The official, currently valid version of the syllabus is in the Study information system (SIS), here is a copy.
1. Heart
1.1. Electrical activity of the heart
Rhythmicity of heartbeats and its origin, regulation of heart rate
Action potential (AP) at various parts of the conductive system, the causes of their shape variations, involvement of various ion channels, cardiac pacemaker, timing of the action potential spreading through the conductive heart system, factors affecting heart rate - sympathetic effect, vagal control, receptors, effect.
Action potential and its spread through cardiac muscles
The shape of the AP myocardial curve, the contributing ion channels, the timing of their action potentiation, the principle of "plateau" and its implication, intercellular propagation, absolute and relative refractory phases, the effect of changes in the composition of the internal environment on AP myocardium.
ECG (the recording principle, basic description)
Types of connections, registration principle, Einthoven's triangle, principle of recording from leads, heart vector and axis, factors that affect them, basic description of the ECG curve elements - intervals, waves, interpretation.
1.2. Mechanical properties of the cardiac action
Comparison of cardiac muscle fiber, skeletal and smooth muscle contraction
Involvement of contractile apparatus components, energy consumption, tetanic contraction, relaxation.
Comparison of the excitation and contraction coupling in cardiac and skeletal muscles
Principles of muscle cell excitation, signal transduction, pathways resulting in the activation of the contractile apparatus, the role of calcium
Mechanisms regulating the force of cardiac contraction
Homeometric, heterometric, contractility, factors affecting it, influence of calcium concentration, effect of vegetative control, Frank-Starling's law, principle, consequences, preload, afterload, factors affecting them, central venous pressure, their significance for cardiac contraction strength and cardiac output.
Cardiac cycle, cardiography, changes of essential points and segments of the curve
Systolic and diastolic cycles, causes and consequences of pressure / volume changes, Laplace's law
Cardiac output
Calculation, Fick's principle, dilution method, echocardiographic estimation, its setting, affecting factors, the influence of changes on the heart rate on its systolic and diastolic durations, the relationship between heart work and oxygen consumption
Ventricular function measurements
Cardiac output, ejection fraction, interpretation, relation to end-diastolic filling, end-systolic pressure and volume, cardiac index, ergometry, influence of the load on the volume of the cardiac output, cardiac work, oxygen consumption and blood pressure
2. Circulation
2.1 General principles
Relationship between pressure and blood flow
Measurement methods, factors affecting the pressure and the flow, elasticity, laminar and turbulent flow, determining factors and thier significance, closing pressure, what determines it and its significance for organ perfusion, parallel and series connection and significance for pressure-flow values
2.2. The pressure-flow relationship at different sections of the vascular bed and its regulation
Factors determining blood pressure, its importance, measurement
High-pressure and low-pressure system, significance, capacitive and resistant flow, flow rate and its relationship to pressure at different flow intervals and phases of cardiac cycle, measurement of blood pressure, mean arterial pressure, significance, influence of body position, relation to capillary filtration
Time factor in blood pressure regulation and involvement of individual regulatory mechanisms
Mechanisms of long-term maintenance of blood pressure stability, the importance of the kidneys, RAAS
Neuroregulation of blood flow distribution, baroreceptors, baroreflex, resetting.
Local regulation of blood flow, autoregulation of blood flow by organs (metabolic, myogenic, vasoconstrictive, vasodilatory factor).
2.3. Local specifics of blood flow, pressure / flow changes at rest and during exercise
Coronary blood flow
Oxygen consumption by the heart muscles at rest and during exercise, coronary reserve, influence of Laplace's law, subepicardial and subendocardial blood flow.
Other specific organs blood flow - brain (HEB), liver, splanchnicus, kidneys
Circulatory changes after birth
Circulatory changes during exercise
Static, dynamic load, differences
3. Blood and hematogenous gas transport
Transport of gases via the blood, affecting factors
Total blood transport capacity and modifying factors, solubility of gases in the liquids, partial pressure, transport in plasma, hemoglobin role in gas transportation and its affecting factors, hemoglobin saturation, Astrup - predictive value, limitations.
Hemoglobin dissociation curve
Types of hemoglobin and its O2 and CO2 affinity and its affecting factors, consequences. Explanation of the sigmoidal character of the curve, shifts of the dissociation curve, factors causing it, Bohr effect, Halden effect.
Blood groups, Rh maternal-fetal incompatibility
Antigenic definition of individual types, determination of blood groups, consequences of incompatibility - transfusion, mother / fetus, preventive methods.
