contraction of a muscle generates tension without changing length. An
example can be found when the muscles of the hand and forearm grip an object; the
joints of the hand do not move, but muscles generate sufficient force to prevent the
object from being dropped.

• In isotonic contraction, the tension in the muscle remains constant despite a change in
muscle length.This occurs when a muscle's force of contraction matches the total load
on the muscle.

• A single(twitch) contraction is a single brief contraction of the muscle that occur in

response to a single threshold or suprathreshold stimulus while a tetanic contraction is
maintained contraction of a skeletal muscle owing to the continuous excitation of the
muscle fibers

14. The concept of reflex. The structure and function of the reflex arc of links.

• Reflex is a change of functional activity of tissues, organs or whole organism as an

- answer on stimulus by help of central neural system.
response • Structure and functions of reflex arc: it consist of receptors which are perceive different
influences which act on organism
• It also consist of afferent neurons which connect receptors with centrsl nervous system
• It again consist of central part of CNS which realize analyses and synthesis of afferent
information.
• Also it consist of efferent chain which secure going out of excitement ftom central
nervous system
• It also consist of effector which is executive organ and it also has opposite connection
T note
15. Receptors, their classification, mechanisms of arousal.

Cholinergic and adrenergic:

1. Cholinergic uses acetylcholine as a neurotransmitter from the parasympathetic nervous

system.

*Nicotinic receptors are found in the somatic system on the motor end plates of skeletal muscle
cells and in the ANS on all postganglionic neurons and the hormone producing cells of the
adrenal medulla. ACh binding to a nicotinic receptor is excitatory. *Muscarinic receptors
(named for muscarine, a mushroom poison) are found in effectors that are stimulated by
cholinergic fibers. The effect is inhibitory or excitatory based on the target

2. Adrenergic uses norepinephrine/epinephrine as a neurotransmitter which comes from the

sympathetic nervous system.

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 Many cells possess these receptors, and the binding of a catecholamine to the receptor will
generally stimulate the sympathetic nervous system. The sympathetic nervous system is
responsible for the fight-or-flight response, which includes widening the pupils of the eye,
mobilizing energy, and diverting blood flow from non-essential organs to skeletal.

• Alpha: excitatory
• Beta: inhibitory, except in the cardiac muscle where it is excitatory

16. The mechanisms and patterns of transmission of excitation in the central

synapses. Divergence 3 Irradiation Core neuron many > → 0¥
>8☒_o→ÉÉ
-
to >

-
Convergence
Reverberation Cshort term
memory ,
-

An excitatory synapse is a synapse in which an action potential in a presynaptic neuron

increases the probability of an action potential occurring in a postsynaptic cell. Neurons form
networks through which nerve impulses travel, each neuron often making numerous
connections with other cells. These electrical signals may be excitatory or inhibitory, and, if the
total of excitatory influences exceeds that of the inhibitory influences, the neuron will generate
a new action potential at its axon hillock, thus transmitting the information to yet another cell.
Time summation : addition of subthreshold potentials over
depolarization it the frequency of potential
is
enough .
time →
-
@cohesion
]
due several subthreshold
space summat : excitation to
potentials over time → EPSP that
-

on
can become ac tive potential .

17. Types central inhibition. Mechanisms of presynaptic and postsynaptic

inhibition.

Inhibition in a general definition is a Indendent nerve process which is caused by exitation &
manifested by the suppression of another exitation.
Inhibitory
pre postsynaptic
or

connector with neurons

Types of inhibition: → neurons form synaptic
've
of excitant
with roistering
collateral axon
1. Opposite →
connection
inhibitor neurons form
2. Lateral collateral owns of of
→
excitatory cells
oppositely contractor of
is inhibited { other is excite ) biceps { triceps
.
→
one
3. Reciprocal inhibition of opposing neurons (
.

4. Recurrent → neuron inhibits the motor (excitatory)

a that excited neuron
it '

Crenshaw cells

Presynaptic inhibiton:
It may be between axons of excitive and inhibitory neurons.
Inhibitory mediator cause hyperpolarization of axon of excitable neuron, prevent arriving of
active potential to presynaptic end and as result decrease production of mediator for the
development of excitement in postsynaptic cell.
The inhibition occurs at the presynaptic terminals before the signal ever reaches the synapse
C and A form an axon-axon synapse (presynaptic synapse). Neuron C has no direct effect on'
l
\
l l l l l l l
lreleased
neuron B, but it exert a presynaptic effect to decrease the amount of neurotransmitter
from A.
Difference between Pre { Postsynaptic Inhibitors Pre cause hyperpolarization to

stop arrival of X-P aol.ie Post causes production of inhibitory mediators

(GABA ,
Glycine ) .

8
 the " " ""
&
" ^^

"" " ""

+ °o° "
&

(
Produce
inhibitory mediators inhibit
to same

cell
(GABA and Glycine ) .

Postsynaptic inhibition:
Neurons may also inhibit themselves in a negative
C A
feedback fashion.
Each spinal motor neuron regularly gives off a
recurrent collateral that synapses with an inhibitory
interneuron which terminates on the cell body of
the spinal neuron and other spinal motor neurons.
The inhibitory interneuron to secrete inhibitory
B mediator, slows and stops the discharge of the
motor neuron.

Effect of inhibitory synapses on the postsynaptic

membrane
– Inhibitory interneuron release inhibitory transmitters and the postsynaptic
neuron produce IPSP →
inhibitory postsynaptic
potential !
Afferent collateral inhibition (reciprocal inhibition)
fPsp→
excitatory postsynaptic
Recurrent inhibition potential .

18. Summation of excitation and inhibition of neurons in the CNS.

Summation, also known as frequency summation is the method of signal transduction between
neurons, which determines whether or not an action potential will be triggered by the combined
effects of postsynaptic potentials. Neurotransmitters emitting from the terminals of a
presynaptic neuron fall under one of two categories. Excitatory neurotransmitters produce
further depolarization of the postsynaptic cell, while an inhibitory neurotransmitter will
mitigate the effects of an excitatory neurotransmitter. While some neurotransmitters are known
to predominately produce one of the two responses, they do widely vary and how they vary
ultimately depends on the type of channel to which the neurotransmitter receptor is attached.
Time summation addition of subthreshold potentials
! over time →

depolarization it the frequency of potential is

enough .

due several subthreshold

Space summat : excitation to
potentials over time → EPSP that
-

on

19. Motor reflexes of the spinal cord, their reflex arc, the physiological
can become a c t i vepotential -

significance. descending
ascending
t f
Spinal cord has 2 kinds of tracts: ascendens and descendens. Ascendens tracts are sensory
of spinal cord
descendens are motor. →
Corticospinal tract is Basic motor tract. It is passing In side columns. It is a conductor of

t
impulses to the skeletal muscles, is regulating free movements.
Reflex is the mechanism by which sensory sensory impulse is automatically converted into a
motor effect thru the involvement of CNS. (see more question iaipg 7) ,

Ascending
Reflex Arc Components: -

nerve fibres come from 1

•

neurons in dorsal root ganglion

1. Afferent limb; -
Dorsal funiculus → tactile , vibration ,
proprioceptor ,
pressure
crude touch
-

Lateral funiculus → Spino thalamic tract → pain ,temperature ,

Spinocerebellar → 9
encoring -
ons proprioception from muscles { tints of dexterity
ventral column
Descending
-

tract
PaleoSpino thalamic
•

tectal
Spino
o -

0
Spiro olio alary
-

•
Spino reticular
 -
Descending
Arises from { brainstem Motor
cortex
.
, posture balance
, , muscle
visceral { somatic reflex activity
-

tone .

-
Lateral corticospinal $ Rnbrospinal tracts → voluntary movement

LisSaner level
's
regulate pain spinal
-

trac t → at

2. Central component:
Retta↳
spinal , balance {
final
-

biospinal tract →
vest { anterior a- + cos

Postural
3. Efferent limb. movement .

20. Conduction function of the spinal cord.

Conducting function of the spinal cord is as follows: gray matter sends impulses from the
peripheral nerves in the organs to other parts of the Central nervous system. The conductors
that make up the white matter transmit signals from receptors of skin, muscles, and internal
organs. The impulses are then transferred via short paths to other segments of the spinal cord,
and the long – to the brain. Grey matter : from peripheral nerve of organ → cus
White matter : from receptor of skin, muscle , organs → s .
c
segments
→ CNS
above red mole
.

21. Motor hindbrain reflexes, detserebratsiyna rigidity. lesion

decerebration →

The hind brain is also called the rhombencephalon and is the brain stem that provides the
connection between the spinal cord and the rest of the brain. The hind brain contains many
structures including the Medulla Oblongata, the Pons and the majority of the cranial nerves, III

gu÷at÷ Inhofe
to XII. tone of neck muscles after excitement Rowena pic reflex .

Static reflex
: Reflex that supports position of pose in space .

Reflexes: Vestibular
>
Decerebrate rigidity (DR) in humans results from a midbrain lesion and is
, manifested by an exaggerated extensor posture of all extremities.
1.Pons It is characterized by shortening and lengthening reactions and
2.Midbrain / Mesencephalon that corrects the orientation of the body when
can be modified by tonic neck, labyrinth and phasic spinal reflexes.
a reflex Decerebrate rigidity is characterized by
-the Righting reflex taken out of its upright position
extension of all four limbs and the trunk. It is caused by a lesion in the
.

-labryrinthe -neck -body on head -body on body rostral brainstem (midbrain or pons). Opisthotonos may be associated

3.Medulla tilting the head while lying backward

with decerebrate rigidity if the rostral lobes of the cerebellum are
causes the
damaged.
back to stiffen 3 archi legs straight Decerebrate
toes point andarms bend
Decorticate at elbow
posturing ! that brain
can indicate
-tonic labyrinthine reflex , ,

herniation is occurring or is about to occur. Brain herniation is an

-tonic neck reflex taken 's head is turned
extremelyto dangerous condition in which parts of the brain are pushed
a
baby one side the
past hard structures within the skull.
,
that side
ar m on

stretches out { the

opposite ar m bends at the elbow
In herniation syndrome, which is indicative of brain herniation,
.

22. Motor reflexes midbrain, theirdecorticate

physiological importance.
posturing occurs, and, if the condition is left untreated,
develops into decerebrate posturing.

• This is the most superior part of the brain stem. The corpora quadrigemina, the red
nucleus, the substantia nigra, the cerebral peduncles, and the cell bodies of two
cranial nerves are located in the midbrain.
• The anterior quadrigeminal ☒ d are the primary optic nerves and involved In certain
Dobies
reflexes responding to light stimuli, including the Visual orientation reflexes.
• Reflex movements of the eyes are induced by impulses conveyed to the eye muscles
from the nuclei of the oculomotor and trochlear nerves.
• The anterioe quadrigeminal Dobies Take part In pupillary reflexes.
• The posteriori quadrigeminal B Dobies are the primary centres. They are involved In the
auditory
performance of sound orientation reflexes: the pricking up of the ears of the Animals,
Turing of the head and body towards a New sound.
Reflex : state { Stato Vinet '
C static
supports of pose
vestibular restoration
- -

Stato kinetic supports pose following sudden

change of movement
speed .

23. Cerebellum and its functions.

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The cerebellum is located behind the top part of the brain stem (where the spinal cord meets
the brain) and is made of two hemispheres.
Functions of cerebellum:
1. Regulation of posture and equilibrium, and muscle tone,
2. Coordination of posture and slow determined movements,
3 . Coordination of fast determined movements.
Cerebellum inputs and outputs:

The 3 deep nuclei are:

(1) fastigial - concerned with balance; sends information mainly to the vestibular and reticular
nuclei
(2) dentate and (3) interposed - both concerned with voluntary movement; send axons mainly
to the thalamus and red nucleus.

All 3 receive inputs from sensory afferent tracts and from the cerebellar cortex.

24. Thalamus its functions.

The thalamus is a small structure within the brain located just above the brain stem between the
cerebral cortex and the midbrain and has extensive nerve connections to both.

The main function of the thalamus:

1. is to relay motor and sensory signals to the cerebral cortex
2. regulates sleep, alertness and wakefulness
3. The thalamus may also be involved in the regulation of some types of memory
4. It also regulates the senses of sight, sound, taste, touch and the sense of where the person's
body is in space → proprioception
5. The thalamus decides which signals from the ears, eyes, mouth and skin to relay to its area
in the cerebral cortex. - attenuation of
sensory input

25. The limbic system, the hypothalamus, their function.

The limbic system, located just beneath the cerebrum on both sides of the thalamus, is not only
responsible for our emotional lives but also many higher mental functions, such as learning and
-

formation of memories.

The primary structures within the limbic system include the amygdala, hippocampus,
thalamus, hypothalamus, basal ganglia, and cingulate gyrus.

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 The hypothalamus is located below the thalamus and right above the brain stem. It forms the
anterior part of the diencephalon.

Functions of the hypothalamus:

1. controls the release of 8 major hormones by the pituitary gland

2. controls body temperature
3. control of food and water intake, hunger and thirst
4. control of sexual behavior and reproduction
5. control of daily cycles in physiological state and behaviour also known as circadian rhythm
6. mediation of emotional responses
Hypothalamic hormones include thyrotropin-releasing, gonadotropin-releasing, growth
hormone-releasing, corticotrophin-releasing, somatostatin, and dopamine hormones. ).
-
Laecotro pin releasing hormone isomatotropin E. releasing hormone
-

26. Basal nuclei, their function. neurons i inhibit

of brain {
sensorimotor
thalamus Gabaergic
regions wa .

Striatum : largest limbic

Input from cor tex ,
- .

from thalamus , brainstem substantia

Globus Pallidus Inputs
-

subthalamic ! input relay Output from

-
.

Basal ganglia, group of nuclei (clusters of neurons) in the brain that are located deep beneath Nigra

globo.IR/l.ds- the cerebral cortex. The basal ganglia comprise a distributed set of brain structures in the -

to
modulation
basal
Output to
telencephalon, diencephalon, and mesencephalon. The forebrain structures include the caudate structures {
basal ganglia
nucleus, the putamen, the nucleus accumbens (or ventral striatum) and the globus pallidus.
,

external
thalamus ,

brainstem
Together, these structures are named the corpus striatum. The basal ganglia is a group of nuclei structures
cortex limbic)
lying deep in the subcortical white matter of the frontal lobes
,

Its functions include:

-
Gross intentional movement that a re
performed subconsciously .

1. organizing motor behavior and coordinating rule-based, habit learning.

-
Hooks with thalamus cingulate gyrus } Limbic system { other
, parts of cortex !
27. Sensory, motor and associative cortex, their function.

The sensory cortex includes portions of the cerebral cortex, which function is process and
make sense out of information from our senses: vision, audition (sound), olfaction (smell),
gustation (taste), and touch.
Primary} pre The motor cortex is located in the rear portion of the frontal lobe, just before the central sulcus
lrrotor
area
-

↳ send fibres to (furrow) that separates the frontal lobe from the parietal lobe. The motor cortex is divided into
-

a-
+05¥ "
"

two main areas Function: planning, control, and execution of voluntary movements .

'[ gagging
Associative cortex is responsible for sensory information processing, multisensory integration,
or sensorimotor integration.
,
, ggggmromotor cortex
28. General plan of the autonomic nervous system. Autonomic reflexes, their reflex arc.

The ANS is the part of the peripheral nervous system that controls visceral functions Autonomic
Nervous Sytem is divided into:

a. Sympathetic Nervous System- paravertebral ganglions, prevertebral ganglions,

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symphatetic nerves.
b. Parasympathetic Nervous System- ganglios present near organs- effectors,
parasympathetic nerves
c. Metasympathetic Nervous System- intramural ganglions Autonomic reflexes control and
regulate smooth muscle cells, cardiac muscle cells and glands.

Types of reflexes:
viscero- visceral
dermato- visceral
viscero- dermal

Parts of reflex:
1. sensory part- receptors are present i many organs, walls of blood vessels and lymphatic
vessels (INTERORECEPTORS). Consists of interoreceptors, dendrites of sensory neurons.
2. central part
3. efferent part.

29. Synapses autonomic nervous system and their mediators.

The autonomic nervous system is a part of nervous system that regulates the activity of internal
organs, glands, blood and lymphatic vessels, smooth and striated muscles and organs of
sensation.
The autonomic nervous fiber go witin cranial nerves and spinal nerves.
There are inhibitory and excitatory synapses between neurons.
inhibitory synapses:
– Causes the membrane to become more permeable to potassium and chloride ions

– Leaves the charge on the inner surface more negative (flow of K + out of the
cytosol makes the interior more negative relative to the exterior of the membrane

– Reduces the postsynaptic neuron’s ability to produce an action potential

Mediators:
acetylcholine
• epinephrine
• norepinephrine
• ATP
• serotonine
• histamine
• substnace
an P

30. The impact of the sympathetic nervous system in visceral functions.

13
 Just vomit the fightfor flight response !
Stimulates effector organ except in digestive tract. Flight or fight reaction. Dilates pupil, inhibits
flow of saliva, accelerates heartbeat, dilates bronchi, inhibit peristaltis and secretion, conversion
of glycogen to glucose, secretion of adrenaline and noradrenaline, inhibit bladder contractin.

31.The impact of the parasympathetic nervous system in visceral functions.

Inhibit effector organs, except digestive tract. Constrict pupil, stimulate flow of saliva, slows
heartbeat, constrict bronchi, stimulates peristalsis and secretion, stimulates release of bile,
contracts bladder

32.The role of metasympathetic system in the regulation of visceral functions.

Includes complex of microganglia situated in walls of visceral organs (in walls) and having
marked motility activity (heart, ureters, intestine, stomach). Visceral activity on local level
(autoregulation, for ex. In heart)

33. Properties of hormones, their main influence. The mechanism of action of hormones
on target cell.

Hormones → organic biologically active compounds of different chemical nature (steroids,

proteins, peptides or amino acid derivatives) that are produced by the endocrine glands, enter
directly into blood and accomplish humoral regulation of the metabolism of compounds and
functions on the organism level.

Half-time life:
• from several min to 20 min – for the majority of hormones
• till 1 h – for steroid hormones
• till 1 week – for thyroid hormones

Specific stimulus for hormones secretion is: nervous impulse, concentration of the certain
compound in blood passing through the endocrine gland

Mechanism of action:
a)Steroid hormones:
-penetrate cell membrane
–stimulate biological effect, if cell is adequate for these receptors
–connection with hormone activates receptor
–regulatory proteins hormone gene linked to fo to nucleus
–there is reactivated regulatory protein binds to its specific DNA regulatory sequence
–this results in transcription of specific gene and ultimately synthesis of corresponding protein

b) Peptide and derivatives amino acids:

-don’t penetrate cell but binds to membrane receptors
– connect to receptor

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– release of inner side of plasma membrane messenger substance called second messenger
which may be, for ex. cAMP (cyclic AMP), cGMP, Ca2+
-increase of second relay in cytoplasm
–cascade of intracellular reactions involving enymes called protein kinases (catalytic subunit
in unlocked by 2nd messenger)
–activation of particular gene regulatory protein
–fusion protein

34. The role of hypothalamic-pituitary system in regulation of the endocrine glands.

Hypothalamus: A collection of specialized cells that are located in the lower central part of the
brain is called the hypothalamus. The hypothalamus is the main link between the endocrine and
the nervous systems. The nerve cells of the hypothalamus control the pituitary gland by
stimulating or suppressing the hormone secretions. hypothalamus sends information that is
sensed by the brain to pituitary triggering production hormones. The pituitary gland is divided
into two parts: the anterior lobe and the posterior lobe. The anterior lobe of the pituitary gland
regulated the activity of the thyroid, adrenals, and the reproductive glands. The anterior lobe
also produces hormones like:

Growth Hormone: To stimulate the growth of the bones and tissues. It also plays a role in the
body's absorption of nutrients and minerals.
• Prolactin: To activate the production of milk in lactating mothers
• Thyrotropin: To stimulate the thyroid gland to produce thyroid hormones
• Corticotropin: To stimulate the adrenal glands to produce certain hormones.
• Endorphins are also secreted by the pituitary that acts on the nervous system and reduces
the feeling of pain.

The pituitary glands produces hormones that signal the reproductive organs to secrete sex
hormones. The menstrual cycle and ovulation in women is also controlled by the pituitary gland.
The posterior lobe of the pituitary gland produces antidiuretic hormone that helps to control the
water balance in the body. Oxytoxins that trigger the contractions of the uterus in a woman who
is in labor is secreted by the posterior lobe.

35. The role of somatotropin, triiodothyronine, thyroxine, insulin regulation of physical

and mental development of organism.

Somatotropin:

- effect on protein:
• promotes entrance of AA into cells
• inhibits catabolism of protein and AA
• activates synthesis of protein, DNA, RNA

- effect on carbohydrates: Ci blood sugar liver )

by acting on

15
 • antiinsulin hormone → activates insulinase in liver
• activates exit of glucose from liver
• inhibits conversion of glucose into fat

- effect on lipids:
• stimulates decomposition of lipids (lipolisis)
• stimulates oxydation of fatty acids

will act like Somatotropin

in normal concentration
Triiodothyronine and thyroxine: →

• in physiological concentration stimulate synthesis of proteins, nucleic acids.

• in the increased concentration activate the protein decomposition.
• accelerate the absorption of carbohydrates in the intestine. see
g. 38 ( P 18 )
• activate the decomposition of glycogen.
• activate the exit of lipids from depot, its decomposition and oxidation.

INSULIN: → see 9.37 Cpg 17

)
a) effect on carbohydrates: increases the permeability of membranes for glucose, activates
glucokinase (hexokinase) in glycolysis, activates TAC (citrate synthase), activates PPC (G-6-
PDH), activates glycogen synthase, activates pyruvate- and alpha-кetoglutarate dehydrogenase,
inhibits gluconeogenesis, inhibits the decomposition of glycogen (glucose-6-phosphatase)
↳ Activates all
pathways for fate of pyruvate !
b) effect on protein: increases the permeability of membranes for AA, activates synthesis of
proteins and nucleic acids, inhibits gluconeogenesis

a) effect on lipid: activates of the lipids synthesis, promotes the saving of fats activating the

:
decomposition of carbohydrate, inhibits gluconeogenesis

b) effect on mineral: activates Na/K-АТP-аse

36. The role of calcitonin and parathyroid homone in the regulation of sustainability
concentrations of calcium and phosphate in blood.

