Regulation of respiration 1

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					Topics for the MCQ II
The material suggested for reading refers to the 11th edition of the Guyton and Hall.
Textbook of Medical Physiology

   1. Physiology of erythrocyte, its structure (with emphasis on the
      hemoglobin) and function.
   2. Hemostasis.
Please read: Chapter 32: Red blood cells, anemia and polycythemia (pages 419-428), Chapter
33: Resistance of the body to infection I (pages 428-437), Chapter 35: Blood types;
Transfusion; Tissue and organ transplantation (pages 451-455), Chapter 36: Hemostasis and
blood coagulation (pages 457-467).

       1. Organization of AUN
       2. Transmission through the autonomic ganglia and its regulation
       3. Specificity of sympathetic and parasympathetic innervation of target
       4. Peripheral receptors, neurotransmitters and co-transmitters of the
       autonomic nerves endings.
       5. Autonomic innervation of cardiovascular system: blood vessels and the
       6. Autonomic control of respiratory tract.
       7. Axonal reflex.

Please read: Chapter 60: The autonomic nervous system and adrenal medulla (pages 748-759)


Physiology of heart muscle
     1. Structure of heart muscle (basis for functional syncytium)
     2. Electrophysiology of the heart myocyte
     3. Cardiac pacemakers
     3. Transmission of the active state
     4. Mechanism of contraction

Heart performance and its regulation
     1. The events of the cardiac cycle
           Phase I Ventricular filling
           Phase II
             Phase III
             Phase IV
      2. Graphical analysis of ventricular pumping
      3. External work of the heart
      4. Preload, afterload and ejection fraction
      5. Basic mechanisms regulating strength of heart muscle contraction
             a. Frank - Starling mechanism and its practical consequences
             b. Contractility – the positive and negative inotropic factors
      8. Methods for evaluating heart contractility
      9. Effects of preload, afterload and contractility on stroke volume (SV)
      and ejection fraction (EF).
      10. Factors affecting cardiac output (CO) and stroke volume (SV)

Reflex and humoral regulation of the circulatory system
  1. Short term mechanisms
         a. Neural control
                - Vasomotor centers in medulla
                - Baroreceptors
                - Chemoreceptors
                - Low-pressure receptors
                - Bainbridge reflex.
         b. Humoral factors
                - Catecholamines
                - Atrial natriuretic peptide
                - Vasopressin (antidiuretic hormone)
                - Angiotensin II
  2. Long term mechanisms (Renal control)
                - Renin-angiotensin-aldosterone system.

Fundamentals of structure and function of the circulatory system.
     1.Principles of hemodynamics:
        a) Poiseuille’s law
        b) Resistance to flow,
        c) Laminar and turbulent flow
  2. Physical characteristics of the circulation,
        a) structure of different compartments of the vascular system
        b) function of arteries, arterioles, capillaries and veins
        c) vascular distensibility, compliance
  3. Blood pressure (systolic, diastolic, mean and pulsatile)
           a) factors which determine systolic and diastolic blood pressure in
           the circulatory system
     4. Veins and their functions
        a) regulation of venous return
       5. Relationship between venous return, pressure in big veins and stroke
       6. Effect of gravity forces on hemodynamics.

Microcirculation and the lymphatic system

   1. Structure of microcirculation
   2. Characteristics of microflow
   3. Exchange processes:
          a. diffusion
          b. filtration, reabsorption
   4. Lymph flow
   5. Regulation of microflow,
             a. autoregulation (relationship pressure-flow)
             b. functional and reactive hyperemia
   6. Role of endothelial cells in the regulation of microflow
   7. Pathology of microcirculation: formation of edema