Hemostasis, hemocoagulation, anticoagulant factors, their interaction, coagulation tests
Vasoconstriction and its factors, platelet reaction, hemocoagulation, binding of individual factors, calcium, vitamin K, formation of definitive thrombus, interaction of coagulation and anticoagulation mechanisms within the coagulation cascade, Quick test, APTT, INR, their significance
Hematological tests
Hemoglobin, hematocrit, mean erythrocyte volume, erythrocyte count, leukocytes, platelets, erythrocyte color intensity, blood count, FW
4. Breathing
4.1. Ventilation and respiratory mechanics
Factors determining the composition of alveolar air, the effect of dead space size
Alveolar ventilation versus tidal volume, effective alveolar ventilation, anatomical and functional dead space, partial pressures of gases in the respiratory system, composition of exhaled air during breathing, affecting factors, hypoventilation, hyperventilation, influence on gases partial pressure within alveolar air and blood , calculations.
Mechanism of inhalation and exhalation, respiratory muscles, respiratory pattern
Barometric, interpleural, alveolar pressure, measurements, their values when breathing is stopped, relation to inspiration and expiration and their changes, its relation to the respiratory rate, inspiratory and expiratory muscles, their activity, management.
Factors determining pulmonary compliance and airway resistance, respiratory work
Relationship of the volume change versus the pressure change, tissue elasticity and surface tension and their affecting factors, surfactant, lung compliance curve, shape interpretation, airway flow resistance and its indicating factors, regulation of bronchial lumen, static, dynamic work, measurement
Examination of lung function
Spirometry: TLC, VC, TV, IRV, ERV, RV, FRC, flow-volume curve: FVC, PEF, resting versus forced expiration, plethysmography, lung and airway resistance.
4.2. Blood-alveolar air gas exchange
Causes and consequences of pulmonary ventilation-perfusion mismatch disproportion and their ratio
Rahn-Fenn scheme, alveolar dead space, venous admixture, O2 and CO2 partial pressures alveolar and arterial
Gas transport across the alveolo-capillary membrane, perfusion and diffusion limitations
Diffusion surface, diffusion path, concentration gradient, gases solubility and membrane diffusion, flow rate, diffusion capacity, measurement, A-V difference
Functional differences between systemic and pulmonary circulation
Pulmonary and systemic bed triggered hypoxic reaction, hypoxic pulmonary vasoconstriction, mechanism, consequences for oxygen saturation, circulation
4.3. Respiratory regulation
Mechanisms of chemical regulation
Central, peripheral, localization, response to change in O2 and CO2, mechanism, adaptation
Neuroregulation of respiration
Defensive reflexes of respiration, origin of respiratory rhythm, inspiratory and expiratory neurons, activity, lung receptors, peripheral receptors of the thorax and respiratory muscles, peripheral receptors of the limbs, baroreceptors, thermoreceptors, pain.
4.4. Hypoxia - causes and implications
Types of hypoxia
Hypoxic, ischemic, anemic, histotoxic, causes, consequences for oxygen transport to tissues, hemoglobin saturation, arterial and venous pO2 and pCO2, dissociation curve in these designated conditions.
Hyperbaria, hypobaria
Influence on gas transport, respiratory center reactions, dissociation curve shift, ABR shift, effect on hematocrit, effect on pulmonary perfusion
Respiratory quotient
5. Kidneys
5.1. Glomerular function
Renal blood flow. Regulation, relation to glomerular filtration.
Flow autoregulation, cortical and medullary flow, differences, significance, blood flow myogenic and tubuloglomerular feedback regulation, changes in vas afferens and vas efferens resistance, relation to GF size, influence of RAAS system, ANP, prostaglandins, sympathetic, effective flow
Factors determining glomerular filtration
Differences in hydrostatic pressures, their causes and consequences, oncotic pressure, permeability of the glomerular membrane and factors influencing it, composition and osmolarity of primary urine,
Measurement of glomerular filtration rate and renal blood flow
Clearance, principle, calculation, creatinine, insulin, advantages, disadvantages, cystatin C, flow measurement using the PAH clearance method.