Calcitonin formone:
-chemical structure: peptide
2T
-biological role: affects the metabolism of Са and Р
1) promotes the transferring of Са2+ from blood into bones
2) inhibits reabsorption of Р in kidneys (decreases the content of Р in blood due to its
excretion with urine)

Parathyroid hormone:

-chemical structure: protein

16
-biological role: affects the metabolism of Са and Р
1) promotes moving of Са2+ from bones into blood
2) inhibits reabsorbtion of Р in kidneys (decreases the content of Р in blood due to its
excretion with urine)
3) stimulates the absorption of Ca in the intestine

37. The role of pancreatic hormones in the regulation of body function.

INSULIN: → see 9
35
•

Cpl b)
• effect on carbohydrates: increases the permeability of membranes for glucose, activates

V1
glucokinase (hexokinase) in glycolysis, activates TAC (citrate synthase), activates PPC (G-
6-PDH), activates glycogen synthase, activates pyruvate- and alpha-кetoglutarate
dehydrogenase, inhibits gluconeogenesis, inhibits the decomposition of glycogen (glucose-
6-phosphatase)

• effect on protein: increases the permeability of membranes for AA, activates synthesis of
proteins and nucleic acids, inhibits gluconeogenesis

• effect on lipid: activates of the lipids synthesis, promotes the saving of fats activating the
decomposition of carbohydrates, inhibits gluconeogenesis

• effect on mineral: activates Na/K-АТP-аse

GLUCAGON:

-chemical structure: polypeptide

-biological role:
• activates the decomposition of glycogen in liver
• activates gluconeogenesis
• inhibits glycolysis
• activates lipolysis

SOMATOSTATIN:
• inhibits secretion of insulin and glucagon
• inhibits secretion of STH and TTH (STH so Mato tropic
→
hormonei TTH
→
thyrotro pic )
• inhibits secretion of local hormones of intestine

LIPOCAIN:
• activates the synthesis of phospholipids in liver
• stimulates the action of lipotropic factors
• activates the oxidation of fatty acids in liver

17
38. The role of thyroid hormones (T3, T4) in the regulation of body functions. g.
35 Cpg 16 )

1 1 11
• in physiological concentration stimulate synthesis of proteins, nucleic acids.
• in the increased concentration activate the protein decomposition.
• accelerate the absorption of carbohydrates in the intestine.
• activate the decomposition of glycogen.
• activate the exit of lipids from depot, its decomposition and oxidation.

39.Physiology of female reproductive system, its function, the role of sex hormones.

Functions of estrogens:
-Development of the female reproductive system organs
-Ability to fertility in reproductive period → regulates fertility cycle
Biochemical functions of estrogens
-Anabolic action on the tissues of reproductive organs
-Inhibit the exit of Ca from bones (osteoporosis in menopause)
Progesterone: stimulates secretion of "uterine milk" by the uterine endometrial glands; also
helps promote development of the secretory apparatus of the breasts 1
to the survival of the fetus
important - .

40.Physiology of male reproductive system, the role of sex hormones.

Functions of testosterone:
- Development of the primary sex features
- Development of the secondary sex features
- Stimulates spermatogenesis

Biochemical functions of testosterone

- Strong anabolic action (stimulates the synthesis of NA, proteins, phospholipids) – increases
the mass of muscles
- Keeps the Ca and P in organism

41.The main effects of glucocoricoids and mineralocorticoids on the body.

a) Glucocorticoids: Cortisol ,
Corticosterone

on carbohydrate metabolism.
Increase the glucose level: activate gluconeogenesis, inhibit hexokinase (glycolisis).

on protein metabolism.
- Stimulate catabolic processes in connective, lymphoid and muscle tissues
- Activate protein synthesis in liver

18
- Stimulate aminotransferases
- Stimulate the urine biosynthesis

on lipid metabolism.
- Activate lipolysis
- Activate the conversion of FA into carbs

b) Mineralocorticoids: aldosterone

Mineralocorticoids regulate - metabolism of water and mineral salt. Aldosteron is principal

mineralocorticoid. Excretion of aldosteron is controlled by rhenin-angiothensin
• e system

Functions:
-activate the reabsorption of Na, water and Cl in kidney canaliculi
- Promotes the excretion of К ions via the kidneys, skin and saliva

II. Physiology analyzers. Higher nervous activity of man.

42.Visual sensory system, its structure and function.

Cornea allows light to enter the eyeball. Aqueous humor fills anterior and posterior chambers
in front of lens. Crystalline lens is a transparent elastic and biconcave lens, which refracts light
and focuses it on retina. Vitreous body is a transparent gel enclosed by vitreous membrane,
color
which fills eyeball behind lens. Retina have pigment(absorb
→
light, filled with melanine) and sensory layer(cones and rods-forms electrical impulses), macula
lutea (focusing light). ↳ photoreceptor \ > non color
-

→ + fovea central's bipolar

Layers of retina: ganglionic
• choroid;
• pigment cell layer;
• photoreceptor layer;
• outer plexiform layer;
• bipolar layer;
• bipolar layer ;
-

• inner plexiform layer;

• ganglionic layer;
o fibers to optic narve.

Rods: noncolor vision, vision in reduced light, contain rhodopsin (protein-opsin bound to
pigment- retinal).
Cones: color vision, function in bright light, has visual pigment- IODOPSIN, sensitive on blue,
red, green; each cone has only on kind of opsin for one color.

19
43.The basic visual functions and methods of their study.

FUNCTION:

- light and dark adaptation

- recognition of colors
-provide sharpness of vision
-accomodation (adaptation of the eye to viewing objects at different distances)
-provide clarity of vision
-binocular vision (two eyes but see only one picture) and three dimensional vision
– dominant eye( is the eye that we use when we look very carefully at near or at far and can
use only one eye. Even when both eyes are used simultaneously one of the eyes is more
dominant than the other)

Method:
-Evaluation of accommodation volume
-Estimation visual acuity (with Landolt rings) →
00
• Perimetry (on computer, Perimetry or campimetry is systematically test visual field. It is
systematic measurement of differential light sensitivity in visual field by the detection of
presence of test targets on a defined background. Perimetry more carefully maps and
quantifies visual field, especially at extreme periphery of visual field.

• Evaluation of color vision (on program oculus on computer, match the color

• By using chart with letters

• When a person’s vision is tested, a chart is placed 20 feet from the eye: person is asked to
read a line of letters that is standardized for normal vision. If the person can read the line,
the vision is considered to be 20/20, which means that the person can see at 20 feet what
people with normal vision can see at 20 feet. If, on other hand, the person can see words
only at 20 feet that people with normal vision can see at 40 feet, the vision is considered
20/40.

44. Theories of color and types of violations of color.

emthrokb ohb- "

j
,

cyano lab
Theories of color vision [

1. The Trichromatic theory, or Young–Helmholtz theory; states that there’re 3 types of cones,
each containing a different photopigment & maximally sensitive to one of three primary
colours… which means that any colour consists of admixture of three primary colours. Red Green Blue !
, ,

2. The opponent colour theory; states that the visual system interprets color in an antagonistic
way: red vs. green, blue vs. yellow, black vs. white.

Usefulness of colour theories :

20
 explains
y
• Trichromatic theory colour vision at the level of the photoreceptors
• Opponent colour theory → neural processing of colour

Violations of colour

1. In colour blindness, faculty to appreciate one or more primary colours is either

defective (anomalous) or absent (anopia).

2. Dyschromatopsia, literally means colour confusion due to deficiency of mechanism to

perceive colours.

3. Anomalous trichromats possess three types of photo pigment in their cones, and so are
truly trichromats. ↳ deviation of pigment from its normal wavelength
a .

• What makes their color vision "anomalous" is that one pigment type is shifted along the
wavelength axis from the normal position

4. The defect in dichromatic color vision is more severe than in anomalous trichromacy.
• Dichromate simply lack one type of photopigment. they can match any color with a
mixture of only two primaries.
Achromcatopsia → cone or rod acromatopsia
Characterised by presence of only one primary colour cone and thus the person is truly colour
blind. Such patients usually have a normal visual acuity and dark adaptation

45. Physiological mechanisms of pain.

Nociceptors are sensory receptors that are responsible for detecting harmful or noxious stimuli
and transmitting electrical signals to the nervous system. The receptors are present in skin,
viscera, muscles, joints and meninges to detect a range of stimuli, which may be mechanical,
thermal or chemical in nature.

There are two main types of nociceptors:

• C-fibres are the most common type and are slow to conduct and respond to stimuli. As
the proteins in the membrane of the receptor convert the stimuli into electrical impulses
that can be carried throughout the nervous system.
• A-delta fibers are known to conduct more rapidly and convey messages of sharp,
momentary pain.

It is important to distinguish between nociception and pain when considering the mechanism
of pain. Nociception is the normal response of the body to noxious stimuli, including reflexes
below the suprathreshold that protect the body from harm. Pain is only perceived when
superthreshold for the nociceptors to reach an action potential and initiate the pain pathway is
reached, which is relatively high.

21
Central Nervous System

The nociceptors conduct the electrical signaling message to the dorsal horn of the spinal cord,
where a complex array of neurons are involved in the synaptic connections that process
nociception and pain. There is not a single pathway that is responsible for the generation of pain
in the central nervous system, but a combination of pathways are involved in the propagation
of signals to the cerebral cortex.
-
Spinothalamic tract →
pain
The perception of pain results from processing of the electrical signals in various regions of the
brain. This explains the varied responses and emotional reactions when an individual
experiences pain.

Neuropathic Pain Mechanism

The mechanisms that lead to the development of persistent neuropathic pain are more complex
than nociceptive pain and should be thought of as distinct.

Neuropathic pain occurs primarily as a result of injury to the nerves involved in the pain
pathways in the nervous system, leading to an alteration in the way pain is processed. This
usually causes increased pain signal transmission, to the extent that innocuous stimuli may
cause a sensation of pain.

Hyperalgesia is a type persistent inflammatory pain that involves increased excitability and
nervous response to noxious stimuli, leading to higher sensitivity to pain.

46. Opiate and nonopiat antinociceptive and body systems and their importance.

Antinociception - the action or process of blocking the detection of a painful or injurious

stimulus by sensory neurons
activate →
High pain → neurons
► To antinociceptive neuro-endocrine system belong nervous structures, which are
concentrated, obviously, in brain stem.

7.
► High intensity of pain stimuli permits activation of these structures, which contain
neurons capable to release endogenous opioids.

► To such structure belong, for instance, prefrontal cortex, hypothalamus, central gray
substance, medial thalamic nuclei and limbic system.

Anti-nociceptive system :

• ► To antinociceptive neuro-endocrine system belong nervous structures, which are

concentrated, obviously, in brain stem.

22
 • High intensity of pain stimuli permits activation of these structures, which contain
neurons capable to release endogenous opioids.

• To such structure belong, for instance, prefrontal cortex, hypothalamus, central gray
substance, medial thalamic nuclei and limbic system. Role of opioid peptides
I
• In brain and digestive tract are located receptors, which bind to morphine. bind to
opioid
receptors → ant
nociception
.

Investigation endogenous ligands of these receptors give ability to reveal two similar
pentapeptides, called encephalines, which bind to opioid receptors: metencephalin and ley-
encepfalin. Such chemicals are known as opioid peptides.

Encephalines are containing in nerve endings of digestive tract and many parts in brain. It
function as neurotransmitters. These peptides are present in gelatinous substance. In injecting
into brain stem, opioid peptides manifestate analgetic effect. Encephalines also may slow down
intestines peristaltic

Opioid (narcotic) analgesics are derived from or related to the Opium. They bind to opioid
receptors, which present in many regions of the nervous system and are involved in pain
signaling and control. There are four groups of opioid receptors: delta, kappa, mu, and sigma.

Non-onopioid (non-narcotic) analgesics include acetaminophen, the most commonly used

over-the-counter pain medicine. Other drugs are not technically part of the analgesic family,
but are nonetheless considered analgesics in practice. These include nonsteroidal anti-
inflammatory drugs (NSAIDs). Aspirin and acetaminophen are two of the most widely used
analgesics and are effective for mild to moderate headache and pain of musculoskeletal origin.

47. Physiological mechanisms of anesthesia.

A general anaesthetic (or anesthetic) is a drug that brings about a reversible loss
of consciousness. These drugs are generally administered by an anaesthetist/anesthesiologist in
order to induce or maintain general anaesthesia to facilitate surgery.

Analgesics:
1) May act at the site of injury and decrease the pain associated with an inflammatory
reaction (e.g. non-steroidal anti-inflammatory drugs (NSAID)

2) May alter nerve conduction (e.g. local anesthetics): block action potentials by blocking
Na channels. Used for surface anesthesia, infiltration, spinal or epidural anesthesia.
Used in combination to steroid to reduce local swelling (injection near nerve root).

3) May affect the central component and the emotional aspects of pain (e.g. opioids,
antidepressant). Problems of tolerance and dependence

23
 48. Auditory sensory system, its structure and function.

The auditory system is the sensory system for the sense of hearing. It includes both
the sensory organs (the ears) and the auditory parts of the sensory system.

Divided into 4 parts (by function):

1. Outer Ear
• Auricle (Pinna)
• Gathers sound waves
• Aids in localization
• Amplifies sound approx. 5-6 dB

a) External Auditory Canal

muscle
2. Middle Ear membrane ; eustachian tube ; staped.us
→
tympanic

a) Tympanic Membrane

• Forms boundary between outer and middle ear

• Vibrates in response to sound waves

balance air
pressure ; connects
b) Eustachian Tube (AKA: “The Equalizer”) →

nasopharynx
• Mucous-lined, connects middle ear cavity to nasopharynx
• “Equalizes” air pressure in middle ear
• Normally closed, opens under certain conditions
• May allow a pathway for infection →to nasopharynx
• Children “grow out of” most middle ear problems as this tube lengthens and becomes
more vertical

c) Stapedius Muscle → acoustic reflex

• Attaches to stapes
of stapes
changes vibration
to

• Contracts in response to loud sounds; (the Acoustic Reflex) reduce →

intensity of vibration
• Changes stapes mode of vibration; makes it less efficient and reduce loudness perceived
• Absent acoustic reflex could signal conductive loss or marked sensorineural loss
occurs
I
in noise !
3. Inner Ear

a) The Cochlea
• Snail shaped cavity within mastoid bone
• 2 ½ turns, 3 fluid-filled chambers → Perilymph { endolymph
• Scala Media contains Organ of Corti Converts mechanical energy to electrical energy
Scala tympani → inferior Perilymph
.
.
→ Eb arachnoid space
24
.
Separated by spiral
cochlear
.

duct
lamina

{
superior Perilymph Conducts sound vibration to is
Scala vestibule
→
-

Reisner 's Membrane At the telicotre

separated from duct
by
.
ma
same

it Joins Scala tympani .

4. Central Auditory Nervous System

VIIIth Cranial Nerve or “Auditory Nerve” → Vestibule

cochlear nerve
•
• Bundle of nerve fibers (25-30K)
• Travels from cochlea through internal auditory meatus to skull cavity and brain
stem
• Carry signals from cochlea to primary auditory cortex, with continuous
processing along the way I

• Auditory Cortex
• Wernicke’s Area within Temporal Lobe of the brain
• Sounds interpreted based on experience/association

49. The functions of the external and middle ear.

The outer ear consists of the ear shell (pinna) and the auditory canal.
• Its function is to guide air pressure waves to the middle ear- with the ear shell increasing
the sensitivity of the ear to the front side of the head, supporting front/rear localisation
of audio signals.

The middle ear consists of: the ear drum (tympanic membrane), attached to the inner ear
through a delicate bone structure (malleus, incus and stapes).
The middle ear bones (ossicles) and the muscles keeping them in place are the smallest in the
human body.
• One of the major functions of the middle ear is to ensure the efficient transfer of sound
from the air to the fluids in the inner ear. If the sound were to impinge directly onto the
inner ear, most of it would simply be reflected back because acoustical impedance of
the air is different from that of the fluids.
• The middle ear acts as an impedance-matching device that improves sound
transmission, reduces the amount of reflect sound and protects the inner ear from
excessive sound pressure levels.
• This protection is actively regulated by the brain using the middle ear’s muscles to tense
and un-tense the bone structure with a reaction speed as fast as 10 milliseconds. The
middle ear’s connection to the inner ear uses the smallest bone in the human body: the
stapes (or stirrup bone), approximately 3 millimetres long, weighing approximately 3
milligrams.

50. The inner ear structure and function.

The inner ear consists of the cochlea - basically a rolled-up tube. The middle ear’s stapes
connects to the cochlea’s ‘oval window’.
The rolled-up tube contains a tuned membrane populated with approximately 15,500 hair cells
and is dedicated to hearing. The structure also has a set of semi-circular canals that is dedicated
to the sense of balance. Although the semi-circular canal system also uses hair cells to provide

25
 the brain with body balance information, it has nothing to do with audio.

The cochlea
In the cochlea, sound waves are transformed into electrical impulses which are sent on to the
brain. The brain then translates the impulses into sounds that we know and understand.
The cochlea resembles a snail shell or a wound-up hose and is filled with a fluid called
perilymph and contains two closely positioned membranes. These membranes form a type of
partition wall in the cochlea. media Organ of Corti
in
Scala .

→
When the fluid moves inside the cochlea, thousands of microscopic hair fibres inside the
partition wall are put into motion. There are approximately 24,000 of these hair fibres, arranged
Scala tympani
in four long rows.
→ inferior Perilymph
.
Eb arachnoid space Separated
.
→
by spiral lamina
.

cochlear duct { is
.

Scala vestibule → superior

-

Perilymph
Conducts sound vibration
.
to

Reisner 's Membrane At the telicotre

separated from duct
by
.
ma
same
The auditory nerve
it Joins Scala tympani .

The auditory nerve is a bundle of nerve fibres that carry information between the cochlea in the
inner ear and the brain. The function of the auditory nerve is to transmit signals from the inner
ear to the brain.

The hair fibres in the cochlea are all connected to the auditory nerve and, depending on the
nature of the movements in the cochlear fluid, different hair fibres are put into motion.

51. Theories of sound perception

Temporal theory
This theory (also called frequency theory) states that the entire basilar membrane vibrates in
consonance with the frequency of the wave entering the cochlea. This idea was subsequently
proved incorrect as it was found that the differences in the width and thickness along the length
of basilar membrane made it physically impossible for it to vibrate as frequency theory predicts.
However it was found that individual auditory nerve fibers could match low frequency
vibrations, and could volley to match frequencies up to about 4,000 hz.

Place theory

Place theory found support in studies by Von Bekesey, who constructed a replica of the basilar
membrane to study the behavior of the waves inside the cochlea. Bekesey found that different
frequency waves peaked out at different places along the basilar membrane with high
frequencies nearer the base, and low frequencies nearer the apex.
However, Bekesey also found that localizing the place of maximal stimulation was much more
precise for high rather than low frequencies.

Duplicity theory
A combination of frequency and place operate to explain the range of human pitch perception
-- and varying sensitivities to pitch.

26
 • 20 to 500 -- frequency coding only
• 500 to 4,000 -- frequency and place coding
• 4,000 to 20,000 -- place coding only

Note that it is frequencies from around 1,000 - 3,000 for which humans have greatest
sensitivity and in which comprises most of human speech.

52. Function of vestibular analyzer.

• Vestibular system - organ of position and balance sense - placed in the semicurcular
canals in petrous bone lying in three mutually perpendicular planes. The canals start in
utricle, which is connected with sacculus. Both parts are placed in vestibulum
communicating with ductus cochlearis.

• One outlet of each canal is transformed in ampulla, divided by the ampullary crist into
ampulla
two parts. Macula utriculi is in the lower part of utricle, the macula sacculi in sacculus.
The crists and ampullae are covered by sensory epithelium composed of hair-cells.
riaala There are also gelatinous cupulae on ampullary crists and the statoconia membranes
utriaih
'

in maculae. Their function is to stimulate stereocilia of sensory cells. The statoconia

are crystals of CaCO3 - it increases the mass of gelatinous membranes.
aka otholithi.SI
Calcium carbonate
-

Marala
statolith's
sacculi
• The semicircular canals allow analyse the rotational motion of the head. Receptors
of ampullary crists react on angular acceleration. The cupulas of crists work as valves,
which are deflected by streaming endolymph and stimulate the hairs of sensory cells by
bending – depolarisation or hyperpolarisation takes place.

• The receptors of utricle and sacculus react on linear acceleration and gravitation.
When changing the head position, the membrane with statoconia shifts against hairs of
sensory cells - excitation arises. Important for keeping erect position - static reflexes.

53. Taste sensor system, its structure, functions and methods.

Taste Buds
• Chemoreceptors housed in taste buds
• Present in oral cavity and throat
• Taste receptors have life span of about 10 days
• Taste bud consists of
– Taste pore
• Opening through which fluids in mouth
come into contact with surface of
receptor cells

27
 – Taste receptor cells
• Modified epithelial cells with surface folds called microvilli
• Plasma membrane of microvilli contain receptor sites that bind
selectively with chemical molecules
• Located in taste buds in:

– Tongue

– Epiglottis

– Soft Palate

– Pharynx

Tastant (taste-provoking chemical) → Taste pathway

• Binding of tastant with receptor cell alters cell’s ionic channels to produce depolarizing
receptor potential

• Receptor potential initiates action potentials within terminal endings of afferent nerve
fibers with which receptor cell synapses

• Terminal afferent endings of several cranial nerves synapse with taste buds in various
regions of mouth

• Signals conveyed via synaptic stops in brain stem and thalamus to cortical gustatory
area → anterior insula insular lobe { frontal operculum
or inferior frontal gyrus !
on

Taste information is send to the CNS by the cranial nerves: 7, 9 and 10 → the taste
nucleus (n. tractus solitarius) → thalamus → primary gustatory cortex insular
The glossopharyngeal nerve innervates a third of the tongue including the circumvallate
papillae. The facial nerve innervates the other two thirds of the tongue and the cheek via
the chorda tympani.
The pterygopalatine ganglia are ganglia (one on each side) of the soft palate. The greater
petrosal, lesser palatine and zygomatic nerves all synapse here. The greater petrosal, carries
soft palate taste signals to the facial nerve. The lesser palatine sends signals to the nasal cavity;
which is why spicy foods cause nasal drip. The zygomatic sends signals to the lacrimal
nerve that activate the lacrimal gland; which is the reason that spicy foods can cause tears. Both
the lesser palatine and the zygomatic are maxillary nerves (from the trigeminal nerve).
Neuronal Pathways for Taste Taste from the anterior two-thirds of the tongue, except from the
circumvallate papillae, is carried by means of a branch of the
facial nerve (VII) called the chorda tympani. Taste from the posterior one-third of the tongue,
the circumvallate papillae, and the superior pharynx is carried by means of the glossopharyngeal
nerve (IX). In addition to these two major nerves, the vagus nerve (X) carries a few .bers for
taste sensation from the epiglottis. These nerves extend from the taste buds to the tractus
solitarius of the medulla oblongata. Fibers from this nucleus decussate and extend to the

28
 thalamus. Neurons from the thalamus project to the taste area of the cortex, which is at the
extreme inferior end of the postcentral gyrus.