Please read: Chapter 9: The heart (pages 103 -114), Chapter 10: Rhythmical excitation of the
heart (pages 116-121), Chapter 11: The normal electrocardiogram (pages 123-129), Chapter
12: Electrographic interpretation of cardiac muscle abnormalities (pages 131-145), Chapter
13: Cardiac arrhythmias and their electrocardiographic interpretation (pages 147-156),
Chapter 14: Overview of the circulation (pages 161-170, Chapter 15: Vascular distensibility
and functions of the arterial and venous systems (pages 171-179), Chapter 16: The
microcirculation and the lymphatic system (pages 111-193), Chapter 17: Local and humoral
control of blood flow by the tissues (pages 195-203), Chapter 18: Nervous regulation of the
circulation (pages 204-214), Chapter 20: Cardiac output, venous return and their regulation
(pages 234-244), Chapter 23: Heart valves and heart sounds (pages 269-276).


Physiology of the respiratory system
  1. Mechanics of pulmonary ventilation
  2. Pulmonary volumes and capacities -spirometry
  3. Alveolar ventilation
  4. Functions of the airways

Pulmonary circulation
  1. Anatomy
  2. Blood volume of the lungs
  3. Blood distribution , effect of hydrostatic
     pressure gradients in the lung on regional pulmonary blood flow

Principles of gas exchange
   1. Composition of alveolar air
   2. Diffusion of gases through the respiratory membrane
   3. Effect of the ventilation-perfusion ratio on alveolar gas concentration

Transport of oxygen and carbon dioxide in blood

Regulation of respiration
  1. Respiratory centers and control of their activity
  2. Chemical control of respiration – peripheral and central chemoreceptors

Please read: Chapter 37: Pulmonary ventilation (pages 471-481), Chapter 38: Pulmonary
circulation, pulmonary edema, pleural pressure(pages 483-490), Chapter 39: Physical
principles of gas exchange (pages 491-501), Chapter 40: Transport of oxygen and carbon
dioxide in blood and tissue fluids (pages 502-512), Chapter 41: Regulation of respiration
(pages 514-522)


Physiologic anatomy of the kidney

Formation of urine by the kidney
  1. Renal blood flow
  2. Glomerular filtration and its regulation
  3. Tubular processing of the glomerular filtrate
  4. Use of clearance merhods to quantify kidney function

Basic mechanisms of urine concentration
  1. Countercurrent mechanism
         a. Characteristics of the loop of Henle
         b. Role of distal tubules and collecting ducts in excretion of
            concentrated urine
         c. Role of the vasa recta
  2. “Free water” and osmolar clearance

Control of extracellular fluid osmolarity and sodium concentration
  1. Osmoreceptors - ADH feedback
  2. Role of thirst and salt appetite

Integration of renal mechanisms for control of blood volume
and extracellular fluid volume
   1. Regulation of potassium excretion
   2. Control of renal calcium excretion
   3. Role of pressure diuresis and natriuresis in maintaining body sodium
   4. Nervous and hormonal factors participating in the renal water-electrolyte

Please read: Chapter 25: The body fluid compartments (pages 291-302), Chapter 26: Urine
formation by the kidneys, Glomerular filtration, renal blood flow, and their control (pages
307-325), Chapter 27: Urine formation by the kidneys II. Tubular processing of the
glomerular filtrate (pages 327-346), Chapter 28: Regulation of extracellular fluid osmolarity
and sodium concentration (pages 348-363), Chapter 29: Renal regulation of calcium,
phosphate and magnesium (pages 365-380)

Acids, bases and pH
Buffer systems
     1. Henderson –Hasselbalch equation

Renal control of acid-base balance
  1. Secretion of hydrogen ions
  2. Reabsorption of biocarbonate ions
  3. Generation of biocarbonate ions
  4. Net acid excretion
  5. Renal correction of acidosis and alkalosis

Respiratory regulation of acid-base balance

Acid-base balance disorders
  1. Respiratory acidosis and alkalosis
  2. Metabolic acidosis and alkalosis
  3. Assessment of the acid-base balance disorders

Please read: Chapter 30: Regulation of acid-base balance (pages 383-400)

It is of utmost importance to know the material that was lectured.

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