5.2. Tubular function
Measurement of tubular transport, fractional excretion of solutes and water
Fractional excretion, tubular resorption, calculations, significance, osmolar fractional excretion, osmolality deficit, osmolar clearance, solute-free water clearance
Transport mechanisms and their importance in the proximal tubule
Na+, glucose, K+, HCO3-, H+, urea, amino acids
Renin-angiotensin-aldosterone system
Juxtaglomerular apparatus and macula densa, principle of function, effects of ANG and aldosterone
Potassium excretion in the kidneys
Localization, importance for maintaining potassium and other factors of the internal environment
Renal excretion of urea and ammonia metabolism in renal tubules
Correlation of the ABR maintenance
Formation of concentrated and diluted urine
Osmolarity of tubular fluid during flow through the tubular system, Henle loop function, osmotic startification of the marrow, significance, maintenance principle, influence of aldosterone and ADH on urine volume regulation, principle of action
5.3 Urination
Mechanism, control, testing
6. ABR (Acid-Base Regulation)
6.1. Basic factors determining acid-base balance in the body
Acid production in the body, buffers
ABR structure
Respiratory and metabolic component
Values detecting the ABR status
Buffer base, base excess, anion gap
6.2. Deviations and regulation of acid-base balance
Acidosis causes, consequences
Respiratory, metabolic
Alkalosis, causes, consequences
Respiratory, metabolic
Respiratory compensation
The role of the kidneys
Urine acidification, principle, localization, acidification tests, titratable acidity, relation to HCO3- transport
7. General physiology
7.1. Thermoregulation and its ontogenetic development
Regulatory functions of the hypothalamus, thyroid hormones, sympathetic nervous system (vasomotor activity of cutaneous vessels, sweat glands, brown fat, uncoupling), tremor. Specificities of thermoregulation in the neonatal period.
7.2. Body fluid compartmentalization, their composition, measurement and regulation
Molarity, osmolarity, electroneutrality. Composition of intracellular and extracellular fluid. Plasma-interstitial fluid gradient differences, Gibbs-Donnan equilibrium. Principle of measuring the volume of body fluid compartments by dissolving the indicator. How changes in fluid intake and expenditure affect the distribution of fluids in the body.
7.3. Tissue fluid production, lymphatic circulation, regional peculiarities in tissue fluid production
Fluid passage through the capillary wall, Starling's equation (hydrostatic and oncotic pressure). Description of the lymphatic system and structural peculiarities of lymphatic vessels. The role of the lymphatic system in fat absorption, reabsorption of fluids from the interstitium and removal of large proteins from the interstitial space. Specificities of the pulmonary microcirculation.
7.4. Ion distribution across cell membranes, significance
Forms of transport of substances across the cell membrane
Diffusion, facilitated diffusion, secondary active transport, primary active transport. Factors determining the molecular size of diffusion. Carriers, the most important ATPases, symport and antiport.
Distribution of ions on the cell membrane, its derive, influence on the setting of membrane tension
Ion channels and selective permeability of the cell membrane, electrochemical gradient. Equilibrium potentials for K +, Na + and Cl-, Nernst equation. Resting membrane potential.
Action potential, mechanism of origin, factors that influence it
Voltage-dependent Na + and K + channel, changes in membrane conductivity for Na + and K +, graph of voltage course during AP (depolarization, threshold value, repolarization to positive values, repolarization, hyperpolarization). Absolute and relative refractory period and AP propagation.
8. Endocrine system
8.1. General principles of hormonal regulation, mechanisms of action of hormones
Negative feedback simple and complex, positive feedback. Number of receptors and their hormone affinity (down-regulation, up-regulation). Membrane receptors associated with second messenger, membrane receptors associated with catalytic activity, steroid and thyroid hormones receptors.
8.2. Pituitary hormones, their importance in individual development
Relationship between hypothalamus and pituitary gland
Relation of adenohypophyseal hormones secretion to the hypothalamic function, connection of hypothalamus and neurohypophysis, overview of neurohypophyseal hormones and their function.
Tropical pituitary hormones
Overview and their functions, connectivity at the levels of the relevant peripheral gland.
Hormones important for growth and development of an individual
Growth hormone, prolactin, function, significance.
8.3 Hormonal function of the thyroid gland and parathyroid glands
Release, transport, activation
Regulation of thyroid hormone production and secretion, plasma thyroid hormone binding, T4 activation in target tissues, tissue receptor.
The effects of thyroid hormones, including their importance for the development
Prenatal and postanatal metabolic, circulatory effects, for the development and functioning of NS.
Functions of parathyroid glands in calcium regulation.
8.4. Adrenal hormones
Glucocorticoids, stress response
Regulation of glucocorticoid excretion, pulsatile secretion, circadian course. Effects of glucocorticoids and the importance of glucocorticoid secretion under stress
Adrenal marrow hormones, reaction to stress
Biological consequences of adrenal medulla activation. Target organs and tissues according to receptor subtypes and the nature of individual types of response. The importance of catecholamine secretion in stress.