54. Olfactory sensory system, its structure and function.

Olfaction is a chemoreception that forms the sense of smell. Olfaction has many purposes,
such as the detection of hazards, pheremones, and food. It integrates with other senses to form
the sense of flavor.
• Smell Olfaction, sense of smell, occurs in response to odors that stimulate sensory
receptors located in the extreme superior region of the nasal cavity, called the olfactory
recess.
• The specialized nasal epithelium of the olfactory recess is called the olfactory
epithelium. Like taste, smell is a chemical sense, but there are no basic sensations for
smell, as there are for touch and taste.

Neuronal Pathways for Olfaction Axons from

Olfactory the olfactory neurons (cranial nerve I) enter
nerve
to the olfactory bulb, where they synapse with
olfactory mitral cells or tufted cells. The mitral and
bulb tufted cells relay olfactory information to the
t brain through the olfactory tracts and synapse
mitral / with association neurons in the olfactory
bulb. Association neurons also receive input
tufted
cells from nerve cell processes entering the
t olfactory bulb from the brain. As a result of
input from both mitral cells and the brain,
olfactory association neurons can modify olfactory
tract
t information before it leaves the olfactory bulb. Olfaction is the only major sensation that is
brain relayed directly to the cerebral cortex without first passing through the thalamus. Each olfactory
t tract terminates in an area of the brain called the olfactory cortex.

olfactory ↳ ventral surface of forebrain

cortex
The olfactory cortex is in the frontal lobe, within the lateralfi.ssure of the cerebrum, and can be
divided structurally and functionally into three areas: lateral, intermediate, and medial. The
t
thalamus
lateral olfactory area is involved in the conscious perception of smell. The medial olfactory area
is responsible for visceral and emotional reactions to odors and has connections to the limbic
system, through which it connects to the hypothalamus. Axons extend from the intermediate
olfactory area along the olfactory tract to the bulb, synapse with the association neurons, and
thus constitute a major mechanism by which sensory information is modulated within the
olfactory bulb.

55. Somato-sensory system, its structure and function.

The somatosensory system is a part of the sensory nervous system. The somatosensory system
29
 is a complex system of sensory neurons and pathways that responds to changes at the surface
or inside the body. The axons (as afferent nerve fibers), of sensory neurons connect with, or
respond to, various receptor cells. These sensory receptor cells are activated by different stimuli
such as heat and pain, giving a functional name to the responding sensory neuron, such as
a thermoreceptor which carries information about temperature changes.
Other types include mechanoreceptors, chemoreceptors, and nociceptors and they send
signals along a sensory nerve to the spinal cord where they may be processed by other sensory
neurons and then relayed to the brain for further processing. Sensory receptors are found all
over the body including the skin, epithelial tissues, muscles, bones and joints, internal organs,
and the cardiovascular system.

General somatosensory pathway

A somatosensory pathway will typically have three long neurons: primary, secondary, and
tertiary (or first, second, and third).
• The first neuron always has its cell body in the dorsal root ganglion of the spinal
nerve (if sensation is in parts of the head or neck not covered by the cervical nerves, it
will be the trigeminal nerve ganglia or the ganglia of other sensory cranial nerves).
• The second neuron has its cell body either in the spinal cord or in the brainstem. This
neuron's ascending axons will cross (decussate) to the opposite side either in the spinal
cord or in the brainstem.
• In the case of touch and certain types of pain, the third neuron has its cell body in the
← VPN of the thalamus and ends in the postcentral gyrus of the parietal lobe.
ventral
posterior nucleus

Photoreceptors, similar to those found in the retina of the eye, detect potentially
damaging ultraviolet radiation (ultraviolet A specifically), inducing increased production
of melanin by melanocytes. Thus tanning potentially offers the skin rapid protection from
DNA damage and sunburn caused by ultraviolet radiation (DNA damage caused by ultraviolet
B). However, whether this offers protection is debatable, because the amount of melanin
released by this process is modest in comparison to the amounts released in response to DNA
damage caused by ultraviolet B radiation.

56. Biological behavior. The needs and motivations, their role in shaping behavior.

In psychology, emotion is often defined as a complex state of feeling that results in physical
and psychological changes that influence thought and behavior. Emotionality is associated with
a range of psychological phenomena including temperament, personality, mood and motivation

Neurotransmission of emotional excitation Emotional excitation is spread in the brain due to

•

variety of neurotransmitters (noradrenalin, acetylcholine, serotonin, dopamine and

neuropeptides including opioides. Positive emotions may be explained by revealing
catecholamines and negative emotions, aggression result from production acetylcholine in the

30
 brain. Serotonin inhibits both kinds of emotions. Decrease of serotonin in blood is followed by
groundless anxiety and inhibition of noradrenergic transmission results in sadness. Structure of
behavioural act

According to theory of functional systems (Anochking) there are such stages of behavioural
act:
1) afferent synthesis;
2) taking of decision;
3) acceptor of result of action;
4) efferent synthesis (or programming of action);
5) performing of action;
6) evaluation of final result of action.

Due to converging and processing of both sensory information and memory traces afferent
synthesis in the brain is performed. Taking of decision is based on afferent synthesis by
choosing optimal variant of action.

57. Mechanisms of conditioned reflexes, their differences of course. overall performance of synapses
condition
formation caused change
reflex by in .

of is
Mechanism ! Synaptic hypothesis →
change of excitability of membrane layers
the
postsynaptic
.

due to
formation is
Membrane hypothesis
→

Conditioned reflexes are individually acquired system of adaptive reactions of the person and
animals. It arises on the basis of formation in the central nervous system of temporary
communication between centers, some of which percept new irritant and other control some
unconditioned reflex. Thus, new irritant form an environment becomes conditional irritant. It
warns person about approach of the subsequent kinds of activity and prepares him for future
kinds of activity (eating, avoidance of danger and another). With the help of the conditioned-
reflex mechanism such function of nervous system as purposeful behavior of the person in an
environment and society, the adaptation to varied conditions of an environment are carried out.
Such activity of nervous system concerns to/ the higher nervous
subcortical
activity. ] → differential stages Cspea ligation ) '

formation of temporary communication (

in Cor te> c
5¥
→ centres
generalization
→ security
different-1 Cinhibiton of formed reflex ) to f ?
58. MEMORY: TYPES AND MECHANISMS OF FORMATION.

Types of memory:
- Genetic memory - keeps information about body structure and forms of its behavior.
- Biological memory - presented in both philogenetic and ontogenetic forms.
- Immune memory and psychical memory for instance, belong to ontogenetic memory.

-According to duration: short-time and long-time memory;

- In relation to kind of information: sensory and logic.
Physiologic mechanism of memory.
At the molecular level, the habitation effect in the sensory terminal results from progressive
closure of calcium channels through the presynaptic terminal membrane. In case of
facilitation, the molecular mechanism is believed to be following. Facilitated synapse releases
serotonin that activates adenylyl cyclase in postsynaptic cell. Then cyclic AMP activates
proteinkinase that then causes phosphorylation of proteins. This blocks potassium channels
Short term ! Tca
"
ion channels → in neurotransmitter release →
phosphorylation of
ion channel
proteins . 31
 CAMP F
Long protein kinase A- →
: stimuli synapse proteins
→ →
term

for minutes or even weeks. Lack of potassium causes prolonged action potential in the
presynaptic terminal that leads to activation of calcium pores, allowing tremendous quantities
of calcium ions to enter the sensory terminal. This causes greatly increased transmitter
release, thereby markedly facilitating synaptic transmission.
Brain mechanism of memory.
It’s discovered the nervous substrate of long-term memory is mostly cerebral cortex. The most
important regions are temporal lobes, prefrontal area and hippocampus. Experimental
researches revealed that some thalamic nuclei and reticular formation take part in memory
function.
Reticular formation gives ascending stimulatory influences to cerebral cortex, which help in
keeping awake condition of cortex and provides voluntary attention.

59. EMOTIONS, MECHANISMS OF FORMATION. BIOLOGICAL AND

INFORMATION THEORY EMOTIONS. THEIR ROLE IN SHAPING BEHAVIOR
Emotions are aspect of higher nervous activity that characterize subjective attitude of person
to various stimuli arousal in surroundings. Emotional status reflects actual needs of man and
helps in its realization.
Emotions role in shaping behaviour
Emotions are important element of human behaviour, creation of conditioned reflexes and
mentation. Negative emotions give fusty evaluation of current situation does it useful or not.
Mobilizing of efforts helps then to satisfy current needs of person. Positive emotions help to
put in memory scheme of behaviour, which was useful and have lead to success.

Theories of emotions
Biological theory of emotions (P.K. Anochkin) considers that life course includes two main
stages of behavioural act: 1) formation of needs and motivations that results from negative
emotions and 2) satisfaction of needs that leads to positive emotions it case of complete
accordance of image and result of action. Incomplete compliance of suspected and real result
of action cause negative emotions and continues behavioural act. of
Information theory of emotions (P.V. Simonov)considers that emotions reflect strength human
^

[
of need and possibility of its satisfaction in current moment. In absence of needs emotions can’t
arise. There is also not emotional excitation, if getting excess information about mode of
satisfaction this need. Lac of information already causes negative emotions that help to recall
to mind life experience and to gather information about current situation.
the presence of human needs !
Emotions are
based on

Formation of emotions
Emotional excitation is spread in the brain due to variety of neurotransmitters (noradrenalin,
acetylcholine, serotonin, dopamine and neuropeptides including opioides. Positive emotions
may be explained by revealing catecholamines and negative emotions, aggression result from
production acetylcholine in the brain. Serotonin inhibits both kinds of emotions. Decrease of
serotonin in blood is followed by groundless anxiety and inhibition of noradrenergic
transmission results in sadness.

32
60.THE FUNCTIONAL ASYMMETRY OF THE CEREBRAL CORTEX OF THE
BRAIN, ITS INTEGRATIVE FUNCTION.
Cerebral asymmetry is the functional disequilibrium between the two brain hemispheres. Even
if they are of almost identical size, the two hemispheres are not used in the same way and have
different functions.

Left hemisphere is categorical hemisphere: specialized for spoken & written language,
sequential & analytical reasoning (math & science), analyze data in linear way

Right hemisphere is representational hemisphere: perceives information more holistically,

perception of spatial relationships, pattern, comparison of special senses, imagination & insight,
music and artistic skill
Highly correlated with handedness: 91% of people right-handed with left side is categorical.

Right hemisphere controls left side of body and visual field.

Left hemisphere controls right side of body and visual field.

61.LANGUAGE AND ITS FUNCTION. PHYSIOLOGICAL BASES OF FORMATION.

Functions
1. Expressive (express speaker's feelings--I feel great today.)
2. Directive (get others to do things--Clean up your room.)
3. Referential (provide information--The apples are on the table.)
4. Metalinguistic (comments on language--Nouns can be mass or count.)
5. Poetic (aesthetic language--poems, mottos, rhymes--A stitch in time saves nine.)
6. Phatic (language for solidarity and empathy
Language, when seen as a system of rules (including phonology, morphology, syntax, grammar,
semantics,pragmatics), and focusing on rules describing competence rather than performance,
limits our ability to look at communication systems more generally and to see important
characteristics of speech forms that are used within speech communities and between them.
Central securing of language’s formation - There are two aspects of communication:
- sensory, involving reading, hearing of speech,
- motor aspect, involving vocalization and its control.

÷
It is known, that lesion of posterior portion of the superior temporal gyrus, which is called
The formation of thoughts is the function of associative areas in the brain.
Wernicke's area in the posterior part of the superior temporal gyrus is most important for this
ability. Broca's speech area lies in prefrontal and premotor facial region in the left hemisphere.

The skilled motor patterns for control of the larynx, lips, mouth, respiratory system and other

33
accessory muscles of speech are all initiated from this area. The skilled motor patterns for
control of the larynx, lips, mouth, respiratory system and other accessory muscles of speech
are all initiated from this area. Articulation means movements of mouth, tongue, larynx, vocal
cords, and so forth that are responsible for the intonations, timing, and rapid changes in
intensities of the sequential sounds. The facial and laryngeal regions of the motor cortex
activate these muscles, and the cerebellum, basal ganglia, and sensory cortex all help control
the sequences and intensities of muscle contractions. Transmitters such as dopamine,
noradrenaline, serotonin and certain neuropeptides transmit their signals by what is referred to
as slow synaptic transmission. The resulting change in the function of the nerve cell may last
from seconds to hours. This type of signal transmission is responsible for a number of basal
functions in the nervous system and is of importance for e.g. alertness and mood. Slow
synaptic transmission can also control fast synaptic transmission, which in turn enables e.g.
speech, movements and sensory perception. Development of signaling systems in children.
The ability of a full-term baby to develop temporary connections of the first signaling system
arises in a few days after the birth.. In the first six months of life speech sounds mean little to
a child. They are simply stimuli to the auditory analyzer like any other sounds. The first signs
of development of the second signaling system appear during the second half of the first year
of life. If a person or an object is named and shown to a child many times, reaction to this
name develops. Later after leaning a few words, a child begins to name objects itself. Finally,
at a later time he uses a stock of words to communicate with other people.

62. TYPE OF HIGHER NERVOUS ACTIVITY.

Four principle types of higher nervous activity (according Pavlov):

1)strong unbalanced type, characterized by predominance of excitation over inhibition;
2) strong well-balanced active type, characterized by high mobility of nerve processes;
3) strong well-balanced passive type, characterized by low mobility of nerve processes;
4) weak type, characterized by extremely weak development of both excitation and inhibition,
which cause fatigue and low workability.

Types of higher nervous activity according to Eizenck’s classification:

1) extraversion or introversion;
2) neurotizm;
3) psychotism.
Extroversive person is openhearted, has high social activity, interesting in public relations. On
other hand, introversive person is passive emotionally unstable and interested mainly in his
inner world. It concerned peculiarities of reticular-cortical interconnections lay in the basis of
this personal fiche. Introversive temperament correlates with grater activity of septal and
hippocampal inhibitory system in the brain.

Neurotic person is high irritable, has unbalanced emotional status even in usual conditions.
Level of neutotizm correlates rate of activity of limbic and cortical interconnections in the brain.

Psychotic person is highly egocentric, cool people relations and aggressive. Importance of

34
social medium in formation of personal temperament is high. Personal fiches of temperament
get brighter with age.

63.SLEEP, TYPES, PHASE ELECTRICAL ACTIVITY OF THE CORTEX,

PHYSIOLOGICAL MECHANISMS.

There are 2 types of sleep:

- NREM – non-rapid eye movement sleep; has 4 stages; (75-80%)
- REM – rapid eye movement sleep; (20-25%)
Sleep Cycles (70-100 min)
Sleep begins with long period of NREM (1,2,3,4 stages) and REM.
Phase electrical activity of the cortex The reticular activating system (RAS),
or extrathalamic control modulatory system, is a set of connected nuclei in the brains of
vertebrates that is responsible for regulating wakefulness and sleep-wake transitions. As its
name implies, its most influential component is the reticular formation.
Anatomical components

The RAS is composed of several neuronal circuits connecting the brainstem to the cortex.
These pathways originate in the upper brainstem reticular core and project through synaptic
relays in the rostral intralaminar and thalamic nuclei to the cerebral cortex.

Several areas traditionally included in the RAS are:

- Midbrain reticular formation, specially the dorsal raphe nucleus.
- Mesencephalic nuclei (in Midbrain), mainly the (parabrachial area, pretectal area,
and periaqueductal gray).
- Pontine tegmentum, mainly the locus coeruleus, laterodorsal tegmental
nucleus, pedunculopontine nucleus and pontine raphe
- Hypothalamus, specially the tuberomammillary nucleus and lateral hypothalamus.
Transmitters:
-cholinergic
-adrenergic

The main function of the RAS is to modify and potentiate thalamic and cortical function such
that electroencephalogram (EEG) desynchronization ensues. There are distinct differences in
the brain’s electrical activity during periods of wakefulness and sleep: Low voltage fast
burst brain waves (EEG desynchronization) are associated with wakefulness and REM
sleep (which are electrophysiologically identical); high voltage slow waves are found during
non-REM sleep. Generally speaking, when thalamic relay neurons are in burst mode the EEG
is synchronized and when they are in tonic mode it is desynchronized.[14] Stimulation of the
RAS produces EEG desynchronization by suppressing slow cortical waves (0.3–1 Hz), delta
waves (1–4 Hz), and spindle wave oscillations (11–14 Hz) and by promoting gamma band (20
– 40 Hz) oscillations.

35
The physiological change from a state of deep sleep to wakefulness is reversible and mediated
by the RAS. Inhibitory influence from the brain is active at sleep onset, likely coming from
the preoptic area (POA) of the hypothalamus. During sleep, neurons in the RAS will have a
much lower firing rate; conversely, they will have a higher activity level during the waking
state. Therefore, low frequency inputs (during sleep) from the RAS to the POA neurons result
in an excitatory influence and higher activity levels (awake) will have inhibitory influence. In
order that the brain may sleep, there must be a reduction in ascending afferent activity reaching
the cortex by suppression of the RAS.
Physiological mechanisms:

- Cardiovascular: changes in blood pressure and heart rate during sleep and are determined by
ANS activity
- Sympathetic activity: decreases as NREM sleep deepness
- Respiratory: -ventilation and respiratory flow change during sleep and become increasingly
faster and more erratic, specifically in REM;
- during REM, there is reduced rib cage movement and increased upper airway resistance due
to loss of tone in intercostals.
- Cerebral blood flow: - reductions in blood flow and metabolism=NREM; -metabolism and
blood flow incerese=REM
- Renal: decreased excretion of sodium, potassium, chloride and calcium which allows for
more concentrated and reduced urine flow.
- Endocrine: -growth hormone secretion takes place; - thyroid hormone secretion takes place;
- melatonin, which induces sleepiness.

64. AGE ASPECTS OF HIGHER NERVOUS ACTIVITY IN HUMANS.

Age specialties of central regulatory mechanisms cause different workability in young and old
persons, comparing to adults. In children tiredness because of slight inhibitory process develops
rather quickly. They can’t keep attention in the same subject for along time. It’s caused by not
perfect maturation of central neurons and incomplete myelinisation of all conductive pathways
in the brain. In old age both metabolic rate of neurons and synthesis of neurotransmitters
decreases. Some quantity of neurons dies in life course. So, close nerve cells take their function.
In old age mental work may lead to severe autonomic and emotional reactions. For example,
stimulation of heart activity in mental work may result in disorders of heart function.

65.PHYSIOLOGICAL MECHANISMS OF FATIQUE. ACTIVITIES AND ITS

MECHANISMS.
Tiredness is a reduction of working ability, which is caused by the fulfilment of certain work.
Objectively, the process of tiredness expresses in reduction of working capacity, and
subjectively into feeling tired.
Source of a feeling of tiredness is a state of nervous system.

36
Main cause of tiredness - change of functional state of central nervous system(CNS),
specifically cerebrum cortex. As a working result in cortex of cerebrum arises a destructive inhibiting
-

process, which prevents excessive exhaustion cortex cells. This theory explains the question
about the mechanism of tiredness as a result of brainwork and static work, which is attended
with insignificant energy expenditures.

Tiredness is explained by the change of functional state of whole organism, in which leading
role belongs to changes in central nervous system (CNS).

A Tiredness, that develops quickly, can appear by reason of big physical efforts or execution of
work task, which is not suitable for functional organism possibilities. Such tiredness
characterizes by violation of functions coordination by central nervous system and beginnings
of hearths of special disorders. The difference of tiredness, that quickly develops, is a fast
organism functions renewing after suppression of work.
A Tiredness, which develops slowly, characterizes by gradual capacity reduction by reason of
usual, but extremely long or monotonous work. Under this braking develops slowly, it unsteady,
superficial and gradually acquires disposition stage. are observed some weakening of reception
functions, of visual and auditory analysers, motions coordination violations etc.
Secondary tiredness can gradually congest and cause an overstrain, a pathological state.
Activities
Keeping of high mental workability requires autonomic control of metabolic.
Supply in the brain, which is necessary for proper excitability of nerve cells. Intensive blood
circulation in nerve centers is possible due to redistribution of blood. Activity of sympathetic-
adrenal and hypothalamo-hypophisial systems rises considerably. Positive effect causes only
not long duration of emotional excitation. Stimulation of adrenal glands provides high level of
glucose and free fatty acids in blood. Arterial pressure rises. Long lasting mentation and
emotional pressure leads to unwanted result. For instance ECG failure is reveled

a) Physiology of the blood system.

66.GENERAL CHARACTERISTICSOF THE BLOOD SYSTEM. COMPOSITION

AND FUNCTIONS OF BLOOD.

Blood system
It consist of:
- blood circulated through the blood circulatory system
- blood forming organs → b. marrow
- blood destroying organs →
spleen
- regulatory apparatus. → kidney Cerythropoietin ? )

Blood is a fluid connective tissue which circulate in the vascular system and together with a

37
lymph and intercellular space formed internal environment of organism. Blood consist of
plasma (55%) and blood cells – erythrocytes (45%), leucocytes and platelets (<1%). Plasma
consists of water 91% and have inorganic chemicals (sodium, calcium, potassium, magnesium,
chloride, bicarbonate, phosphate, sulfate– 0,9 %) and organic chemicals (proteins: serum
albumin, serum globulin, fibrinogen– 8 %,others: – 1,1 %).pH = 7,4.Volume = 5L.

Functions:
1.Gas transport – blood carries oxygen from lung to the tissues and carbon dioxide from
tissues to lung.
2.Transport of nutritional substances for all cells (glucose, amino acids, fatty acids, vitamins,
ketone bodies, microelements etc.). Blood carries final products of metabolism (urea, uric
acid, bilirubin, creatinin etc.) from tissues to kidney, where from they excreted with urine.
3.Regulation of different processes.Blood creates and carries local hormones (hormonoids) to
the target organs ↳ Hormones
4.Thermoregulation– heat change between tissues and blood.
5.Osmotic function– maintenance of the osmotic pressure in blood vessels. > Defensive
6.Protective function - blood has antibodies and leucocytes, which perform phagocytosis. function
7.Detoxification– blood enzymes can neutralize (split) different toxic substances.

67. ELECTROLITES IN BLOOD PLASMA.

Plasma electrolytes (inorganic compounds)
1) Na + : Nat
- important for maintenance of the osmotic pressure
Kt
- involved in regulation of acid – base balance "

- participates in stimulation of excitable tissues Mg 2T

Ca

2) K + : important for excitability of neurons, muscles and myocardium a-

3) Mg2+ :
- relations to excitation of neurons
- essential for the enzyme activity
- activation of cAMP
4) Ca2+
- essential for function of excitable tissues and for the muscle contractility (alltypes)
- blood clotting → plat et factor 3 (converts to i → to a) vascular endothelial factor
+

all
balance in { out of
maintain

5) Cl- : important for osmotic pressure and ECT volume → fluidvolume

,

blood ,
blood
pressure ,
body fluids

68. THE PLASMA PROTEINS, THEIR FUNCTIONAL SIGNIFICANCE.

Albumin: 80% defines oncotic pressure transfer bilirubin, urobilin , fatty acids , antibiotics ,
sulfonamides , are formed in the liver , 17 g per day.
Globulin. In a fraction of α1- globulins are proteins associated with carbohydrates. The fraction
of α2- globulins include protein ceruloplasmin, thyroxine binding protein , vitamin B12 -
38
binding globulin , angiotensin . By β- globulins include transfer of lipids, polysaccharides and
iron.
Antibodies are mainly γ- globulins. Globulins are synthesized in the liver , bone marrow , spleen
and lymph nodes. By day 5 grams of globulin synthesized
Fibrinogen . (2-4 g / L) takes part in the formation of a blood clot . Formed exclusively in the
liver.

