Předmět Patologická fyziologie (DA0105341)

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Materiál	Typ	Datum	Počet stažení

Sylabus

Pathological PhysiologyPathophysiology approaches problems of diseases from the functional viewpoint. It analyzes pathological symptoms and signs and the mechanism of their development. To comprehend the implications of functional interrelationships in a diseased body, a good knowledge of other preclinical disciplines, especially physiology and biochemistry is a necessity.The textbook we recommend is Textbook of Medical Physiology, A.C. Guyton, Saunders Comp., but other textbooks of human or medical physiology (Review of Medical Physiology, W.F. Ganong, Lange medical publications) or pathophysiology (Essentials of Pathophysiology, Ch.E. Kaufman, Little, Brown and Company) contain informations you may find useful.Pathophysiology is taught in following courses: general pathophysiology pathophysiology of blood pathophysiology of circulation pathophysiology of endocrine glands pathophysiology of gastrointestinal tract and metabolism pathophysiology of nervous system pathophysiology of respiration pathophysiology of urinary tractGeneral pathophysiology Health and disease. Definition of the disease. Pathogenic factors (physical, chemical, biological) and the response of an organism (adaptation, developmental periods, state). Types and stages of a disease. Death (clinical, brain death, biological). Reaction to the impairment of tissue integrity and infection. Nonspecific (inborn) immunity, inflammation (mediators, cells, course, including local and total changes, and the basic disorders of inflammatory reaction. Specific (acquired) immunity, disorders of acquired immunity - immunodeficiency, hypersensitivity and autoimmune disorders. Malignant proliferation. Induction of proliferation. Tumor growth. Malignancy and the organism. Disorders of thermoregulation. Hypothermia. Hyperthermia.Pathophysiology of blood. Disorders affecting erythrocytes. The classification of anemias, of polycythemias (erythremias), their functional consequences and the adaptation of organism to these situations. Disorders of erythropoesis (defects of hemoglobin synthesis, impaired cell production and maturation. Hemolytic anemias (red blood cell defects,extra corpuscular changes). Disorders of the leukocytes. Leukocytopenia. Leukocytosis. Leukemia. Hemorrhagic disorders. Vascular factors (purpura). Platelet defects. Coagulation factor defects. Circulating anticoagulants. Intravascular coagulation (disseminated intravascular coagulation, consumption coagulopaties).Pathophysiology of circulation. Impairments of cardiac output. Length-tension and pressure-volume relations during ventricular cycle. Determinants of ventricular performance: preload, afterload, contractility. Analysis of ventricular function: cardiac output, ejection fraction, end systolic pressure-volume relations, ergometry. Acute cardiac failure: extreme changes of cardiac rate, contractility, increased peripheral resistance, impairments of ventricular filling. Chronic cardiac failure: contractile failure, decrease of cardiac output, increase of venous pressure, phase of stable (compensated) function, decompensation, left heart failure, right heart failure, cardiac failure with high cardiac output, basics of treatment of cardiac failure. Valvular heart disease: stenosis, insufficiency (regurgitation), cardiac hypertrophy, mitral valve stenosis, mitral insufficiency, aortic valve stenosis, aortic insufficiency, tricuspid and pulmonary valvular disease. Cardiomyopathy. Ischemic heart disease: specific features of coronary circulation, decrease of pressure gradient, increase of vascular resistance, ischemia, myocardial infarction, basics of treatment. Cardiac arrhythmias: classification, disorders of impulse generation, disorders of impulse conduction, haemodynamic effects of arrhythmias. Abnormal arterial blood pressure. Hypotension. Circulatory shock: definition, major causes, main abnormalities which occur during each type of shock, compensatory mechanisms. Fainting. Hypertension: classification of arterial hypertensions, consequences of hypertension, basics of the treatment, essential hypertension and its development. Local disorders of blood flow. Disorders of capillary blood flow, edema. Disorders of venous flow. Arteriolar obturation: atherosclerosis, inflammatory changes in the arterial wall. Disorders of the circulation of lymph. Congenital heart diseases. Classification of heart malformations: shunts. Acyanotic defects. Cyanotic defects, development, pulmonary vascular resistance and blood flow.Pathophysiology of the endocrine glands. General principles of humoral