8.5. Endocrine function of the pancreas, regulation of glycemia (growth hormone, corticoids…)
Regulation of insulin secretion in pancreatic β cells. Mechanism of insulin action in target cells, main effects of insulin. Glucagon - regulation of secretion and effects. Pancreatic somatostatin. General overview of glycemic control.
8.6. Endocrine function of the gonads
Endocrine function of the testes
regulation of GnRH, FSH and LH secretion in men. Effects of androgens.
Endocrine function of the ovaries, menstrual cycle
Regulation of ovarian function (GnRH, FSH and LH), negative and positive feedback. Phases of the menstrual cycle and levels of LH, FSH, 17β-estradiol and progesterone. Effects of estrogens and progesterone on the target tissues.
Hormonal changes in pregnancy, placenta, childbirth
Events in the early phase of pregnancy (fertilization, implantation, HCG secretion). Overview of hormones in pregnancy. Synthesis of progesterone and estriol during pregnancy. The role of hormones in childbirth (oxytocin, prostaglandins, fetal cortisol and the estrogen / progesterone ratio). Regulation of milk secretion and ejection
9. GIT
9.1. General GIT functions
GIT motility and its control (general principles)
Slow and fast waves, enteric NS, autonomic and hormonal control of motilities, inhibitory and excitatory GI neurotransmitters (noradrenalin, acetylcholine, CCK, VIP, histamine, somatostatin), effectors, GIT reflexes
Secretion and function of regulatory substances
Paracrine hormones (somatostatin, histamine, pepsin), neurocrine (Ach, VIP, subst P…); gastrointestinal; (gastrin, secretin, CCK, GIP)
9.2 Functional specifics of individual sections of the GIT
Oral cavity and esophagus
Chewing and swallowing (function, nervous mechanisms), motility, regulation of saliva production and their function; significance of saliva secretion volume
Stomach
Main functions (storage, mixing, propulsion), chyme, regulation and importance of gastric secretion (HCL, mucus, enzymes, hormones); gastric emptying mechanism
Digestion of chyme in the small intestine
Motility, absorption and postabsorption phases, mechanism and regulation of intestinal juice secretion
Exocrine pancreas, liver, gallbladder
Hormonal control of pancreatic secretion, bile output, bile salt circulation
The main function of the large intestine
Propulsion, haustration, defecation, function of intestinal bacteria, resorption of ions, vitamins, water, calcium, iron.
9.3. Systems and substances affecting food intake
Influence of hypothalamus, adipose tissue, leptin, insulin, GLP-1, Ghrelin, peptide YY
10. Nervous system
10.1. General neurophysiology
Synapsis
Neurotransmission (presynaptic part), postsynaptic receptors and potentials (ionotropic and metabotropic r.), EPSP and IPSP, neurotransmitters (overview, receptors, synthesis, reuptake), learning (synaptic scales, LTP, LTD)
Neuron, glial cell
Specifics of the function of individual parts of nerve cells, types of nerve fibers, the relationship between their thickness and myelination to the rate of signal transmission, glia function
10.2. Senses
Vision
Retinal circuits, photoreceptors, receptive fields
Hearing
Mechanics, frequency coding, potassium circulation
Vestibular system
Function, nystagmus
Smell
Odorant effect, circuits in the olfactory bulb
Taste
The effect of five different tastes on receptor cells
Somatosensory system
Touch, pain, muscle elongation, tendon strain
Visceral system
Baroreceptors, osmoreceptors, chemoreceptors
10.3. Spinal cord and ANS
Reflex activity of the spinal cord
Postural, defensive, monosynaptic, polysynaptic connections, crossed reflexes, reflex arc, gamma loop
ANS
Sympathetic, parasympathetic, effect on various organs
10.4. Brain
Brainstem centers
Cerebellum
Functions of its three main components (vermis, flocculus, hemispheres), involvement of mediators
Hypothalamus
Nerve functions, endocrine functions
Basal ganglia
Circuits involvement, expected role (behavior control, planning, skills learning)
Cerebral cortex
Primary cortical areas (sensory areas, motor cortex), higher order cortical areas (secondary, associative, premotor, frontal)
Involvement of brain structures in the motor control
Sleep
Phases, sleep cycle, neurochemical nature of sleep and awakening, ARAS
Memory
Structures and mechanisms involved in memory track storage, short-term memory - long-term, declarative - non-declarative
10.5. Nervous system tests
EEG
Principle, waves, meaning
Evoked potentials