69.ERYTHROCYTES SEDIMENTATION RATE (ESR), FACTORS THAT AFFECT

THE ESR.
ESR - is the rate at which RBC sediment in a period of one hour.
In normal state ESR of men is 2-10 mm/hour, of women 2-15 mm/hour. I

Factors, which affect ESR

when left standing !

The first group of factors – plasma factors:

1) The protein content of blood plasma
When albumins concentration is increased, ESR decreases.
When concentration of high molecular proteins, globulins or fibrinogen increases – ESR
increases. I
Globulins concentration increases in case of inflammatory processes, infectious sicknesses
and malignant tumors. That is why these patients have increased level of ESR.
2) Plasma volume - When increased plasma volume, hematocrit decreases, blood stickiness
decreases, and as a consequence ESR increases. ↳ % of RBCs in blood

The second group of factors – erythrocyte factors:

1) The amount of erythrocytes in blood volume (hematocrit)

- The higher amount of erythrocytes – the higher stickness – the lower ESR.
- The lower amount of erythrocytes – the lower stickness – the higher ESR.
2) The ability of erythrocytes to aggregate
The increase of erythrocyte ability to aggregate leads to the decrease of stickiness. Aggregates
sediments faster and ESR increases.
3) Erythrocytes shape - The change of the erythrocytes shape (for example when sickle-cell
anemia) or its modification (for example, when pernicious anemia) can cause the oppression
of the erythrocytes ability to aggregate. It causes the increase of stickiness and, as a
consequence, the decrease of ESR.
- Except these factors, there are some other ones, which affect ESR.For example, steroid
hormones (estrogen, glucocorticoid hormones) and some medicine (salicylates) increase ESR.
- Erythrocytes sedimentation rate increases when the content of cholesterol in blood increases,
during alkalosis, and it decreases when content of bilious pigments and bilious acids in blood
increases and also during acidosis.

39
 70. THE ACID-BASE STATUS BLOOD AS A BUFFER SYSTEMS OF BLOOD TO
MAINTAIN ITS SUSTAINABILITY.
Maintaining a constant acid-base balance of blood provided by buffer systems:
a)Bicarbonate buffer-> the most important, (HCO3-)/(H2CO3) system, normal bicarbonate
level in plasma 24mmol/L, HCO3- is regulated by kidney, H2CO3 is regulated by respiratory
regulation. The bicarbonate is regulated in the blood by sodium. When sodium bicarbonate
(NaHCO3), comes
into contact with a strong acid, such as HCl, carbonic acid (H 2CO3), which is a weak acid,
and NaCl are formed. When carbonic acid comes into contact with a strong base, such as
NaOH, bicarbonate and water are formed.
NaHCO3+HCl→H2CO3+NaCl
(sodiumbicarbonate)+(strong acid)→(weakacid)+(salt)
H 2 CO 3 +NaOH→ HCO 3- +H 2O
(weakacid)+(strong base)→(bicarbonate)+(water)

b) Phosphate buffer-> HPO4(2-)/ H2PO4-; any acid reacts with monohydrogen phosphate to
form dihydrogen phosphate (H2PO4- + H2O->HPO4(2-) + H3O+); base is neutralized by

( dihydrogen phosphate (H2PO4- + OH- ->HPO4(2-) H3O+)

Aa'd + mono
hydrogen phosphate saltdihydrogen
✓ Base + dihydrogen
phosphate →
→

1- water
phosphate

c) Protein buffer->protein hemoglobin makes an excellent buffer. It can bind to small amounts
of acid in the blood, helping to remove that acid (H+) before it changes the blood's pH;
bicarbonate ions diffuse into plasma and occure exchange for chloride ions.Proteins are made
up of amino acids, which contain positively charged amino groups and negatively charged
carboxyl groups. The charged regions of these molecules can bind hydrogen and hydroxyl ions,
and thus function as buffers.

d) Hemoglobin buffer system is the strongest buffer system (more than 50 % of all buffer
capacity of blood). System of hemoglobin-oxyhemoglobin has buffer act that is why the
oxyhemoglobin in 80 time more acids that renew.

Passing of oxide form in redox form prevent moving of blood рН in acid side during it contact
with tissues, where it enrichment by Н2СО3. Forming of oxyhemoglobin in lungs capillaries
prevent movement of this blood reaction in base side at the expence of moving СО2 and Сl–
from erythrocytes in blood plasma and forming NаНСО3.
• Lungs are regulated Ee
educe of СО2 and absorb of О2.
• KHb + H2CO3 ⇄ HHb + KHCO3
• Value of buffer systems’ work carry out by following indexes:
• pH – 7,35-7,54
• AB (actual bicarbonate) – 19-25 mEq/L → mini equivalents / Litre

40
 • SB (standard bicarbonate) – 20-27 mEq/L
• BB (base buffer) – 40-60 mEq/L
• BE, BD (buffer excess, buffer deficit) – ± 2,3 mEq/L

71)RED BLOOD CELLS, THEIR FUNCTION.

In men – 4,0-5,1 Tera/L; in women – 3,7-4,7 Tera/L.
The quantity of erythrocytes may be increase – in pregnancy, in physical training, mental
work, in newborn or decrease.
Human erythrocytes - nuclear-cells that are shaped like concave discs.
↳ non nuclear
Functions:
-

- Transport function. Red blood cells carry: O2, CO2, NO, adsorbed proteins, drugs,
physiologically active substances.
- Provide acid-base balance.
- Maintaining the ionic composition of the plasma.
- Hemostatic

72. Regulation of erythropoiesis.

-neural and humoral mechanisms (sympathetic innervation stimulates hematopoiesis and

parasympathetic brakes)
-erythropoietin
-hematopoiesis is enhanced by hormones front of the pituitary gland, adrenal glands, thyroid
gland -male sex hormones stimulate, increasing the sensitivity of bone marrow to
erythropoietin, and women - inhibit erythropoiesis. male 9 : female f erythropoiesis .

-inhibitors of erythropoiesis (their content increases with the number of red blood cells) I
* -erythropoiesis depends on supplies of iron, amino acids and B vitamin *
- -

73. Types of hemoglobin and its compounds, their physiological role.

Hemoglobin → is the iron-containing oxygen-transport metalloprotein in the red blood cells

a) Hemoglobin A1
→ is present 90-95 % in adult human
→ composed of 2α and 2β chains
b) Hemoglobin A2
→ present in 5-10 % of adult people
→ 2α and 2δ chains → delta
c) Hemoglobin F
→ present in fetus
→ two alpha and two gamma chains
→ after birth it is reduced to 15 %

41
 → is replaced by HbA1
d) Hemoglobin P (prymitive, embryonic)
→ present in 7-12 week of life
→ is made up of two alpha and two epsilon chains
→ is replaced by foetal hemoglobin
e) Hemoglobin A3
→ found in old red blood cells
f) glycosylated hemoglobin (Hb-A1c)
→ present in 3-5% of people
→ is important for the diagnosis of diabetes and is present 6-15 % in diabetic patient

PATHOLOGICAL HEMOGLOBIN
1) HbCO = carboxyhemoglobin (composition of hemoglobin and carbon monoxide)
-> CO has higher affinity to Hb than O2 (300 times)
-> binding of CO is permanent, so the hemoglobin is blocked for O2
->can be treated by clean oxygen
2) MetHb = HbOH = methemoglobin
-> it occur when ferrous iron Fe2+ is oxidized to Fe3+ (brown color)
->cannot bind oxygen
-> occurs also in normal state but metHb reductase system of erythrocyte turns metHb into
normal hemoglobin (methemoglobin reductase = diaphorase, take part in this system); if this
system doesn’t work can occur methemoglobinemia

PHYSIOLOGICAL HEMOGLOBIN
1) Oxyhemoglobin - it is used for transport of O2 in the body (HbO2)
2) (HbCO2) = carbhemoglobin

74. White blood cells, their function.

White blood cells, or leukocytes, are classified into two main groups: granulocytes and
nongranulocytes (also known as agranulocytes). I

f General Structure and Function: neutrophils

eosinophils
monocytes 1. protection from microbes, parasites, toxins, cancer basophils
lymphocytes 2. 1% of blood volume; 4-11,000 per cubic mm blood 4- 110001mm
}

3 diapedesis - can "slip between" capillary wall

4. amoeboid motion - movement through the body
5. chemotaxis - moving in direction of a chemical
6. leukocytosis - increased "white blood cell count" in response to bacterial/viral
infection

GRANULOCYTES
→ include neutrophils eosinophils and basophils
→ have granules in their cell cytoplasm
→ have a multilobed nucleus (polymorphonuclear leukocytes or "polys”)
↳ Prints
42
(2-7,5 giga/L) Neutrofils: protection against infections, response to bacteria and parasites, 60-
70% of all leucocytes, main source of energy – glucose in glycolysis (small amount of
mitochondria), granules (contain hydrolases, peroxidases, phosphatases, lysozyme), release
strong oxidants.

(0,01 giga/L) Basophils: – allergic & inflammatory reactions, blood clotting, 1-5 % of all
leucocytes; produce a lot of histamine, serotonin, heparin; energy mainly from oxidative
phosphorylation, leave capillaries->enter tissue

(0,04-0,44 giga/L) Eosinophils: – protection from microorganisms, allergic reactions, 3-6 % of

:
all leucocytes; amount is increased in helmintosis, organism sensibilization, alergy; release
histaminase, phagocytize antibody-antigen complex

AGRANULOCYTES
→ lymphocytes and monocytes
→ don't have granules
→ have nonlobular nuclei

(0,2-0,8 giga/L) Monocyte: a lot of lysosomal hydrolases, after long time arrived to place of
infection but in large amount, leave capillaries and become macrophages, destroy microbes and
clean up dead tissue(phagocytosis), aerobic pathway of energy obtaining

(1,3-3,5 giga/L) Lymphocyte: Т- і В-limphocytes, formation of humoral and cell immunity,

synthesis of protein - immunoglobulins, energy mainly from glycolysis ; B-cells → destroy
bacteria and their toxins, produce and release antibodies(IgM, IgN, IgA, IgG, IgB, IgE); T-cells
→ attack viruses, fungi, transplanted organs, cancer cells; regulate phagocytosis; 2 types of
cells → T helper cells and T killer cells

75. Regulation development of leukocytes. Physiological leukocytosis.

Regulation
→ irritation of sympathetic nerves increases number neutrophils levels
→ irritation of vagus nerve reduces number of white blood cells
→ hormones like a adrenaline, glucocorticoids leads to change in number of leukocytes in blood
→ accumulation of monocytes promotes development of prostaglandins isof erytin that inhibits
formation of colony-stimulating factor and level of neutrophils in blood is reduced

Leukocytosis
1. Physiological – is normal, physiological reaction of the organism in some irritations. There
are following types, dependently on their causes:
• emotional leucocytosis (occurs in result of emotional stresses);
• myogenic (occurs in result of intensive physical exercises);
• static (occurs in result of change of the position of the human body

43
 • from horizontal to vertical);
• alimental (occurs during or after eating);
• painful (occurs during strong painful feelings);
• leucocytosis of pregnant; → in
• leucocytosis of newborn. pregnancy } in newborns

Physiological leucocytosis: → difference between it { Pathological leucoaytos

's

1) it is redistributing (leucocytes from the parietal pool are moving into circulation);
2) it has transient character (it is normalizing fast after the cause disappears);
3) leukogram does not change (the correlation between different forms persists);
4) degenerative forms of leucocytes do not appear

76. Antigens and antibodies AB0 system and CDE.

ABO system comprises two agglutinogens A and B (whose corresponding agglutinins are α
and β). Accordingly, there are 4 blood groups in the ABO system: 1
→ group A, which has A agglutinogen, α agglutinin ( anti a antibody
- ) antibody
→ group B which has B agglutinogen, β agglutinin (anti b antibody )
-
antibodies IgM
are

→ group AB having both, don't have agglutinin ( no

antibody ) Rhesus is IgG
→ group O having neither, has both agglutinin ( no
antigen )

Both α and β agglutinins are immunoglobulin-M (IgM), which is very effective in causing
agglutination (clumping) of red cells.

CDE system there are 6 major Rh antigens D, C, E, d, c, e (Rh0 (D); rh '(C); rh "(E); Hr0 (d);
hr' (c); hr" (e)). Antigen Rh0 (D) - main antigen of Rh-system. It is found in red blood cells
85 % of people. Anti-D agglutinins are predominantly immunoglobulin G (IgG) and partly
immunoglobulin M (IgM). IgG does not agglutinate red cells although they do react with the
agglutinin. Letter "d" indicates absence of D antigen (the gene is usually deleted or otherwise
nonfunctional).

77. Methods definitions of blood groups.

DETERMINATION OF BLOOD IN THE SYSTEM AB0 BY MONOCLONAL ANTIBODIES

1) Clean white space for glass divided into 4 sections: anti-A, anti-B, antiD and control.
2) Put in relevant sector 1 drop of monoclonal antibodies antiA, anti-B, anti-D and control saline
NaCl.
3) Angle of glass make ten times smaller amount of blood in two drops of monoclonal
antibodies. Observation of reaction on plate shaking for 2.5 minutes.

78. Samples of blood before transfusion.

Before transfusion we must do test on individual blood compatibility

→ ABO system
→ CDE system → rhesus !

44
 → biological test
BIOLOGICAL SAMPLE
Recipient pour 10-15 ml of blood, then stop infusion and monitor its condition. If no violations
of life, then after 3-5 minutes pour 10-15 ml of blood and re-infusion is stopped. Watch 5
minutes. Such manipulation is carried out for third time. If health of recipient is not observed
any violations of health, blood can be transfused. Otherwise, stop transfusion.

79. The mechanism of Rh konflict during pregnancy.

- Remember that Rh ☒ is
IgG 3 can cross the placenta
Mechanism of Rh conflict in pregnancy: immune antibodies formed in body of Rh negative
women pregnant Rh positive fetus, have ability to cross placenta into body of fetus, its cause
hemolysis of erythrocytes. During labor in blood of a newborn baby comes many antibodies
and developed hemolytic disease.

Rht man

{
Rh - woman

t
Rh + child
t
woman
sensitive

to
anti - Rht antibody
in woman

t
attacks next child

80. Platelets, their physiological role.

Properties of platelets
→ quantity of platelets is 180-320 G/L.
→ diameter of platelets is 1-4 micrometers, thickness – 0,5 -0,75 micrometers.
→ they are little peace
ie s of megacariocytes cytoplasm (from one megacariocytes may develop

few hundred of platelets).

→ platelets circulated in blood from 5 to 11 days → Lifespan
→ are destroyed in liver, lungs, spleen by cells of macrophagal system.

Function of platelets are:

→ hemostatic function – platelets produce substances, which are secure the
hemostasis. Its produce 12 platelets factors (1– proaccelerin, 2- factor, which are increase speed

45
 of development fibronogen in fibrin, 3 - platelets thromboplastin, 4 - antiheparinic factor, 5-
factor which promote aggregation of platelets, 6 – thrompostenin, 7 – antifibrinolizin, 8 –
serotonin, 9- fibrinstabilising factor, 10 – factor which activate profibrinolisin, 11 – inhibitor of
thromboplastin, 12 – antilighting factor)

→ angiotrophic function – provide trophic of endotheliocytes of vessel wall, support structure

and functions of microvessels. These function is realize by adgesion h of platelets to
endotheliocytes and injection enzymes into endotheliocytes. For one day near 35 G/L platelets
do this function.

→ transport function – transfer the enzymes, ADP, serotonin and other.

→ phagocytosis function – contain of platelets help to kill viruses and antigens bodies

→ regeneratory function – platelets have growth factor, which help to grow endothelial and
muscles cells which are present in vessel wall

81. Vessel-platelet hemostasis, its mechanisms and physiological significance.

small blood vessel
→ Events that occur due to damage to a

1. Shorting spasm of vessels – vascular spasm duration to 1 minute is caused by catecholamins

and other enzymes. Diameter of vessels decrease on ½-⅓. Mechanism of it development
determine by secretion of serotonin and thromboxan A2 from platelets and epinephrine from
ending of sympathetic nerves.
2. Adhesion of platelets – activation of platelets and stick it to place of defect in vessel wall.
3. Reverse aggregation of platelets – thromb which are formed may make way for plasma.
4. Unreverse aggregation of platelets – thromb which are formed can not may make way for
plasma.
5. Retraction of platelets plug – decrease size of plug, pack down plug.

Physiological significance:
→ keep blood in a damaged blood vessel
→ so , hemostasis ?
→ prevention and control of bleeding

82. Coagulation hemostasis, its mechanisms and physiological significance.

There are two systems of clotting:

1) Intrinsic or blood system - this system is called, because all factors taking part in the process
are derived from blood

• Stage No.1. Three plasma proteins, i.e. Hageman factor (XII), kininogen and pre-
kallikrein form a complex with vascular subendolhelial collagen. Factor XH- i becomes
activated to Xll-a, which acceleates conversion of pre-kallikrein to kallikrein which then
accelerates conversion of still more XII- i to XII- a.

46
 Factor 12 + Kinirwgen + prekalliarein + vascular endothelial factor
to
factor 12 a
12 a
↳ factor 12i → factor
1
• Stage No.2. Factor XII-a converts factor XI-i to XI-a. factor 11 i → 1¥→ a
1
• Stage No.3. Factor XI-a converts factor IX-i to IX - a. factor qi → 9a

• Stage No.4. Factor IX-a in presence of factor VIII C, Ca2+ a platelet membrane
(cast;)
lipoprotein (platelet factor 3) converts X-i to X -a. * Factor 9 factor 8Gt platelet factor 3
at

Converts to i → 109

Y
• Stage No.5. Several factors take part in conversion of prothrombin to thrombin. These
include factor X-a, factor V-a, Ca2+ and phospholipids. Although conversion of
prothrombin to thrombin can take place on a phospholipid-rich surface, but it is
L
accelerated several thousand -fold on surface of activated platelets. Prothrombin thrombin
→

• Stage No.6. Conversion of fibrinogen to fibrin is brought about thrombin by following

mechanism. Fibrinogen is a symmetrical dimer; each half of its molecule has following
1
structure: fibrinogen →
fibrin
• Alpha polypeptide joined to a short A-fibrinopeptide.
• Beta polypeptide joined to a short B-fibrinopeplide.
• Gamma polypeptide

2) The extrinsic or the tissue system - this is called so because it needs presence of tissue juice
that contains tissue thromboplastin which is not present in blood. Tissue thromboplastin in
presence of factor VII and Ca2+ activates factor X-i to X-a. Subsequent reactions are same as
intrinsic system and is common to both intrinsic and extrinsis systems, are designated as final
common pathway. Because extrinsic system involves fewer steps than intrinsic system,
therefore it proceeds faster than latter. For this reason, while intrinsic system takes 2 to 6
minutes for clotting to take place, extrinsic system takes as little as 15 seconds.

83. Coagulants and anticoagulants and their role in maintaining blood in the liquid state.

→ COAGULANTS: An agent that produces coagulation (Coagulation is a complex process by

which blood forms clots).

→ COAGULATION FACTORS:
• I Fibrinogen.
• II Prothrombin.
• III Tissue factor.
• IV Calcium.
• V Proaccelerin, labile factor.
• VI Accelerin. • VII Stable factor
• VIII Antihemophilic factor.
• IX Christmas factor
• X Stuart-Prowers factor.

47
• XI Plasma thromboplastin antecedent.
• XII Hageman factor.
• XIII Fibrin-stabilizing factor

→ ANTICOAGULANTS: An anticoagulant is a substance that prevents coagulation; that is, it

stops blood from clotting
→ NATURAL ANTICOAGULANTS: 1. PGI-2. 2. Antithrombin. 3. Protein-C. 4. TFPI. 5.
Heparin. 6. Fibrinolytic system to t
Prostaglanding-
2 Tissue factor
pathway
inhibitor
84. Mechanisms fibrinolysis, their physiological importance.

Fibrin/fibrinogen degradative products (FDP) as well as fibrin/fibrinogen split products (PSP).

FDP → promote bleeding I

→ fibrin degradation products / Fibrin split Products -
stop everything
blood
1. They inhibit binding of fibrinogen to platelets and inhibit aggregation of platelets. clotting
2. They inhibit thrombin formation and also destroy any thrombin formed.
3. They prevent fibrin polymerization.

Mechanisms of fibrinolysis activation

→ there are 2 mechanisms of fibrinolysis activation: external and internal.
→ main internal mechanism put in action by XIIa factor
→ external mechanism stimulated by protein activators of plasminogen, which are produce by
vessel wall
1) Plasmin is produced in an inactive form, plasminogen, in liver.

2) Tissue plasminogen activator and urokinase convert plasminogen to the active plasmin.

48
 3) t-PA is released into the blood very slowly by damaged endothelium of blood vessels, such

( that, after several days (when bleeding has stopped), the clot is broken down.
>Tissue Plasminogen
activator

4) t-PA and urokinase are inhibited by plasminogen activator inhibitor-1 and plasminogen
activator inhibitor-2 (PAI-1 and PAI-2).

5) Plasmin further stimulates plasmin generation by producing more active forms of both tissue
plasminogen activator (tPA) and urokinase.

6) Alpha 2-antiplasmin and alpha 2-macroglobulin inactivate plasmin. Plasmin activity is also
reduced by thrombin-activatable fibrinolysis inhibitor (TAFI).

b) Physiology of the circulatory system.

85. Automatism heart. Gradient automatism.

49
 Automatism of heart - the ability of cells of heart conducting system to produce independently
bioelectric impulses, that cause its excitement. →
produce its own impulses { generate its
own action potential !
Gradient of automaticity caused by different spontaneous permeability cell membrane of

f.
conduction system to Ca2 +. Sino-atrial node impose rhythm to departments of conduction
system, that lying lower, it is called pacemaker of first order. Pacemaker of second order is
atrio-ventricular node. Pacemaker third order – it is His node and its ramifications.
caused
by difference in the spontaneous
permeability of all membranes to Cazt So th . s . A node has to maintain a
rhythm { is
called 1st order pacemaker - Au node , 2nd order .Bundle of His → 3rd order .