feedback control and its disturbances. Disorders of hypophysis. Disturbances of STH secretion. Panhypopituitarism. Hypervasopressinism, diabetes insipidus. Tumors. Disorders of thyroid. Disorders of adrenal medulla. Disorders of adrenal cortex. Disorders of parathyroid. Disorders of endocrine pancreas. Disorders of sex determination and differentiation.Pathophysiology of gastrointestinal tract and metabolism. Nutrition. Disorders of energetic balance, obesity, starvation. Malnutrition. Vitamin deficiency. Atherosclerosis. Liver diseases. Disorders of pancreatic function. Motility of gastrointestinal tract. Gastrointestinal obstructions. Diarrhea. Peptic ulcer.Pathophysiology of nervous system. Disorders of somatic sensation. Disorders of the anterolateral and the dorsal column-lemniscal system. Pathophysiology of pain. Disorders of movement. Systems involved in movement control. Disorders of the neuromuscular transmission, the muscle excitability, and the muscles. Lower motor neuron diseases. Upper motor neuron diseases. Cerebellar disorders. Disorders of the basal ganglia. Disorders of consciousness and sleep. Epilepsies. Brain hypoxia, ischemia and haemorrhage. Intracranial pressure and its disorders. Neurobiology of schizophrenia and affective disorders. Dementia. Electroencephalography, electromyography. Disorders of myelination. Reaction of nervous tissue to injury.Pathophysiology of respiration. Mechanics of breathing in respiratory diseases. The changes of alveolar and interpleural pressures in abnormal conditions. The changes of compliance of the lung, chest wall and respiratory system. The effect of changes in airway and lung resistance. The consequences of pneumothorax. Increased work of breathing in relation to respiratory insufficiency. Interpretation of VC, FVC measurements, F-V loops. Ventilation. The difference between minute and alveolar ventilation in relation to the pattern of breathing. Identification, causes and consequences of hypoventilation and hyperventilation. Respiratory acidosis and alkalosis and their compensation. Benefits and risks of oxygenotherapy. Indications of assisted and artificial ventilation. The role of the cough reflex, tracheo-bronchial cilia and nasal airways in ventilation. Pulmonary circulation. The causes and consequences of unequal lung perfusion. Pulmonary hypertension. Interstitial and alveolar lung edema. Pulmonary embolism. Gas transport. Classification and consequences of hypoxia. The consequences of exposure to high altitude or hyperbaria. The changes in blood gases in diffusion impairment. Ventilation-perfusion ratio. The changes in alveolar air composition due to changes in V/Q ratio. Local and systemic mechanisms controlling the ventilation-perfusion ratio. Ventilation-perfusion inequality and arterial hypoxemia in lung diseases. Examinations of ventilation-perfusion inequality. Regulation of breathing and ventilatory problems. The relative role of central motoneurons, mechanical and chemical reflexes in the control of breathing in various conditions. Interactions between the PCO2, PO2 and H+ effects on ventilation in disease. The mechanism of exercise hyperpnoea. Defense reflexes in lung clearance. Ventilatory response to CO2 and to hypoxia in chronic lung diseases. Dyspnea and its clinical meaning. Respiratory diseases and their signs. Bronchial asthma (bronchial hyperreactivity), chronic obstructive bronchopulmonary disease (chronic bronchitis, emphysema), lung fibrosis. Cough, cyanosis, tachypnoea, Kussmaul´s breathing, Cheyne Stoke´s breathing, Biot´s breathing. Principles of examination of pulmonary function, spirometry, plethysmography, lung compliance, lung resistance, airway resistance, dead space, venous admixture, work of breathing, blood gases, CO2 response curve, transfer factor, bronchoconstriction and bronchodilation tests.Pathophysiology of urinary tract. Disorders of glomerular functions. Glomerular permeability. Filtration area. Disorders of tubular functions. Acquired impairments. Disorders of tubular transport. Tubular adaptation to decrease of glomerular filtration. Renal edema. Renal hypertension. Renal failure. Quantification of renal functions. Obstruction of urinary tract. Disorders of water balance. Dehydration. Hyperhydration. Disorders of A-B balance. Classification. Acidosis. Alkalosis.

Literatura

Guyton, A. C.: Textbook of medical physiology : W. B. Saunders company, 2006 (B), (avaible as ebook)+Kaufman, Ch. E.: Essentials of pathophysiology : Little, Brown and Company, 1996 (B)Schmidt, R. F.: Physiologie des Menschen mit Pathophysiologie: Springer-Lehrbuch, 2007Damjanov, I.: Pathophysiology: Saunders Elsevier, 2009

Garant

Doc. MUDr. Hana Maxová, Ph.D.