Gradient automatism – A decrease in the degree of automatism in the conduction system (the

I
automatism gradient) is responsible for the reliablegeneration of excitation in the heart. For
example, when the sinoat ial node becomes dysfunctional, the atrioventricular nodebecomes
the pacemaker. Under normal conditions, the automatism of other cardiac segments is repressed
by the sinoatrialnode, which discharges becomes
more frequent impulses and is the major pacemaker.
✓ When an order of pacemaker fails
, the next order responsible for the excitation of the heart !

86. The action potential atypical cardiomyocytes mechanisms of physiological role.

1) Sinoatrial (SA) node normally generates action potential, i.e. electrical impulse that initiates
contraction. SA node excites right atrium (RA), travels through Bachmann’s bundle to excite
left atrium (LA). Impulse travels through internodal pathways in RA to atrioventricular (AV)
node.

2) From AV node, impulse then travels through bundle of His and down bundle branches, fibers
specialized for rapid transmission of electrical impulses, on either side of the interventricular
SA node
septum.
-

µ
R Bundle
.

intermodal R atrium
.

←
•
fibres Bundle *✓ '

Pathway - < ←

€
←
Purkinje ← mode atrium Bachman bundle
of µ, 50
fibres c-

t
2. Bundle
fibres
 3) Right bundle branch (RBB) depolarizes right ventricle (RV).

4) Left bundle branch (LBB) depolarizes left ventricle (LV) and interventricular septum.

5) Both bundle branches terminate in Purkinje fibers, millions of small fibers projecting
throughout the myocardium.

Automatisity:
→ SA-node – 60-90 /min
→ AV – node – 40-60 /min
→ Hiss bungle – 30-40 /min
→ Purkinje fibers - <20 /min

87. Conducting system of the heart. The sequence and speed of conduction of excitation
in the heart.

The electrical conduction system of the heart transmits signals generated usually by the
sinoatrial node to cause contraction of the heart muscle. The pacemaking signal generated in
the sinoatrial node travels through the right atrium to the atrioventricular node, along the Bundle
of His and through bundle branches to cause contraction of the heart muscle. This signal

f.
stimulates contraction first of the right and left atrium, and then the right and left ventricles.
This process allows blood to be pumped throughout the body.

• SA-node – 60-90 /min

talk • AV – node – 40-60 /min
summarized • . Hiss bungle – 30-40 /min
• Purkinje fibers - <20 /min
v • Conduction velocity in atrial muscle = 0.3 to 0.5 m/sec
SA node start
d here
R Brindle
.

intermodal R atrium
←
.

←
•
f- b "
"

← Bundle *✓ '

Pathway - < ←
Purkinje ← rode atrium Bachman bundle
offers
fibres c-

1
2. Bundle
fibres

51
 88. The action potential of ventricular contractile cardiomyocytes, mechanisms of phase,
physiological role.

During systole, the ventricles contract, pumping blood through the body. During diastole, the
ventricles relax and fill with blood again

After the delay at A-V node, the impulses rapidly spread to the ventricles via specialized fibers,

c. Purkinje fibers.which are located in the subendocardial layer, fastest conduction (4 m/s). And
Ordinary ventricular myocardial cells which are able to conduct AP at a slower speed .
→allows props
emptying of the
heart
before next contraction
.

delay
89. Changes in the excitability of cardiomyocytes during arousal.

Each electrical impulse can trigger cardiac muscle contraction normally only once.
Contraction of the heart is triggered by elevation of intracellular calcium influx
A normal heart generates 60 to 100 impulses in 1 minute at resting state.
The myocytes have Long refractory period during which they do not respond to any electrical
impulses.
Role of a Long Refractory Period – prevent ventricles from contracting at too high rates so that
enough time is allowed for refill of the ventricles.

Excitation > Ca2+ >contraction

52
 X-P → spread in Cordia Transverse
muscle
fibre
→
Tubule → cdtgates-c.at →
toe
feedbag
→
contraction
open influx -

,
90. Conjugation excitation and emission in the myocardium. Mechanisms of contraction
and relaxation of the myocardium. ,

When AP passes over cardiac ms membrane, AP also spread to interior of cardiac ms fiber I
along membranes of transverse (T) tubules.Depolarization of myocardial cell stimulates

÷
opening of Ca2+ channels in sarcolema.

When the wave of electrical excitation reaches the T tubules, voltage-gated Ca2+ channels open
to provide relatively small entry of Ca2+, which triggers additional release of Ca2+ from the
SR via closely apposed release channels. This is the Ca2+ that initiates myocardial contraction.
Ca2+ sequestration by the SR causes relaxation (diastole)

SA- node membrane permeability to K+ → less K+ efflux.

-

• membrane permeability to Ca → more Ca

2+ 2+
influx. ←
• As a result, the slope of depolarization , causing rate of SA- node firing & HR.
• sR→ sarcoplasmic retaken !

91. Formation electrocardiogram of the heart muscle fibers, wave dipole properties
repolarizationreopolyaryzatsiyi depolarization and muscle fiber, the concept of vector
,

ventricular
Electrocardiography - is the process of recording the Contraction
electrical activity of the heart over a period of time #
using electrodes placed on the skin. These electrodes
detect the tiny electrical changes on the skin that arise
from the heart muscle's electrophysiologic pattern of
depolarizing and repolarizing during each heartbeat

The p-wave represents depolarization of the atria.

Atrial depolarization spreads from the SA node towards the AV node, and from the right atrium
to the left atrium

The PR interval is measured from the beginning of the P wave to the beginning of the QRS
complex. This interval reflects the time the electrical impulse takes to travel from the sinus node
through the AV node

The QRS complex represents the rapid depolarization of the right and left ventricles. The
ventricles have a large muscle mass compared to the atria, so the QRS complex usually has a
much larger amplitude than the P-wave

The T wave represents the repolarization of the ventricles. It is generally upright in all leads
except aVR and lead V1.

The ST segment connects the QRS complex and the T wave; it represents the period when the
ventricles are depolarized.

53
 92. Formation of the propagation of excitation electrocardiogram heart:

(same as 91)

93. Electrocardiographic leads

A standard 12-lead ECG report (an electrocardiograph) shows a 2.5 second tracing of each of
the twelve leads. the first column is the limb leads (I,II, and III), the second column is the
augmented limb leads (aVR, aVL, and aVF), and the last two columns are the precordial leads
(V1-V6).

I RAKA • Lead I: Potential difference between

>

right arm and left arm. Vector

RA { LL
-

oriented to 0º
III.→ LA } LL
• Lead II: Potential difference
between right arm and left leg.
Vector oriented to 60º.
• Lead III: Potential difference
between left arm and left leg. Vector
oriented to 120º.
auth → RA • aVR: Right arm absolute potential,
art> LA vector oriented at -150º.
au f- → LL
• aVL: Left arm absolute potential, vector oriented at -30º.
• aVF: Left leg absolute potential, vector oriented at 90º.
• V1: This chest lead registers potentials from the atria, part of the septum and the right
ventricle anterior wall. The QRS complex is formed by a small R wave (septum
depolarization) followed by a deep S wave (ventricles activation), see QRS
Morphology.
• V2: The electrode for this precordial lead rests over the right ventricle wall. Therefore,
the R wave is slightly bigger than in V1, followed by a deep S wave.
• V3: It is the transitional lead between the electrocardiogram left and right potentials, as
the electrode rests over the interventricular septum. The R and S waves are almost
identical (Biphasic QRS).
• V4: The electrode for this chest lead rests over the left ventricle apex, where the walls
are thicker. Therefore, it presents a tall R wave followed by a small S wave (right
ventricle depolarization).
• V5 y V6: These electrocardiogram leads are situated over the Left Ventricle
myocardium, which has thinner walls than in V4. Therefore, the R wave is not as tall as
in V4, preceded by a small q wave (septum depolarization)

54
 94. Characteristics teeth , segments, ECG intervals.

-Assessment of wave R:
a) measuring the amplitude and
b) comparing it with Q wave amplitude in the same tooth extraction and other R leads.
Time→ duration

Length Cmm> →amplitude

-Assessment of wave S: seconds
Q → 003
-2mm
,

a) measuring the amplitude and R→ 20 -25mm ,

b) comparing the amplitude of R wave in the same leads. S→ 20mm ,

o -

03 seconds

PQ → 0.12 -
0.20 seconds

0 5- 2mm
ST→
-

-Analysis of wave T. In the analysis of the T wave should:

a) identify the direction,
b) to assess its shape and
c) to measure the amplitude.
-Wave Q displays spread of excitation through the middle and lower thirds of the
interventricular septum. It should not exceed 1/4 of prongs ʼ R amplitude in a healthy person,
and its duration – 0,03 sec. But aVR-lead – is exception, where deep and wide Q-prong
-

registered.
-Wave R normally registered in all standard and reinforced leads. In lead aVR R-prong slightly
expressed or absent completely. In the precordial leads R-wavesʼ amplitude gradually increases
from V1 - V4, and decreases in V5 - V6. Height of R wave does not exceed 20 mm in standard
and reinforced leads, and 25 mm – in thoracic (pectoral). It displays the spread of excitation
through the side walls of the right and left ventricles.
-Wave S Its amplitude in different leads varies in a wide range In a healthy person, but not
exceeding 20 mm. Its duration – 0,03 s. Wave S decreases from V1, to V6 in the precordial
leads. It displays the spread of excitation in the basal parts of the ventricles.
-Analysis of segment interval and P -Q segment is measured from the end of P before Q. The
interval is measured from the beginning of P to the Q. 0 12 O 20 Seconds
l .
-
-

l
- Analysis of the QT interval is to measure its duration (from the beginning to the end of QT).
l
- Analysis of segment interval and P -Q segment is measured from the end of P before Q. The
l interval is measured from the beginning of P to the Q.
l - Analysis of S-T segment . Analyzing segment , you must set its deviation from the isoline.
l - Analysis of the QT interval is to measure its duration (from the beginning to the end of QT).
v
- Interval P -Q reflects a time of spread of excitation within atrium, atrioventricular node, Htt
Gis
bundle and its branches. The duration of the interval P -Q varies from 0,12 to 0,20 s, depending
on heart rate.
55
 This is an electrical ventricular systole . Duration of Q- T interval depends on heart rate. The
proper duration time of interval Q- T can be counted with the Bazett formula: Q- T = K · √ R-
R,
where K - coefficient of 0,37 for men and 0,40 for women;
RR - duration of one cardiac cycle or intercyclic іnterval
- Segment P -Q reflects a spread of excitation throuh the atrio -ventricular node, Gis bundle and
its branches. Duration of segment P-Q is normal to 0,12 sec.
- S-T segment – reflects full coverage of both ventricles with stimulation. As usual segment S-
T is on the isoline in standard and reinforced single-pole leads from limbs and its displacement
is less than 0,5 mm. In thoracalis leads lV1 - V3 may be a slight shift acording to the isoline up
to 2 mm, and in V4, 5,6 - shift down less than 0,5 mm.

95. Cardiac cycle, its phases and their physiological role.

-
Note the Phases !
CARDIAC CYCLE: 1ST DIASTOLE PHASE
During the diastole phase, the atria and ventricles are relaxed and the atrioventricular valves are
open. De-oxygenated blood from the superior and inferior vena cavae flows into the right
-
atrium. The open
- atrioventricular
- - valves allow blood to pass through to the ventricles.
- -
- The SA
node contracts triggering the atria to contract. The right atrium empties its contents into the
right ventricle. The tricuspid valve prevents the blood from flowing back into the right atrium.

CARDIAC CYCLE: 1ST SYSTOLE PHASE

During the systole phase, the right ventricle receives impulses from the Purkinje fibersand
contracts. The atrioventricular valves close and the semilunar valves open. The de-oxygenated
blood is pumped into the pulmonary artery. The pulmonary valve prevents the blood from
flowing back into the right ventricle.
The pulmonary artery carries the blood to the lungs. There the blood picks up oxygen and is
returned to the left atrium of the heart by the pulmonary veins.

CARDIAC CYCLE: 2ND DIASTOLE PHASE

In the next diastole period, the semilunar valves close and the atrioventricular valves open.
Blood from the pulmonary veins fills the left atrium. (Blood from the vena cava is also filling
the right atrium.) The SA node contracts again triggering the atria to contract. The left atrium
empties its contents into the left ventricle. The mitral valve prevents the oxygenated blood from
flowing back into the left atrium.

CARDIAC CYCLE: 2ND SYSTOLE PHASE

56
During the following systole phase, the atrioventricular valves close and the semilunar valves
open. The left ventricle receives impulses from the Purkinje fibers and contracts. Oxygenated
blood is pumped into the aorta. The aortic valve prevents the oxygenated blood from flowing
back into the left ventricle.
The aorta branches out to provide oxygenated blood to all parts of the body. The oxygen
depleted blood is returned to the heart via the vena cavae.

>
Regulatory
96. Cardiac,mechanisms of their origin. PCG its analysis.
• The aim of the circulatory regulation is to regulate the blood flow of organs to fit their
metabolic requirement in different condition.
• The regulation of blood flow are of three major types:
brainstem centre in
• Neural → Sympathetic parasympathetic cardiac
, ,

atrial natriuretic peptide Vasopressin

angiotensin aldosterone
,

• Humoral → adrenaline noradrenaline

-
,
renin .

, ,

• Local →
PCG- A phonocardiogram (or PCG) is a plot of high-fidelity recording of the sounds and
murmurs made by the heart with the help of the machine called the phonocardiograph; thus,
phonocardiography is the recording of all the sounds made by the heart during a cardiac cycle.

97. The types and value of echocardiography. → see

9.98 t
98. The advantages over other methods of echocardiography of the heart and its
limitions.

Echocardiography is the study of the heart us ing ultrasound. Similar to a scan of a baby
undertaken during pregnancy, an ultrasound probe applied to the chest wall an be used to study
the heart. Ultrasound produces images of the pumping and collecting chambers of the heart,
the heart valves, and the main blood vessels, providing detailed information about heart
structure and function.

There are several types of scan including:

1. Transthoracic echocardiography → Painless , Safe , can see good structure

2. Stress echocardiography (using exerc ise or dobutamine) assess inadequate blood

supply { value defect
obese 3
holes { shunts heart , better for
3. Contrast echocardiography (bubble study) → can see
in

lung disease patient.

4. Transoesophageal echocardiography (TOE) → when transthoracic can't produce clear enough images .

Like obesity hang disease

,
.
Does not have to pass through fat { skin since its taken from inside

oesophagus .

Transthoracic Echocardiography (TTE)

The standard echo (transthoracic echocardiogram) takes about twenty minutes and is performed
in the outpatient setting. It is painless and completely safe. A small handheld ultrasound probe
is moved over the front of the chest wall to produce images of the beating heart on an ad jacent

57
monitor. The size and shape of the various heart chambers can be seen, together with the
movement of the heart valves. A vast amount of information can be gleaned from this test,
which helps greatly with the diagnosis and management of a wide variety of heart conditions.
For example, the effects of aheart attackon the heart muscle can be accurately
assessed, the severity of a leaky or narrowed valve can be quantified, and many different causes
of breathlessness can be identified.
Stress Echocardiography
This is a dynamic form of echocardiography, whereby repeated ultrasound scans of the heart
are carried out when the heart is placed under increasing amounts of controlled stress. Exercise
in the form of stationary cycling or walking on a treadmill may be used to “stress” the heart and
make it beat faster and harder, but in some instances, particularly when a patient is unable to
exercise, an infusion of the drug dobutamine is used instead. The purpose of a stress
echocardiogram is to highlight those cases where the blood supply to the heart becomes
&

inadequate when placed under stress, which will help with the assessment and management
ofangina and certain valve problems.

Contrast Echocardiography and Bubble Studies

Contrast echocardiography takes advantage of the acoustic properties of microbubbles in the
circulation. Blood conventionally appears black on an ultrasound monitor, because the
ultrasound scattered by blood cells at conventional imaging frequencies is very weak. Contrast
bubbles oscillating in an ultrasound beam are several million times more effective at scattering
sound than red blood cells, and as a result greatly enhance the blood pool signal. This has a
number of applications, one of which is to improve the image quality in patients where
conventional echo images are suboptimal, for example, due to obesity or lung disease. The
contrast is administered as a simp le injection into an arm vein. Contrast can also be used to
look for holes and shunts in the heart, such as a patent foramen ovale (PFO) or atrial septal
defect (ASD) with an investigation known as a bubble study. As the contrast reaches the right
side of the heart, the patient is asked to perform the Valsalva mano euvre, “bearing down”,
which increases the pressure gradient across the heart. If bubbles can be seen flowing from the
right atrium into the left atrium (these chambers should be separated completely) then the test
result is positive for a ho le or shunt. T his test takes only s lightly longer than a standard
transthoracic echocardiogram.

Transoesophageal Echocardiography (TOE)

It is an ultrasound scan of the heart whereby pictures are taken from the oesophagus (gullet)
rather than from the front of the chest. There are times when the transthoracic echocardiogram
cannot provide enough detail, for example in very overweight patients, patients with lung
disease and in cases where extremely fine detail is required, particularly when infection of the
heart is suspected. The main advantage of a TOE over a transthoracic echocardiogram is that
the ultrasound beam does not have to pass through skin, fat, muscle, bone and lung tissue before
reaching the heart. The miniaturised TOE probe is attached to a flexib le tube which connects

58
 to the main echo machine; it is positioned in the oesophagus, which lies behind and
immediately ad jacent to the heart, giving exquis itely detailed images of the heart structures
and function, particularly the areas at the back of the heart, the left atrium and mitral valve,
which can be difficult to visualise adequately from the front of the chest.

99. The mechanism of influence of sympathetic nerves on heart activity.

The sympathetic nerves are accelerator nerves. These fibres stimulate the SA node, AV node
and also the muscles of the auricles and the ventricles .Stimulation of the sympathetic nerves
causes
a) Increase in frequency of heart rate + chromo tropic effect

+ ionotropic effect
b) Increase in force of contraction
c) Increases excitability and irritability of the heart + bathmotrop:c effect dronotropic
+
effect
d) Increases the conductivity of the cardiac muscle and bundle of His thermal regulation.
Cardiac inhibitory lateral horn
accelerator centre
cardiac centre Lite →

→ g.
It begins at C.A.C in the medulla oblongata near C.I.C. The axons of their neuron descend in
the white matter of the spinal cord, and relay at L.H.C of upper 5 thoracic segment.
Preganglionic fibers of L.H.C pass in sympathetic chain and ascend upwardsto relay in the three
cervical sympathetic ganglia (superior, middle and inferior cervical sympathetic ganglia.
Postganglionic fibers pass from the ganglia to the heart where they supply all the structures of
the heart inc lud ing the ventricles.
oh
PAIN'm:c fibres
" →

C. A- c-> Sc
→ LHC → cervical sympathetic→ heart
F- s Ganglia Cs > smear

100. Mechanisms parasympathetic nerves influences on heart activity.

Parasympathetic innervation: (vagus nerve)
Preganglionic fibers of vagus arise from the neurons of C.I.C. They reach the heart as
preganglionic fibers and relay in terminal ganglia present in the substance of the atrial muscle
particularly the nodal tissues. Postganglionic fibers supply SA node, A-V node and main stem
of A-V bundle (but not its branches), atrial
muscle, and coronary blood vessels. Vagus nerve does not supply the ventric les, branches of
A-V bundle and Purkinje fibers.
a) Specialties of vagal innervations of the heart.
Right n. vagus controls mainly right atrium and SA node. Left n. vagus control AV node, His
bundle and all contractile myocardium. So irritation of right nerve causes bradycardia. Effects
of left nerve lead to decrease of contractility and conductibility.
b) Effects of nn. vagus on the heart activity.
Parasympathetic stimulation causes decrease in heart rate and contractility, causing blood flow
to decrease. It is known as negative inotropic, dromotropic, bathmotropic and chronotropic
effect.

59
 -

catecholamines -

adrenal hormones
-

acetylcholine caldosterone )
for S insulin { glucagon !
-

hormones
thyroid
-

101. Humoral regulation of the heart.

a) Effects of catecholamynes are transmitted by alfa and beta adrenoreceptors. →adrenergic
receptors
Adrenalin and noradrenalin stimulate heat activity and cause positive regulatory effects:
- Positive inotropic effect - increasing strength of heart contractions;
- Positive chronotropic effect - increasing heartbeat rate;
- Positive dromotropic effect - increasing heart conductibility; → Catecholamines
to
- Positive bathmotropic effect - increasing exc itab ility of heart muscle. adrenaline ,
nor -
adrenaline
Nor - epinephrine increases permeab ility of cardiac fiber membrane to Na+ and Ca2+.

b) Effects of acetylcholin leads to increase of K+ permeability through cell membrane in

conductive system, which leads to hyperpolarisation and cause such effects to the heart
activity:
- Negative inotropic effect - decreasing strength of heart contractions; → acetylcholine
- Negative chronotropic effect - decreasing heartbeat rate;
- Negative dromotropic effect - decreasing heart conductibility;
−Negative bathmotropic effect - decreasing excitability of heart muscle.
+

→
Catt,
K ,
Nat
c) Effects of ions:
- Ca 2+ causes spastic contraction of heart. Decreasing Ca2+ causes cardiac flaccidity.
Excessive concentration of K+ causes decreasing heart rate. Impulse' transmission through AV
bundle is blocked. If K+ level was previous ly decreased, increasing Concentration of K+
capable normalize cardiac rhythm. Na+ competes Ca2+ in contractile process. So increasing
Na+ may depress cardiac contraction.

metals
formation from regulating →
rate →
atp
d) Effects of thyroid hormones. Theart
activity { conductor
→
cells
Tmitochrial activity of heart
Thyroid hormones increase transmission process in ribosome and nuc leus of cells. Intracellular
enzymes are stimulated due to increasing protein synthes is. Also increases glucose absorption
and uptake of glucose by cells, increases glycolis is and gluconeogenes is. In blood plasma
increases contents of free fatty acids. All
these effects of thyroid hormones lead to in crease activity of mitochondria in heart cells and
ATP formation in it. So, both activity of heart muscle and conduction of impulses are
stimulated.

→
aldosterone
e) Effects of adrenocortical hormones. → G- + so I

Aldosterone causes increas ing Na+ and Cl- in blood and decreases K+. This is actually for
producing action potential in the heart. Cortisol stimulates gluconeogenesis and increase blood

60
glucose level. Amino acids blood level and free fatty ac ids concentration in b lood increases
also. Utilization of free fatty acids for energy increases. These mechanisms actual in stress
reaction. So heart activity is stimulated.

insulin →
Both promote glucose or FFA use /
→
uptake → 9 biochemical activity in
f) Hormones of islets of Langerhans effects. → glucagon heart muscles → The
activity ar t °

Insulin promotes facilitated diffusion of glucose into cells by activation glucokinase that
phosphorilates glucose and traps it in the cell, promotes glucose utilization, causes active
transport of amino acids into cells, promote trans lation of mRNA in ribosome to form new
proteins. Also insulin promotes glucose utilization in cardiac muscle, because of utilization
fatty ac ids for energy. Glucagone stimulate gluconeogenesis, mobilizes fatty ac ids from
adipose tissue, promotes utilization free fatty ac ids foe energy and promotes gluconeogenes is
from glycerol. So both hormones can increase strength of heartbeat.

102. Dependence of the heart to change the ionic composition of the blood.
phase 0; Nat influx
Phase 4: The resting phase phase 1 : K+ efflux : Membrane potential → omu

K+ outside
efflux
" "

phase 2: Ca influx balances K

Phase 0: Depolarization + channel )

Na+ inside phase 3 :
Catt closer f- is
delayed [rectifier
→
MR = -90mV
Phase 1: Early repolarization ←
Phase 4
'

Nat { Ca close , K+ stable

open →
.

K+ outside
membrane -90
potential = Mu

Phase 2: The plateau phase

Ca 2+ - inside
K+ - outside

Phase 3: Repolarization
K+ outside

61
103. The mechanisms of self-regulation of heart: the law of Frank-Starling effect Anrepa
phenomenon Boudichi.

b) Intrinsic regulation is performed in response changes of blood volume, flowing into

the heart. It is known as Frank Starling low.a Within physiological limits heart pumps all blood
that comes to it without allowing excessive damming of blood in veins. Cardiac contraction is
directly proportional to initial length of its fibers. In end-diastolic volume over 180 ml excessive
stretching heart fibers occurs and strength of next cardiac contraction decreases.

c) Anrep's law. Increase of blood flow in aorta and so coronary arteries leads to excessive
stretching surrounding myocardial cells. According to Frank Starling low cardiac contraction
is directly proportional to initial length of its fibers. So increase of coronary blood flow leads
to stimulation heartbeat.

62
 Catt influx without effluk →
shortening of cardiac

cycle duration → Observing the start of the next

contraction before the current one is finished .

→
d) Boudichi phenomenon. In evaluation heart beat rate increase of every next heart
contraction is observed. It caused by rising of Ca2+ influx into myocardial cells without perfect
outflow, because of shortening of cardio cycle duration.

104. Functional types of blood vessels.

1. Arteries carry blood away from the heart, Arteries carry blood away from the heart
a. Pulmonary trunk to lungs
b. Aorta to everything else
2. Veins carry blood toward the heart
3. Capillaries contact tissue cells and directly serve cellular needs,
4. Microcirculation is where exchange occurs
a. Arterioles to feed the capillaries
b. Capillaries exchange with the tissues
c. Venules to receive capillary blood

105. Arterial pulse mechanism of properties, methods.

pulse is tactile palpation of an
artery of heartbeats by fingertips
-

The pulse may be palpated in any place that allows an artery to be compressed near the surface
of the body { allows f- heart rate .

Normal pulse rates at rest, in beats per minute (BPM):

newborn infants infants children children over 10 years

(0–3 months (3 – 6 (6 – 12 (1 – 10 & adults, including
old) months) months) years) seniors

100-150 90–120 80-120 70–130 60–100

The pulse rate can be used to check overall heart health and fitness level. Generally lower is
better, but bradycardias can be dangerous. Symptoms of a dangerously slow heartbeat include
weakness, loss of energy and fainting.

106. Blood pressure, factors that determine its value.

Blood pressure (BP) is the pressure of circulating blood on the walls of blood vessels. When used
without further specification, "blood pressure" usually refers to the pressure in large arteries of
the systemic circulation. Blood pressure is usually expressed in terms of the systolic
pressure (maximum during one heart beat) over diastolic pressure (minimum in between two heart
beats) and is measured in millimeters of mercury (mmHg), above the surrounding atmospheric
pressure (considered to be zero for convenience).
-
Cardiac output
resistance
-

Peripheral vascular
Volume of circulating blood
63
-

blood
Viscosity of
-

walls
-

Elasticity of vessel
 - NORM: 120/80 mmHg".
- FACTORS:
- Emotional State
- Talking
- Smoking
- Alcohol/Caffeine
- Temperature
- Full bladder
- Sickness

107. Lines blood pressure. →

measuring blood pressure directly from a blood vessel
by
using an arterial line .

- arterial line
Pressure transducer { this system
-1
-

pressure bag
-

bpinqsIYI.t ?-fPstorevoheme-sTbpDiastolicbp-
facII.f-at.cn
systolic { diastolic
arteries
of
-

SV pressure
HR o
between
or
→
diff .

Rilsepessnre
fa.IQ
propelling blood
to Issues
vessel compliance Pressure
theanitrteiapossne
o →

USES
• blood pressure (systolic, diastolic, mean and pulse pressure)
'S pulse pressure120180mm#
• arterial blood sampling Mean Pressure
diastolic
average for
=
g) +

= 93mm Hgc

108. The method of recording blood pressure.

→ remember
> Kosotk off sound
✓
manometer
1. The auscultatory method → listen * sphyno
2. The oscillometric technique → vibrations by vessels
blood flows be translated
electrically
as
can

gave reading
to

3. Ultrasound techniques
4. The finger cuff method of Penaz → conferees realtime measurement Non-invasive .
.

109. Circulation in capillaries. Mechanisms mechanisms tar

transkapillyarnogo exchange.

The vessels on the arterial side of the microcirculation are called the arterioles, which are well
innervated, are surrounded by smooth muscle cells, and are 10-100 µm in diameter. Arterioles
carry the blood to the capillaries, which are not innervated, have no smooth muscle, and are
about 5-8 µm in diameter. Blood flows out of the capillaries into the venules, which have little
smooth muscle and are 10-200 µm. The blood flows from the venules into the veins. In addition
to these blood vessels, the microcirculation also includes lymphatic capillaries and collecting

64
 ducts. The main functions of the microcirculation are the delivery of oxygen and nutrients and
the removal of carbon dioxide (CO2). It also serves to regulate blood flow and tissue perfusion
thereby affecting blood pressure and responses to inflammation which can include edema
(swelling).

"
" "
"
" "

"
"
110. Blood circulation in the veins. Factors that provide blood flow to the heart.
• Collect blood from capillaries Bhodffowinveins > actor of heart
intrathecal - ve
-
,

{ muscle pump Venous pressure

• Merge into medium-sized veins pressure
.

'
• Merge then into large veins
' o Blood pressure is low here
: o Valves keep blood flowing toward the heart vasodilation → coronary bbodfbu
)
'

> Nervous factors

→
syrup { paraqmp
→
ardiacmetsb
☒
(thrown →
-
-

metals hormones
chemical factors → ,

Heart rate
mechanical factors
111. Characteristics afferent link in the regulation of vascular tone.
112. Characteristics central element in the regulation of vascular tone.
113. Characteristics of efferent neural link in the regulation of vascular tone.
115. Characteristics of efferent humoral regulation of vascular tone in ..

ODP NA 111 - 115 : (114 pytanie było takie samo jak 113)
Central part in regulation of vascular tone
Central mechanisms, which regulate connection between level of cardiac output and
tone of vessels, working by help of complex of nervous structures, which named vasomotor
center. Structures of vasomotor center are present in spinal cord, medulla oblongata,
hypothalamus, cortex of big hemisperes.
Spinal level of regulation is in the lateral root of thoracic and lumbar segments and
consist of nervous cells, axons of which produce the vasculoconstrictors fibers. That neurons

65
 support their level of excitation by help of impulses from higher structures of nervous system.
Centers of hypothalamus give the descendent influences on the vasomotor center of
medulla oblongata. In hypothalamus present depressor and pressor zones. That is why
hypothalamic level give the same double reaction as bulbar center. Posterolateral part of
hypothalamus cause excitation of vasomotor center. Anterior part of hypothalamus can cause
mild inhibition of one.
Some zones of cortex also give the descendent influences on the vasomotor center of
medulla oblongata. Motor cortex excites vasomotor center. Anterior temporal lobe, orbital areas
of frontal cortex, cingulated gyrus, amygdale, septum and hippocampus can also control
vasomotor center.
That influences form as a result of compare the information, which enter in higher part of
nervous system from different receptor zones. It support realization of cardio-vascular
component of emotions, reaction of behavior.

Neural mechanism of efferent regulation of blood flow act by:

- Preganglionic sympathetic neurons, body of which present in the anterior root of
thoracic and lumbar part of spinal cord and postganglionic neurons, which are present
in para- and prevertebral sympathetic ganglion.
- Preganglionic parasympathetic neurons of nucleus of n. vagus, nucleus of pelvic nerve,
i which present in sacral part of spinal cord, and their postganglionic neurons.
I
- For whole
hole visceral organs is efferent neurons of metasympathetic nervous system, which
are present in the intamural ganglion of their wall.
1
• All neurons is the end way from efferent and central influences, which throught the
I
\
adrenergic, cholinergic and other mechanism of regulation act on heart and vessels.
Postganglionic neurons Cin para { pre vertebral sympathetic ganglion ]
- →
neurons (bodies of Thoracic { Lumbar vertebrae )
in ant root
'
-
→ pre ganglionic sympathetic
Catecholamine is based receptors d{ $
.
action on
vessel tone .

Catecholamines } vasopressin I
on

Efferent Humoral -7
constrictor i
→ relaxation - Adrenalin → A { 31 adenoseaptor
a →
→
receptor noradrenalin → d
→ adrenaline dilates → skeletal muscle vessels - heart , brain vessels
contracts →
vessels of 66
skin i
git kidney lung
, ,
116. Regulation of blood flow by changing the position of the body.

Changes of blood flow in the clinostatic pose → vertical to horizontal

● Change the body pose from vertical to horizontal
→ initial increase in .HR { stroke volume
● Increase of blood flow to heart
● Increase the stroke volume
followed
by series of man in
a

depressor vasomotor centre

● Increase of impulsation from mechanoreceptors of aortic arc
to
THR dilate
,

vessels -

● Activation of depressor part of vasomotor center

● Inhibition of pressor part of vasomotor center
● Decrease of frequency and force of heart beat, dilation of vessels
●
Changes of blood flow in the orthostatic pose
● Change the body pose from horizontal to vertical opposite of above
→
● Depo of blood in the vein of down part ofbody
● Decrease of blood flow to heart
● Decrease of stroke volume
● Decrease of impulsation from mechanoreceptors of aortic arc
● Activation of pressor part of vasomotor center
● Increase of frequency and force of heart beat, vascular spasm

67
 PCO2: until one approaches maximal O2 consumption, there is no significant change; thus the
Pulmonary Circuit increase in ventilation is proportional to the increase in metabolism
• Mean arterial pressure: slight increase.
• Blood flow (CO): large increase Exercising skeletal muscle
• Pulmonary arterial pressure: slight increase • Blood flow increases.
• Pulmonary vascular resistance: large decrease • Capillary pressure increases. • Capillary filtration increases.
• Pulmonary blood volume: increase Regulation of blood flow:
• Number of perfused capillaries: increase • In physical exercises impulses from pyramidal neurons of motor zone in cerebral cortex passes
both to skeletal muscles and vasomotor center.
• Capillary surface area: increase, i.e., increased rate of gas exchange • Than through sympathetic influences heart activity and vasoconstriction are promoted.
Systemic circuit • Adrenal glands also produce adrenalin and release it to the blood flow.
• PO2: no significant change, hemoglobin still fully saturated • Proprio-receptor activation spread impulses through interneurons to sympathetic nerve centers.

117. Regulation of circulation in exertion Physical load

On the physical load, emotional load it increase blood flow through skeletal muscles, brain and
heart.
In physical exercises impulses from pyramidal neurons of motor zone in cerebral cortex passes
both to skeletal muscles and vasomotor center. Than through sympathetic influences heart
activity and vasoconstriction are promoted. Adrenal glands also produce adrenalin and release
it to the blood flow.

Proprioreceptor activation spread impulses through interneurons to sympathetic nerve centers.

So, contraction of skeletal muscle during exercise compress blood vessels, translocate blood
from peripheral vessels into heart, increase cardiac output and increase arterial pressure.

118. Restoration of blood flow in blood loss

119. Features of circulation in the blood vessels of the brain and its regulation.

68
see g. 115
Central mechanisms, which regulate connection between level of cardiac output and tone of
vessels, working by help of complex of nervous structures, which named vasomotor center.
Structures of vasomotor center are present in spinal cord, medulla oblongata, hypothalamus,
cortex of big hemisperes.

Centers of hypothalamus give the descendent influences on the vasomotor center of medulla
oblongata. In hypothalamus present depressor and pressor zones. That is why hypothalamic
level give the same double reaction as bulbar center. Posterolateral part of hypothalamus cause
excitation of vasomotor center. Anterior part of hypothalamus can cause mild inhibition of one.

Some zones of cortex also give the descendent influences on the vasomotor center of
medulla oblongata. Motor cortex excites vasomotor center. Anterior temporal lobe, orbital areas
of frontal cortex, cingulated gyrus, amygdale, septum and hippocampus can also control
vasomotor center.

That influences form as a result of compare the information, which enter in higher part of
nervous system from different receptor zones. It support realization of cardio-vascular
component of emotions, reaction of behavior.

120. Features of circulation in the blood vessels of the heart and its regulation.
Talk about arteries veins {
capillary circulation !
-

Arterial Circulation- is the part of circulatory system that involves arteries. Arteries are blood
vessels that carry blood away from your heart. Healthy arteries are strong and elastic (stretchy).
They become narrow between heartbeats, and they help keep blood pressure consistent. This
helps blood move through the body. Arteries branch into smaller blood vessels called arterioles .
Arteries and arterioles have strong, flexible walls that allow them to adjust the amount and rate
of blood flowing to parts of the body.

Venous Circulation- is the part of your circulatory system that involves veins, Veins are blood
vessels that carry blood to the heart. Veins have thinner walls than arteries. Veins can
widen as the amount of blood passing through them increases.

Capillary Circulation is the part of circulatory system where oxygen, nutrients, and waste pass
between blood and parts of the body. Capillaries are very small blood vessels. They
connect the arterial and venous circulatory subsystems. Oxygen and nutrients in blood
can pass through the thin walls of the capillaries to the parts ofbody that need them to
work normally.
121. Features of pulmonary circulation and its regulation.

Pulmonary Circulation - is the movement of blood from the heart to the lungs and back to the

Ht
heart again. Pulmonary circulation includes both arterial and venous circulation.

Arteries - From the right ventricle, blood is pumped through the semilunar pulmonary valve

69
 into the left and right pulmonary arteries (one for each lung) and travels through the lungs.

Lungs- The pulmonary arteries carry deoxygenated blood to the lungs, where carbon dioxide is
released and oxygen is picked up during respiration. Arteries are further divided into very fine
capillaries which are extremely thin-walled. Their function is to assist in the carrying of blood
to all cells of the body. The pulmonary vein returns oxygenated blood to the left atrium of the
heart.

Veins - The oxygenated blood then leaves the lungs through pulmonary veins, which return it
to the left heart, completing the pulmonary cycle. This blood then enters the left atrium, which
pumps it through the mitral valve into the left ventricle. From the left ventricle the blood passes
through the aortic valve to the aorta. The blood is then distributed to the body through the
systemic circulation before returning again to the pulmonary circulation.

122. Mechanisms of lymph. The movement of lymph vessels

* *
Lymphatic vessels are thin-walled, valved structures that carry lymph. As part of the lymphatic

¥¥
system, lymph vessels are complementary to the cardiovascular system . Lymph vessels act as
reservoirs for plasma and other substances including cells that have leaked from the vascular
system and transport lymph fluid back from the tissues to the circulatory system. Without
functioning lymph vessels, lymph cannot be effectively drained and edema typically results.

Afferent Vessels ( only found in lymph node) - enter at all parts of the periphery of the lymph
node, and after branching and forming a dense plexus in the substance of the capsule, open into
the lymph sinuses of the cortical part. It carries unfiltered lymph into the node. In doing this
they lose all their coats except their endothelial lining, which is continuous with a layer of
similar cells lining the lymph paths.

Efferent vessels (found in the thymus and spleen) - commences from the lymph sinuses of the
xxxxx
medullary portion of the lymph nodes and leave the lymph nodes at the hilum, either to veins
or greater nodes. It carries filtered lymph out of the node.

a. Physiology of the respiratory system.

123. General characteristics of the respiratory system. The main stages of breathing.
Biomechanics of inhalation and exhalation.

Respiratory system - is a biological system consisting of specific organs and structures used
for the process of respiration in an organism. The respiratory system is involved in the intake
and exchange of oxygen and carbon dioxide between an organism and the environment.

70
Oxygen is required by cells in the body to allow various metabolic reactions to take place and
to produce energy and is therefore essential to life.

Main functions:
•Gas exchange: Oxygen enters blood and carbon dioxide leaves
•Regulation of blood pH: Altered by changing blood carbon dioxide levels
•Voice production: Movement of air past vocal folds makes sound and speech
•Olfaction: Smell occurs when airborne molecules drawn into nasal cavity
•Protection: Against microorganisms by preventing entry and removing them

Inhalation (center – upper part of medulla oblongata): is an active process. The contraction of
the inspiratory muscles and diaphragm increases intrathoracic volume. It stretches the thorax
and lungs.

Mechanism: Note this !

Contraction of external intercostal muscles > elevation of ribs & sternum > increased front- to-
back dimension of thoracic cavity > lowers air pressure in lungs > air moves into lungs
Contraction of diaphragm > diaphragm moves downward > increases vertical dimension of
thoracic cavity > lowers air pressure in lungs > air moves into lungs:

Exhalation (medulla oblongata, anterior and lateral to the inhalation center) : is a passive
process. The thorax and lungs recoil when the respiratory muscles relax.

Mechanism:
relaxation of external intercostal muscles & diaphragm > return of diaphragm, ribs, & sternum
to resting position > restores thoracic cavity to preinspiratory volume > increases pressure in
lungs > air is exhaled.

124. An elastic thrust lungs, pleural negative pressure in the gap.

the rebound of the lungs after having been stretched by inhalation or rather, the ease with which
the lung rebounds. With inhalation, the intrapleural pressure (the pressure within the pleural
cavity) of the lungs decreases. Relaxing the diaphragm during expiration allows the lungs to
recoil and regain the intrapleural pressure experienced previously at rest. Elastic recoil is
inversely related to lung compliance.

Negative ressure (intrapleural pressure ) refers to the pressure within the pleural cavity.
Normally, the pressure within the pleural cavity is slightly less than the atmospheric pressure.
When the pleural cavity is damaged/ruptured and the intrapleural pressure becomes equal to or
exceeds the atmospheric pressure, pneumothorax may ensue.

71
 Intrapleural pressure depends on the ventilation phase, atmospheric pressure, and the volume
of the intrapleural cavity.
At rest we have a negative intrapleural pressure. This gives us a transpulmonary pressure
expanding the lungs. Intrapleural pressure is sub-atmospheric. This is due to the recoil of the
chest and lungs away from each other.

125. External breathing. Indicators of respiratory and evaluation.

External respiration - is the processes by which external air is drawn into the body in order to
supply the lungs with oxygen, and (used) air is expelled from the lungs in order to remove
carbon dioxide from to body. Gas exchange between air in lungs and blood. External respiration
also known as breathing refers to a process of inhaling oxygen from the air into the lungs and
expelling carbon dioxide from the lungs to the air. Exchange of gases both in and out of the
blood occurs simultaneously. External respiration is a physical process during which oxygen is
taken up by capillaries of lung alveoli and carbon dioxide is released from blood.

126. Anatomical and physiological "dead space", its physiological role.

Dead space is the volume of air which is inhaled that does not take part in the gas exchange,
either because it remains in the conducting airways, or reaches alveoli that are not perfused or
poorly perfused. In other words, not all the air in each breath is available for the exchange of
oxygen and carbon dioxide. •Functional (physiological) dead space includes all the areas of
respiratory system where gas exchange does not occure (anatomical dead space + volume of
alveoli that are ventilated, but not perfused by blood). Alveoli, which are perfused, but not
ventilated, form alveolar arterio-venous shunt. d
airways (
Plus air still in bronchi ,) etc

127. The diffusion of gases in the lungs. Diffusion lung capacity and factors on which it
depends.

Diffusion – 2 stage of gas exchange (ventilation, diffusion, perfusion)

Diffusion is the spontaneous movement of gases, without the use of any energy or effort by the
body, between the gas in the alveoli and the blood in the capillaries in the lungs.
The volume of gas that passes through the aero-hematic barrier in 1 minute at pressure gradient
of gas on both sides of the barrier at 1 mm Hg is called diffusive lung capacity.

Diffusion capacity in human lungs for oxygen is 25 ml O2/min*mm Hg.

128. The transport of oxygen in blood. Oxygen capacity of blood.

Although oxygen dissolves in blood, only a small amount of oxygen is transported this way.

72
Only 1.5% of oxygen in the blood is dissolved directly into the blood itself. Most oxygen, 98.5
%, is bound to a protein called hemoglobin and carried to the tissues.

Features :
• Oxygen entering the bloodstream is initially dissolved in plasma.
• The compound of oxygen with hemoglobin - oxyhemoglobin (HbO2).
• One molecule can conjunct four molecules of O2; in terms of 1 g of heamoglobin -
1.34 ml O2.
Note these
• Oxygen capacity of blood equals 1,34ml.
• 100 ml of blood contain only 0.3 ml of dissolved O2.

Solubility of gas in a liquid depends on :

• temperature,
• liquid composition,
• gas pressure and its nature.

129. Oxyhemoglobin dissociation curve, factors influencing its course.

Factors that affect the oxyhemoglobin dissociation curve:

- temperature,
- pH,
- concentration of 2,3-DPG in erythrocyte.
- reducing the pH shifts the curve to the right, due to reduce of the affinity of Hb to O2.
- Increasing the pH increases the affinity of Hb to O2 and the curve shifts to the left.
- formation of large quantities of CO2 in the tissues increases oxygen release in tissues by
lowering its affinity with Hb.
- with the decrease of temperature O2 release by oxyhemoglobin slows down, and with the
increase its accelerating.
- displacement of the curve to the right also contributes to increased content of 2,3-DPG in
erythrocytes.

130. Transport of carbon dioxide in blood

73
Carbon dioxide is transported in the blood from the tissue to the lungs in three ways:
1) Bicarbanate ion (HCO3-) - 70% CO2;
2) Carbohemoglobin (HHbCO2) - 23% CO2.
3) Carbonic acid (H2CO3) - 7% CO2

The transfer of CO2 from tissues to blood cells also occurs by diffusion. The average tension
of CO2 in blood is 40 mm Hg and in tissues - 50-60 mm Hg.

CO2 tension in tissues is largely dependent on the intensity of oxidative processes (CO2
production) Approximately 75% of carbon dioxide is transport in the red blood cell and 25%
in the plasma. The relatively small amount in plasma is attributable to a lack of carbonic
anhydrase in plasma so association with water is slow; plasma plays little role in buffering and
combination with plasma proteins is poor.

Carbon dioxide is more soluble in blood than is oxygen; about 5 to 7 percent of all carbon
dioxide is dissolved in the plasma. Carbon dioxide has the ability to attach to hemoglobin
molecules; it will be removed from the body once they become dissociated from one another.
In the bicarbonate buffer system, the most common form of carbon dioxide transportation in
the blood, carbon dioxide is finally expelled from the body through the lungs during exhalation.
Importantly, the bicarbonate buffer system allows little change to the pH of the body system; it
allows for people to travel and live at high altitudes because the system can adjust itself to
regulate carbon dioxide while maintaining the correct pH in the body.

131. The physiological role of the respiratory tract, regulation of their lumen.

The respiratory tract is the path of air from the nose to the lungs. It is divided into two sections:
Upper Respiratory Tract and the Lower Respiratory Tract. Included in the upper respiratory
tract are the Nostrils, Nasal Cavities, Pharynx, Epiglottis, and the Larynx. The lower respiratory
tract consists of the Trachea, Bronchi, Bronchioles, and the Lungs.
-
Neural regulation
Function : - Humoral regulator
1. Warming.
2. Moisturizing.
3. Clearing the air

Inhaled air: t 18-22 C, 45-55%

In the bronchi: t 37 ° C, 100%

132. RESPIRATORY CENTER, ITS STRUCTURE, REGULATION OF BREATHING.

The centres in the medulla oblongata and pons that collects sensory information about the level
of oxygen and carbon dioxide in the blood and determines the signals to be sent to the
respiratory muscles. Stimulation of these respiratory muscles provide respiratory movements

74
which leads to alveolar ventilation. Respiratory centers are situated in the reticular formation
of the brainstem and depending upon the situation in brainstem, the respiratory centers are
classified into two groups:

Medullary centers and Pontine centers

There are two centers in each group:

Medullary Centers:
• Inspiratory center
• Expiratory center

Pontine Centers:
T depth of inspiration
• Pneumotaxic center →rate { pattern of breathy .
Absence→
to respiratory rate
• Apneustic center → controls
intensity of breathing !
Inspiratory center:
Inspiratory center is situated in upper part of medulla oblongataThis center is also called dorsal
group of respiratory neuronsIt is formed by nucleus of tractus solitariusFunction: it is concerned
with inspiration.

Expiratory center:
It is situated in medulla oblongata anterior and lateral to the inspiratory centerIt is also called
ventral group of respiratory neuronsIt is formed by neurons of nucleus ambiguous and nucleus
retro ambiguous
Function: this center is inactive during quiet breathing and inspiratory center is the active center,
but during forced breathing or when the inspiratory center is inhibited it becomes active.

133. The mechanism of first breath of a newborn child.

The most profound change at birth is your baby’s first breath. At this point, your baby’s lungs,
which were filled with fluid during pregnancy, must suddenly fill with oxygen from the air. The
fluid in the lungs is removed through the blood and lymph system, and is replaced by air.

Your baby’s lungs must be able to exchange oxygen for carbon dioxide. At the same time,
vigorous blood circulation in the lungs will begin. The first few breaths after birth may be the
most difficult breaths your baby will take for the rest of her life.

"l t
There are a couple of things that will stimulate your baby to take her first breath. Hormonal and
other changes during labour slow down or stop the production of fluid in the lungs, and may
initiate the reabsorption of fluid from the lungs. This process is unlikely to have occurred if
labour was very short or did not occur at all, for example, if your baby was delivered by
caesarean section. Furthermore, physical stimulation and handling during delivery will
encourage your baby to breathe. There are probably many other factors that stimulate baby’s
first breath, but they have not been identified yet.

75
134. The role of mechanoreceptors in the regulation of breathing. → cough reflex in
response to irritation
Receptors are stimulated by dust, caustic gases, bronchial secret and alien bodies. It causes a
cough reflex, which is expresed in a quick exhalation on a background of narrowing of the
larynx and contraction of bronchial smooth muscle, which remains long after the reflex.

Cough reflex is the main pulmonary reflex of the vagus nerve .

- Irritation causes hyperpnoe, bronchoconstriction, laryngeal spasm, mucus hypersecretion, but
never accompanied by cough.

Receptors are most sensitive to three types of stimuli:

1) tobacco smoke, numerous passive and irritational chemicals;
2) damage and mechanical stretching of airways during deep breathing, and pneumothorax
3) pulmonary embolism, pulmonary capillary hypertension and pulmonary anaphylactic
phenomena.

135. The role of the central and peripheral chemoreceptor’s in regulating breathing.

Peripheral and central respiratory chemoreceptors are ultimately responsible for maintenance
of constant levels of arterial PO2, PCO2 and [H+], protecting the brain from hypoxia and
ensuring that thebreathing is always appropriate for metabolism.
Central chemoreceptors, located on the ventrolateral surface of medulla oblongata, detect
changes in pH of cerebrospinal fluid. o Peripheral chemoreceptors act mmostly to detect
variation of the oxygen in the arterial blood, in addition to detecting arterial carbon dioxide and
pH.

136. Regulation of respiratory exertion.

c) Physiology of the digestive system.

137. General characteristics of the digestive system. Digestion in the mouth

The digestive system is a group of organs working together to convert food into energy and
basic nutrients to feed the entire body. Food passes through a long tube inside the body known
as the alimentary canal or the gastrointestinal tract (GI tract). The alimentary canal is made up
of the oral cavity, pharynx, esophagus, stomach, small intestines, and large intestines. In
addition to the alimentary canal, there are several important accessory organs that help your
body to digest food.. but do not have food pass through them. Accessory organs of the digestive
system include the teeth, tongue, salivary glands, liver, gallbladder, and pancreas. To achieve

76
the goal of providing energy and nutrients to the body, six major functions take place in the
digestive system:

• Ingestion
• Secretion
• Mixing and movement
• Digestion
• Absorption
• Excretion

138. The composition of saliva, its role in digestion

Human saliva is 99.5% water, while the other 0.5% consists of electrolytes, mucus,
glycoproteins, enzymes, and antibacterial compounds such as secretory IgA and lysozyme.

Role of saliva in vitality of human

• Moisten of solid food;
• Dissolving of substances;
• Moisten of mouth;
• Cover food;
• To help of swallowing;
• Primary hydrolyzing of carbohydrates;
• Antibacterial properties;
• Neutralized the stomach juice.

139. Mechanisms of saliva, primary and secondary saliva

• The secretory acinus produces the primary saliva, which is isotonic with an ionic composition
resembling that of plasma. In the duct system, the primary saliva is then modified by selective
reabsorption of Na+ and Cl- (without water) and secretion of K+ and HCO3-.

Salivary secretion is a two-stage process:

1. Initial Formation stage involves acini to secrete a primary secretion that contains ptyalin
and/or mucus in a solution of ions similar in plasma.
2. Modification stage is when the primary secretion flows through the ducts and the ionic
composition of saliva is modified.

Mechanism of saliva
Initial Formation Stage: Stimulation of the parasympathetic nerve, or mainly muscarinic
cholinergic receptors, initiates intracellular second messenger events of acinar cells, the signal
transduction system involves the release of Ca2+ from intracellular stores. The increase in
intracellular Ca2+ levels leads to the Cl– channels at the apical membrane to open and an influx
of Cl– into the lumen.

77
In the next step, the composition of primary saliva is modified in the duct system. The
intralobular ducts reabsorb Na+ and Cl– excluding water, and make the final saliva hypotonic.
Stimulation of the sympathetic nerve, or ß-adrenergic receptors, causes exocytosis but less fluid
secretion. Activation of ß-adrenoceptors increases the intracellular cyclic adenosine
monophosphate (cAMP) level, which is the primary second messenger for amylase secretion.
cAMP is thought to activate protein kinase which may regulate the process by which cells
release the contents of their secretory granules. This involves the fusion of the granule
membrane with the luminal plasma membraneof the secretory cell followed by rupture of the
fused membranes.

140. Regulation of salivation. The impact of autonomous systems nerve quantity and
quality of saliva

The production of saliva is stimulated both by the sympathetic nervous system and the
parasympathetic. The saliva stimulated by sympathetic innervation is thicker with relatively
high organic material, and saliva stimulated parasympathetically is more watery with relatively
low organic material.
Sympathetic stimulation of saliva is to facilitate respiration, whereas parasympathetic
stimulation is to facilitate digestion

141. Methods secretory function of the stomach in humans → see go 144

Cephalic secretion: This phase occurs before food enters the stomach and involves preparation
of the body for eating and digestion. ii. Gastric secretion: Enhances secretion started in the
cephalic stage; homogenize and acidify chyme; initiate digestion of protein by pepsin iii.
Intestinal secretion: control rate of chyme entry into duodenum

142. The composition and properties of gastric juice.

Gastric juice, thin, strongly acidic ( pH varying from 1 to 3), almost colorless liquid secreted
by the glands in the lining of the stomach. Its’ essential constituents are the digestive enzymes
pepsin and rennin. It is a digestive fluid, formed in the stomach. It is composed of hydrochloric
acid (HCl) .05–0.1 M (roughly 5,000–10,000 parts per million)[1] potassium chloride (KCl)
and sodium chloride (NaCl). The acid plays a key role in digestion of proteins, by activating
digestive enzymes, and making ingested proteins unravel so that digestive enzymes break down
the long chains of amino acids. Gastric acid is produced by cells in the lining of the stomach,
which are coupled in feedback systems to increase acid production when needed.

143. Mechanisms of secretion of hydrochloric acid, its role in the digestive process

Parietal cells (also known as oxyntic or delomorphous cells), are the epithelial cells that secrete.
Hydrochloric acid (HCl) and intrinsic factor. These cells are located in the gastric glands found

78
in the lining of the fundus and in the body of the stomach.

Hydrochloric acid is formed in the following manner:

• Hydrogen ions are formed from the dissociation of carbonic acid. Water is a very minorsource
of hydrogen ions in comparison to carbonic acid. Carbonic acid is formed from carbon dioxide
and water by carbonic anhydrase.
• The bicarbonate ion (HCO3−) is exchanged for a chloride ion (Cl−) on the basal side of the
cell and the bicarbonate diffuses into the venous blood, leading to an alkaline tide phenomenon.
• Potassium (K+) and chloride (Cl−) ions diffuse into the canaliculi.
• Hydrogen ions are pumped out of the cell into the canaliculi in exchange for potassium ions,
via the H+/K+ATPase. These receptors are increased in number on luminal side by fusion of
tubulovesicles during activation of parietal cells and removed during deactivation. This receptor
maintains a million fold difference in proton concentration. ATP is provided by the numerous
mitochondria.
As a result of the cellular export of hydrogen ions, the gastric lumen is maintained as a
highlyacidic environment. The acidity aids in digestion of food by promoting the unfolding (or
denaturing) of ingested proteins. As proteins unfold, the peptide bonds linking component
amino acids are exposed. Gastric HCl simultaneously activates pepsinogen, an endopeptidase
that advances the digestive process by breaking the now-exposed peptide bonds, a process
known as proteolysis.

144. Home (brain) stomach phase regulation of gastric secretion. → see g. 141

Cephalic phase is caused by nervous system. It has conditional and unconditional reflexes.
Conditional reactions caused by appearance of food, it smell and other stimulus, which are
connect with food. Unconditional influences is parasympathetic and beginning from receptors
of tongue and other receptors of the oral cavity. From these receptors impulses pass through the
fibers of n. trigeminus, n. facialis, n. glossopharyngeus, n. vagus to the medulla oblongata.
Impulses return to stomach by n. vagus. Except neuron influences this phase has humoral
influences – brunch of n. vagus produce hormone gastrin. These phase is very short.
• Stomach phase: is depends on the quantity of food, which are present in stomach. It has vago-
vagal reflexes (by mean of central nerves system) and local – peripheral reflexes, which are
closed in stomach walls. Duration of these phase is longer and quantity of juice is much. It has
humoral mechanisms too (production of gastrin and histamin.

145. Intestinal phase regulation of gastric secretion

(Presence of food in the upper portion of food in the small intestine can cause the stomach to
secrete small amount of gastric juice). Through this result gastrin are also m.released by
duodenal mucosa in response of distension or chemical stimuli of the same type as those that
stimulates the stomach gastrin.

146. Methods of pancreatic juice secretion in humans. Structure and properties of

79
 pancreatic juice

External and internal.

Pancreatic juice is a liquid secreted by the pancreas , which contains a variety of enzymes ,
including trypsinogen , chymotrypsinogen , elastase , carboxypeptidase , pancreatic lipase ,
nucleases and amylase . The pancreas is located in the visceral region, and is a major part of the
digestive system required for proper digestion and subsequent assimilation of macronutrient
substances required for living. Pancreatic juice is alkaline in nature due to the high
concentration of bicarbonate ions. Bicarbonate is useful in neutralizing the acidic gastric acid,
allowing for effective enzymic action. Pancreatic juice secretion is regulated by the hormones
secretin and cholecystokinin , which is produced by the walls of the duodenum upon detection
of acid food, proteins, fats and vitamins.
Pancreatic secretion consists of an aqueous bicarbonate component from the duct cells and
enzymatic component from the acinar cells. A clear alkaline secretion of the pancreas
containing enzymes that aid in the digestion of proteins, carbohydrates, and fats.

147. Phase regulating the secretory function of the pancreas.

g. 1411144
• Overview
o Secretion of pancreatic fluid can be divided into three phases which correspond to the different
stages of food ingestion. Each phase tends to induce a slightly different composition of
pancreatic secretion with slightly different regulatory mechanisms.
• Cephalic Phase
o This phase is initiated by the sensory experience of seeing and eating food and primarily
involves vagus nerve stimulation of acinar cells to produce digestive enzymes. Because little
aqueous sodium bicarbonate solution by ductal cells these enzymes lie inactive within the
pancreatic acini and ducts.
• Gastric Phase
o This phase is initiated by the presence of food within the stomach and is once again primarily
involves vagus nerve stimulation of acinar cells to produce digestive enzymes. By the end of
the cephalic and gastric phases, the pancreatic ducts are filled with inactive digestive zymogens
ready for washing out into the intestinal lumen by aquous sodium bicarbonate solution.
• Intestinal Phase
o This phase is initiated by emptying of stomach contents into the small Intestine and involves
release of both secretin and cholecystokinin which stimulate pancreatic ductal cells to
synthesize aqueous sodium bicarbonate solution. The generation of aqueous sodium
bicarbonate solution washes out all of the inactive pancreatic enzymes waiting within the
pancreatic ducts into the duodenum where they activated as discussed previously.

80
148. The composition and properties of bile.

-
97% water
-
solids , belie acids , mucin , cholesterol , inorganic salts , etc

Properties of Gall-Bladder Bile: P It 7 I 7 3 .

- •

a. Gall-bladder bile may be golden-yellow, brownish-yellow or olive-green in colour depending

on the proportions of the bile pigments.

b. It is a viscid fluid.

c. It has a bitter taste and characteristic smell.

149. The role of bile in digestion.

Functions of Bile:
• Bile salts help to lower the surface tension of water and thus emulsify fats in the intestine
and dissolve fatty acids and water-insoluble soaps. The presence of bile in the intestine
helps the digestion and absorption of fats and the absorption of fat-soluble vitamins A,
D, E and K.

• Bile salts are activators of lipase.

• Choleic acid formed by deoxycholic acid assists the absorption of many important
insoluble compounds.

81
 • Bile salts are reabsorbed from the intestine and pass back to the liver where they
stimulate further secretion of the bile (cholagogue action).

• Bile is an important source of alkali which helps to neutralize the acid chyme from the
stomach.

• Bile is an important channel for the excretion of some substances like bile pigments,
many drugs, toxins, and various inorganic substances such as copper, zinc and mercury.

• Fat digestion is impaired in the absence of bile. The fat then covers the other food
particles and prevents enzymes from attacking them. These undigested food particles
ultimately leads to putrefaction in the large intestine.

• Bile salts keep cholesterol in solution in gall-bladder bile. In the absence of bile salts,
cholesterol becomes precipitated. This results in the formation of gall-stones.

150. The composition and properties of intestinal juice. Regulation of its secretion.
Intestinal juice refers to the clear to pale yellow watery secretions from the glands lining
the small intestine walls. The Brunner's glands secrete large amounts of alkaline mucus in
response to (1) tactile or irritating stimuli on the duodenal mucosa; (2) vagal stimulation, which
causes increased Brunner’s glands secretion concurrently with increase in stomach secretion;
and (3) gastrointestinal hormones, especially secretin.
Its function is to complete the process begun by pancreatic juice; the enzyme trypsin exists in
pancreatic juice in the inactive form trypsinogen, it is activated by the intestinal enterokinase in
intestinal juice. Trypsin can then activate other protease enzymes and catalyze the reaction pro-
colipase → colipase. Colipase is necessary, along with bile salts, to enable lipase function.
Intestinal juice also contains hormones, digestive enzymes, mucus, substances to
neutralize hydrochloric acid coming from the stomach and erepsin which further
digests polypeptides into amino acids, completing protein digestion.

151. Cavity and membrane digestion

Enzymes:
• Secreted by enterocytes
• Fixed on the apical membrane of the enterocyte
• On enterocyte destruction get into glycocalyx, mucus & enternic juice
• Break down olygo- & dimers to monomers

Characteristic properties of membrane digestion:

• Large catalytic surface
82
 • Highly effective
• Sterile
• Closely connected with absorption

152. The absorption in the digestive canal. The mechanisms of absorption of sodium and
water.

The small intestine must absorb massive quantities of water. A normal person or animal of
similar size takes in roughly 1 to 2 liters of dietary fluid every day. On top of that, another 6 to
7 liters of fluid is received by the small intestine daily as secretions from salivary glands,
stomach, pancreas, liver and the small intestine itself.

By the time the ingesta enters the large intestine, approximately 80% of this fluid has been
absorbed. Net movement of water across cell membranes always occurs by osmosis, and the
fundamental concept needed to understand absorption in the small gut is that there is a tight
coupling between water and solute absorption. Another way of saying this is that absorption of
water is absolutely dependent on absorption of solutes, particularly sodium:

83
 • Sodium is absorbed into the cell by several mechanisms, but chief among them is by
cotransport with glucose and amino acids - this means that efficient sodium absorption
is dependent on absorption of these organic solutes.
• Absorbed sodium is rapidly exported from the cell via sodium pumps - when a lot of
sodium is entering the cell, a lot of sodium is pumped out of the cell, which establishes
a high osmolarity in the small intercellular spaces between adjacent enterocytes.
• Water diffuses in response to the osmotic gradient established by sodium - in this case
into the intercellular space. It seems that the bulk of the water absorption is
transcellular, but some also diffuses through the tight junctions.
• Water, as well as sodium, then diffuses into capillary blood within the villus.

153. Mechanisms absorption of proteins, fats and carbohydrates.

Carbohydrates alpha amylase-

Carbs begin to digest in the mouth, where enzymes in saliva start breaking complex molecules
down into simpler sugars. Chewed-up carbs then pass through the esophagus and stomach with
- - -
- - -
- -

little additional digestion. In the small intestine, they are broken down into the simplest sugar →
- - -

Pancreatic
molecules, which are then absorbed through the small intestine walls into the bloodstream and nice
used by the body as fuel or sent for storage in the liver for use at a later time. Fiber, the amylase
indigestible cell walls found in carb plant foods such as beans, brown rice and whole wheat, I
maltose sucrose lactose
passes through the digestive tract essentially undigested. , -

+ to v1
Stncose fructose galactose
Proteins
Protein is found in meat, eggs, dairy products and beans, and is used by the body to build muscle
and organs. Protein molecules are quite large. Chewing helps break proteins down into smaller
particles for digestion. Chemical protein digestion starts in the stomach, where enzymes start
to soften the protein molecules. A number of enzymes, including substances from the pancreas,
then break down protein into its component amino acids in the small intestine. Amino acids are
absorbed through the wall of the small intestine into the bloodstream and distributed throughout
the body to repair injuries and replace dying cells. carboxypeptidase dipetidase
, ,

pepsin (stomach) → duodenum (trypsin , elastase , chymotrypsin) → aminopeptidase

Fats
Fats and oils do not easily dissolve into the watery digestive juices of the intestinal tract. Bile,
produced by the liver and stored in the gallbladder, can attach to molecules of both water and
fat. Bile breaks up conglomerations of fat in the digestive tract into smaller emulsified particles,
where lipase, a fat-digesting enzyme, can break it down. The broken down fat particles -- fatty
acids and cholesterol -- are absorbed through the intestinal walls into the bloodstream, where
they accumulate in the chest veins and are then carried to fat-deposit areas throughout the body
to be stored and used for fuel when necessary.
bite → drytonic irons → lymph vessels
{ gastric lipase pancreatic lipase +
Lingual
→

154. The motor function of the intestines, the types of cuts, their regulation

◼ Regulation of small intestines movement may be myogenic, nervous and humoral.

84
 ◼ There are 2 pacemakers in small intestines: in the entrance place of bile and pancreatic
ducts in duodenum and in ileum.

I _-
◼ The anterior hypothalamus stimulate motility, posterior – inhibit motility.
◼ Stimulate motility acethylcholine, inhibit – katecholamines, serotonine, histamine,
bradikinine.

◼ Segmentation and
peristalsis are the two
major types of
contractions observed in
the intestine.
◼ Segmentation, primarily
a ◼function
2 major types of circular of
muscle is observed
contractions occur most
frequently.
in the small It consists of a
2- or 3-centimeter
intestine:
◼ Segmentation:
segment that contracts
while the◼ Major muscle on
contractile
either sideactivity of it relaxes.of
◼ As the contracted the small
segment relaxes, intestine.the
previously relaxed
◼ Contractio
d) Metabolism and thermoregulation.
segments nonofeither side
circular
155. The physiological importance of proteins and their transformation in the body.
may contract.
During protein metabolism, smooth
some protein is converted to glucose in a process
called◼ Segmentation
gluconeogenesis, cycling
the formation of glucose
muscle.
from non-carbohydrate sources.

efficiently mixes ◼ Mix the

85

chyme with the chyme. digestive

The basic difference between protein and carbohydrate is that while carbohydrates are made
out of simple sugars (carbon, hydrogen, and oxygen), protein is made from amino acids (carbon,
hydrogen, oxygen, nitrogen, and sufur). The nitrogen is a basic component of the protein's
amino acids and accounts for 13 to 20% of the total mass.

The first step in protein metabolism is to break it into its constituent amino acids. These are
absorbed into the blood stream.

The second step is to break down the amino acids into their constituent parts--catabolism, if
you want to get technical about it. This removes the nitrogen or amino group from the amino
acids. The process is called deamination.

Deamination breaks the amino group down into ammonia and what is termed the carbon
skeleton. Ammonia is converted to urea, filtered through the kidneys, and excreted in urine.
The carbon skeleton--which is composed of carbon, hydrogen, and oxygen--can then by used
either for protein synthesis, energy production (ATP), or converted to glucose by
gluconeogenesis.

Most authorities believe that the amount of protein converted to glucose is quite small, except
under conditions of intense exercise or metablic starvation. Under these conditions amino acids
produce the major source of glucose for blood sugar maintenance.

156. Nitrogen balance, protein minimum, optimum protein, biological value proteins.

Nitrogen balance is a measure of nitrogen input minus nitrogen output

Nitrogen is a fundamental component of amino acids, which are the molecular building blocks
of protein. Therefore, measuring nitrogen inputs and losses can be used to study protein
metabolism
The Recommended Dietary Allowance (RDA) for protein is a modest 0.8 grams of protein per
kilogram of body weight.

As most will learn in the early stages of chemistry, the building blogs of all proteins are 'amino
acids.' Each protein has its own set of amino acids that are ordered in their own sequence and
can be classified as one of two things:

• Essential
• Cannot be produced during metabolism by the body
• Have to be provided via nutritional intake (diet)
• Non-Essential
• Produced int he body from other proteins or carbohydrates

There are essentially eight amino acids for adults (Leucine, Isoleucine, Valine, Threonine,
Methionine, Phenylalanine, Tryptophan and Lysine) and one additional for children (histidine).

86
157. The physiological significance of fats, their transformation in the body.

Triglyceride Mobilization
Triglycerides are primarily mobilized through stimulation of cells in your adipose tissue by
hormones, which include epinephrine, commonly known as adrenaline. Hormone stimulation
causes the breakdown of triglycerides to fatty acids, which are released into your blood and
picked up by tissues such as your heart, muscles and liver. Triglycerides are usually broken
down when there is a relative deficiency of glucose reaching your body’s tissues and energy is
needed. This can occur during overnight fasting, during prolonged intense exercise or if you
have diabetes and glucose uptake into your tissues is not functioning properly.

Fatty Acid Metabolism

Your liver is the primary organ where fatty acid oxidation to produce energy occurs, but your
heart and muscles also use fatty acids for part of their energy needs. Fatty acid oxidation occurs
in cell organelles called mitochondria, where energy production occurs. Fatty acids enter
mitochondria and are broken down to a molecule called acetyl coenzyme A, which enters a
metabolic pathway called the citric acid cycle. All of the energy released during fatty acid
oxidation is captured by carrier molecules and brought to a system where the energy is stored
in a phosphate bond of a molecule called ATP, which is your body’s energy store for all essential
functions. Carbon dioxide and water are produced as by-products.

Ketone Bodies
For complete combustion of fatty acids to ATP plus carbon dioxide plus water, glucose is
required to keep the citric acid cycle running. If glucose is not available, acetyl coenzyme A is
converted to molecules called ketone bodies. This is important during starvation, as ketones
provide energy to your heart, muscle and brain. However, if you go on a sustained high-fat,
high-protein, no-carbohydrate diet in an attempt to lose weight, you risk developing a disorder
called ketoacidosis, which increases the acidity of your blood and is potentially life-threatening.
The condition often develops in people with Type 1 diabetes.

Cholesterol Metabolism
Your body cannot utilize cholesterol for energy. The only major way to eliminate cholesterol
from your body is through your stool. Cholesterol is a component of the bile that is produced
in your liver and stored in your gall bladder. Bile is released from your gall bladder into your
small intestine to aid lipid digestion and absorption. Additionally, cholesterol is the fundamental
building block from which bile acids are made in your liver. Importantly, the high-density
lipoproteins in your blood carry cholesterol to your liver for bile production. Much smaller
amounts of cholesterol are used to make your sex hormones and vitamin D.

158. The physiological significance of carbohydrates, their transformation in the body.

Metabolic pathways
• Carbon fixation, or photosynthesis, in which CO 2 is reduced to carbohydrate.

87
 • Glycolysis - the oxidation metabolism of glucose molecules to
obtain ATP and pyruvate
• Pyruvate from glycolysis enters the Krebs cycle, also known as the citric acid cycle, acetyl
in aerobic organisms after moving through pyruvate dehydrogenase complex. → Pyruvate → GA
• The pentose phosphate pathway, which acts in the conversion
of hexoses into pentoses and in NADPH regeneration. NADPH is an essential
antioxidant in cells which prevents oxidative damage and acts as precursor for
production of many biomolecules.
• Glycogenesis - the conversion of excess glucose into glycogen as a cellular storage
mechanism; this prevents excessive osmotic pressure buildup inside the cell

Glycogenolysis - the breakdown of glycogen into glucose, which provides a glucose supply for
glucose-dependent tissues.

Gluconeogenesis - de novo synthesis of glucose molecules from simple organic compounds.

An example in humans is the conversion of a few amino acids in cellular protein to glucose.
Metabolic use of glucose is highly important as an energy source for muscle cells and in the
brain, and red blood cells.

159. The regulation of metabolism of proteins, fats and carbohydrates.

Hormone Message
insulin glucose and amino acids available, more substrates on the way
glucagon glucose and amino acids in short supply, need to mobilize internal
reserves
epinephrine prepare for imminent sharp rise in substrate demand
glucocorticoids prepare for extended period of high demand
thyroid increase basal metabolic rate
hormones

Carbohydrate metabolism regulation

Protein:

Abstract

While all the hormones described have regulatory effects on the rates of protein synthesis and
breakdown there is a complex interaction between them in this control process. Insulin, GH and
IGF-I play a dominant role in the day-to-day regulation of protein metabolism. In humans
insulin appears to act primarily to inhibit proteolysis while GH stimulates protein synthesis. In
the post-absorptive state IGF-I has acute insulin-like effects on proteolysis but in the fed state,
or when substrate is provided for protein synthesis in the form of an amino acid infusion, IGF-
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I has been shown to stimulate protein synthesis. Growth hormone and testosterone have an
important role during growth but continue to be required to maintain body protein during
adulthood. Thyroid hormones are also required for normal growth and development. The
hormones glucagon, glucocorticoids and adrenaline are all increased in catabolic states and may
work in concert to increase protein breakdown in muscle tissue and to increase amino acid
uptake in liver for gluconeogenesis. While increased glucocorticoids result in reduced muscle
mass the effects of glucagon may be predominantly in the liver resulting in increased uptake of
amino acids. In contrast to the catabolic effect of adrenaline on glucose and lipid metabolism,
studies to date suggest that adrenaline may have an anti-catabolic effect on protein metabolism.
Despite this adrenaline increases the production of the gluconeogenic amino acid alanine by
muscle and its uptake by the splanchnic bed. There is considerable interest in the use of anabolic
hormones, either alone or in combination, in the treatment of catabolic states. GH combined
with insulin has been shown to improve whole-body and skeletal muscle kinetics while GH
combined with IGF-I has a greater positive effect on protein metabolism in catabolic states than
either hormone alone. If catabolic states are to be treated successfully a greater understanding
of the role of the catabolic hormones in these states and the possible treatment of these states
with anabolic hormones is required.
Fats:
The fate of labelled free fatty acids in isolated perfused livers shows that on entering the liver
they are esterified or oxidized. The more acid which enters the oxidation pathway, the more
goes into ketogenesis and the less into the citric acid cycle, so that the total production of energy
remains constant.

160. The physiological significance of vitamins

e
Function
Each of the vitamins listed below has an important job in the body. A vitamin deficiency occurs
when you do not get enough of a certain vitamin. Vitamin deficiency can cause health problems.
-
List vitamin functions !
Not eating enough fruits, vegetables, beans, lentils, whole grains and fortified dairy foods may
increase your risk for health problems, including heart disease, cancer, and poor bone health
(osteoporosis).

161. Methods for determining energy person. The respiratory coefficient

The respiratory quotient (or RQ or respiratory coefficient), is a dimensionless number used in
calculations of basal metabolic rate (BMR) when estimated from carbon dioxide production. It
is calculated from the ratio of carbon dioxide produced by the body to oxygen consumed by the
body. Such measurements, like measurements of oxygen uptake, are forms of
indirect calorimetry. It is measured using a respirometer. The Respiratory Quotient value
indicates which macronutrients are being metabolized, as different energy pathways are used
for fats, carbohydrates, and proteins.

162. The main exchange and its definitions conditions, factors affecting its value.

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Metabolism is the sum total of all chemical reactions involved in maintaining the living state
of the cells, and thus the organism. In general metabolism may be divided into two categories:
catabolism or the break down of molecules to obtain energy; and anabolism or the synthesis of
all compounds needed by the cells (examples are DNA, RNA, an protein synthesis). The
diagram on the left contains a summary of all the types of metabolism that will be examined.
In this module, the electron transport chain is examined. Bioenergetics is a term which describes
the biochemical or metabolic pathways by which the cell ultimately obtains energy. Nutrition
is a science that deals with the relation of food substance to living things. In the study of
nutrition, the following items must be considered:
a) bodily requirement for various substances;
b) function in body;
c) amount needed;
d) level below which poor health results.

Essential foods supply energy (calories) and supply the necessary chemicals which the body
itself cannot synthesize. Food provides a variety of substances that are essential for the building,
upkeep, and repair of body tissues, and for the efficient functioning of the body. A complete
diet must supply the elements; carbon, hydrogen, oxygen, nitrogen, phosphorus, sulfur, and at
least

163. The temperature of the human body, its daily fluctuations.

The normal temperature range obtained by either a mercury or an electronic thermometer may
extend from 36.2 C to 37.6 C (97 F to 100 F). Body temperature varies with the time of day.
Usually, it is lowest in the early morning because the muscles have been relaxed and no food
has been taken in for several hours. Temperature tends to be higher in the late afternoon and
evening because of physical activity and consumption of food.

Normal temperature also varies in different parts of the body. Skin temperature obtained in the
axilla (armpit) is lower than mouth temperature, and mouth temperature is a degree or so lower
than rectal temperature. It is believed that, if it were possible to place a thermometer inside the
liver, it would register a degree or more higher than rectal temperature. The temperature within
a muscle might be even higher during activity. Although the Fahrenheit scale is used in the

164. The physiological significance homoyotermiyi. Center thermoregulation,

thermoreceptors.

Center for thermoregulation

The temp. of the body is regulated almost entirely by temp. regulating centers located in the
hypothalamus.
1. The anterior hypothalamus-preoptic area :

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 The preoptic & anterior hypothalamic nuclei contain two types of neurons :
A) Heat – Sensitive neurons(receptors) which are present in large numbers.They increase their
rate of firing as the temp. rises.

Thermoreceptors
1.Peripheral thermoreceptors are found in the skin
2.Central thermoreceptors are found in the anterior hypothalamus
3.These thermoreceptors are important for behavioral and physiological thermoregulation both in
the short term and in the long term.
-
see 9^162 for neural regulation
165. The heat in the body, its regulation.

Body Temperature Is Controlled by Balancing Heat Production Against Heat Loss

When the rate of heat production in the body is greater than the rate at which heat is being lost,
heat builds up in the body and the body temperature rises. Conversely, when heat loss is greater,
both body heat and body temperature decrease.
Heat Production
Heat production is a principal by-product of metabolism. The most important of these factors
are listed here:
(1) basal rate of metabolism of all the cells of the body;
(2) extra rate of metabolism caused by muscle activity, including muscle contractions caused
by shivering;
(3) extra metabolism caused by the effect of thyroxine (and, to a less extent, other hormones,
such as growth hormone and testosterone) on the cells;
(4) extra metabolism caused by the effect of epinephrine, norepinephrine, and sympathetic
stimulation on the cells;
(5) extra metabolism caused by increased chemical activity in the cells themselves, especially
when the cell temperature increases; and
(6) extra metabolism needed for digestion, absorption, and storage of food (thermogenic effect
of food).
-
9- 167 for neural regulation
Heat Loss
Most of the heat produced in the body is generated in the deep organs, especially in the liver,
brain, and heart, and in the skeletal muscles during exercise. Then this heat is transferred from
the deeper organs and tissues to the skin, where it is lost to the air and other surroundings.
Therefore, the rate at which heat is lost is determined almost entirely by two factors:
(1) how rapidly heat can be conducted from where it is produced in the body core to the skin
and
(2) how rapidly heat can then be transferred from the skin to the surroundings.

The temperature of the body is regulated almost entirely by nervous feedback mechanisms, and
almost all these operate through temperature-regulating centers located in the hypothalamus.
For these feedback mechanisms to operate, there must also be temperature detectors to

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determine when the body temperature becomes either too high or too low.

166. Heat in the body and its regulation. 165

→ same as
g.
In the body, heat is produced by muscular exercise, assimilation of food, and all the vital
processes that contribute to the basal metabolic rate. It is lost from the body by radiation,
conduction, and vaporization of water in the respiratory passages and on the skin. Small
amounts of heat are also removed in the urine and feces. The balance between heat production
and heat loss determines the body temperature. Because the speed of chemical reactions varies
with the temperature and because the enzyme systems of the body have narrow temperature
ranges in which their function is optimal, normal body function depends upon a relatively
constant body temperature.

167. Regulation sustainability of body temperature at different ambient temperatures

The human body has the remarkable capacity for regulating its core temperature somewhere
between 98°F and 100°F when the ambient temperature is between approximately 68°F and
130°F according to Guyton. This presumes a nude body and dry air.
The external heat transfer mechanisms are radiation,conduction and convectionand evaporation
of perspiration. The process is far more than the passive operation of these heat transfer
mechanisms, however. The body takes a very active role in temperature regulation.

The temperature of the body is regulated by neural feedback mechanisms which operate
primarily through the hypothalmus. The hypothalmus contains not only the control
mechanisms, but also the key temperature sensors. Under control of these mechanisms,
sweating begins almost precisely at a skin temperature of 37°C and increases rapidly as the skin
temperature rises above this value. The heat production of the body under these conditions
remains almost constant as the skin temperature rises. If the skin temperature drops below 37°C
a variety of responses are initiated to conserve the heat in the body and to increase heat
production. These include:
-

• Vasoconstriction to decrease the flow of heat to the skin.

• Cessation of sweating.
• Shivering to increase heat production in the muscles.
• Secretion of norepinephrine, epinephrine, and thyroxine to increase heat production
• In lower animals, the erection of the hairs and fur to increase insulation

e) Physiology of the excretion system

168. General description of the excretion system. The role of the kidneys in the process of
selection. Features of the blood supply to the kidneys.

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 inter Gba - cortical radial
Renal artery
→
artery → arcuate
→ a- a. -
>

afferent a. → glomerular capillaries → efferent arterioles → peritrbnlar capillaries

→ renal venules → renal vein ↳ form was a reata in the medulla

Blood supply
Each kidney receives its blood supply from the renal artery, two of which branch from the
abdominal aorta. Upon entering the hilum of the kidney, the renal artery divides into smaller
interlobar arteries situated between the renal papillae. At the outer medulla, the interlobar
arteries branch into arcuate arteries, which course along the border between the renal medulla
and cortex, giving off still smaller branches, the cortical radial arteries (sometimes called
interlobular arteries). Branching off these cortical arteries are the afferent arterioles supplying
the glomerular capillaries, which drain into efferent arterioles. Efferent arterioles divide into
peritubular capillaries that
provide an extensive blood supply to the cortex. Blood from these capillaries collects in renal
venules and leaves the kidney via the renal vein. Efferent arterioles of glomeruli closest to the
medulla (those that belong to juxtamedullary nephrons) send branches into the medulla,
forming the vasa recta. Blood supply is intimately linked to blood pressure.

169. Mechanisms of urine formation. Filtration in the glomeruli and factors on which it
depends.

The rates at which different substances are excreted in the urine represent the sum of three renal
processes:
1. glomerular filtration
2. reabsorption of substances from the renal tubules into the blood, and
3. secretion of substances from the blood into the renal tubules.

Expressed mathematically
Urinary excretion rate = (Filtration rate - Reabsorption rate) + Secretion rate

Filtration is a passive process.

• The fluid that enters the glomerular capsule is called glomerular filtrate.
• Amount of filtrate produced in the kidneys each minute. 125mL/min = 180L/day

Effective filtration pressure =

P hydrostatic of blood - (P oncotic of blood + P hydrostatic capsula)
= 65 - (25+15) = 25 mm Hg.
• Glomerular filtration rate is the volume of filtrate produced by both kidneys each
minute.

Glomerular filtration rate (GFR)

• Factors that alter filtration pressure change GFR. These include:
– Increased renal blood flow -- Increased GFR
– Decreased plasma protein -- Increased GFR. Causes edema.
– Hemorrhage -- Decreased capillary BP -- Decreased GFR

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 Glomerular filtration rate in average is
90-130 ml/(min x 1,73 m2)

170. Reabsorption and secretion in the nephron, their physiological mechanisms

reabsorption of water.

Reabsorbtion:
• Process of returning filtered material to bloodstream
• 99% of what is filtered
• May involve transport protein(s)
• Normally glucose is totally reabsorbed

171. Countercurrent mechanism reabsorption of water.

In the presence of ADH, which increases water permeability, the hyposmotic fluid that enters
the distal tubule (DT) from the thick ascending limb (TAL) looses most of its water by osmotic
equilibration with the surrounding cortical interstitium along the CNT and cortical collecting
duct (CCD). It also continues loosing NaCl through reabsorptive transport along DT, CNT and
CCD, until the tubule fluid becomes isoosmotic with plasma, by the end of the CCD. The
relatively small amount of isoosmotic fluid that flows into the medullary collecting ducts losses
progressively more and more water to the hyperosmotic medullary and papillary interstitia and
is finally excreted as hyperosmotic, highly concentrated urine

172. Regulation reabsorption of sodium and glucose in the tubule nephrons.

The nutrient glucose (blood sugar) is entirely reabsorbed back into the blood from the proximal
tubules. In fact, it is actively transported out of the tubules and into the peritubular capillary
blood. None of this valuable nutrient is wasted by being lost in the urine. However, even when
the kidneys are operating at peak efficiency, the nephrons can reabsorb only so much sugar and
water. Their limitations are dramatically illustrated in cases of diabetes mellitus, a disease which
causes the amount of sugar in the blood to rise far above normal. As already mentioned, in
ordinary cases all the glucose that seeps out through the glomeruli into the tubules is reabsorbed
into the blood. But if too much is present, the tubules reach the limit of their ability to pass the
sugar back into the bloodstream, and the tubules retain some of it. It is then carried along in the
urine, often providing a doctor with her first clue that a patient has diabetes mellitus. The value
of urine as a diagnostic aid has been known to the world of medicine since as far back as the
time of Hippocrates. Since then, examination of the urine has become a regular procedure for
physicians as well as scientists.

Sodium ions (Na+) and other ions are only partially reabsorbed from the renal tubules back into
the blood. For the most part, however, sodium ions are actively transportedback into blood from
the tubular fluid. The amount of sodium reabsorbed varies from time to time; it depends largely
on how much salt we take in from the foods that we eat. (As stated earlier, sodium is a major
94
component of table salt, known chemically as sodium chloride.) As a person increases the
amount of salt taken into the body, that person's kidneys decrease the amount of sodium
reabsorption back into the blood. That is, more sodium is retained in the tubules. Therefore, the
amount of salt excreted in the urine increases. The process works the other way as well. The
less the salt intake, the greater the amount of sodium reabsorbed back into the blood, and the
amount of salt excreted in the urine decreases.

173. Regulation reabsorption of amino acids and bilkiv in the tubules of nephrons
-
Reabsorbed in prox -
correlated tubule
using Nato transporter via Nat K+ ATPase ,

Tubular reabsorption is the process by which solutes and water are removed from the tubular Nat proton
fluid and transported into the blood. It is called reabsorption (and not absorption) because these exchange ,

substances have already been absorbed once (particularly in the intestines). Reabsorption is a
two-step process beginning with the active or passive extraction of substances from the tubule
fluid into the renal interstitium (the connective tissue that surrounds the nephrons), and then the
transport of these substances from the interstitium into the bloodstream. These transport
processes are driven by Starling forces, diffusion, and active transport.
homeostasis
174. The role of the kidneys in ensuring izoosmiyi. Mechanisms thirst.
-

• The kidneys minimize fluid loss during water deficits through the osmoreceptor - ADH
feedback system.
• Adequate fluid intake, however, is necessary to counterbalance whatever fluid loss does
occur through sweating and breathing and through the gastrointestinal tract.
• Fluid intake is regulated by the thirst mechanism, which, together with the
osmoreceptor-ADH mechanism, maintains precise control of extracellular fluid
osmolarity and sodium concentration.
• Many of the same factors that stimulate ADH secretion also increase thirst, which is
defined as the conscious desire for water.

Threshold for Osmolar Stimulus of Drinking

• The kidneys must continually excrete at least some fluid, even in a dehydrated person,
to rid the body of excess solutes that are ingested or produced by metabolism.
• Water is also lost by evaporation from the lungs and the gastrointestinal tract and by
evaporation and sweating from the skin.
• Therefore, there is always a tendency for dehydration, with resultant increased
extracellular fluid sodium concentration and osmolarity.
• When the sodium concentration increases only about 2 mEq/L above normal, the thirst
mechanism is activated, causing a desire to drink water. This is called the threshold for
drinking. Thus, even small increases in plasma osmolarity are normally followed by
water intake, which restores extracellular fluid osmolarity and volume toward normal.
In this way, the extracellular fluid osmolarity and sodium concentration are precisely
controlled.

95
 ¥6m
175. The role of the kidneys in ensuring izovolyumiyi.
?

◼ ADH release is also controlled by cardiovascular reflexes in response to decreases in

blood pressure and/or blood volume, including the arterial baroreceptor reflexes and the
cardiopulmonary reflexes. These reflex pathways originate in high-pressure regions of
the circulation, such as the aortic arch and carotid sinus, and in the low-pressure regions,
especially in the cardiac atria. Afferent stimuli are carried by the vagus and
glossopharyngeal nerves with synapses in the nuclei of the tractus solitarius. Projections
from these nuclei relay signals to the hypothalamic nuclei that control ADH synthesis
and secretion.
◼ Thus, in addition to increased osmolarity, two other stimuli increase ADH secretion:
decreased arterial pressure and decreased blood volume. Whenever blood pressure and
blood volume are reduced, such as occurs during hemorrhage, increased ADH secretion
causes increased fluid reabsorption by the kidneys, helping to restore blood pressure
and blood volume toward normal.

176. The role of the kidneys in ensuring the sustainability of acid-base status of blood
The lungs and kidneys work together to produce a normal extracellular fluid and arterial pH of
7.35-7.45.
The kidney excretes fixed acid and performs three functions to achieve this
1) Tubular secretion of acid
2) Glomerular filtration of buffers which combine with H+
3) Ammonia is produced enzymatically from glutamine and other amino acids, and is secreted
in the tubules
The kidneys contribute to acid-base regulation, along with the lungs and body fluid buffers,
by excreting acids and by regulating the body fluid buffer stores. The kidneys are the only
means for eliminating from the body certain types of acids generated by metabolism of proteins,
such as phosphoric acid.
In the normal person, the kidneys account for almost all the erythropoietin secreted into the
circulation.

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