34. Thiobarbituric Acid 43. Ascorbic or Erythorbic 17.

43. Ascorbic or Erythorbic 17. Pasteuization refers to the process of heating every particle of milk to at least 63ºCfor 30 min or heating
to 72ºC for 15 sec.
35. Shrinkage 44. Nitrite Burn 18. The time-temperature combinations used for producing sterilized milk are 145ºC and 3 sec.
19. The low temperature storage of raw milk prior to processing is likely to increase Psychrotrophic counts.
[Link] 45. Fat Caps
20. The spores of B. stearothermophilus are known to withstand UHT treatment.
37. 80-90% 46. Warmed Over
21. Sterilizing effect refers to the number of decimal reductions that the heat treatment is able to effect in
38. Grayish Pink [Link] death time milk.
22. For aseptic packaging of UHT milk, Tetra pack, Tetra-Brick etc are used as packaging materials
39. Bloom 48. 4.5
23. The common groups of post-pasteurization contaminants include Coliforms and psychrotrophs
40. Metmyoglobin 49. Actomyosin 24. The thermal destruction of bacteria in milk is based on the principle of Protein denaturation
41. Nitrosyl Haemochromogen 50. Mountain Oysters 25. Pseudomonas putrefaciens causes surface taints in butter.
26. The gas producing organisms may enter milk chiefly from soil and manure.
42. 200
27. The blue discolouration in milk is caused by the associative action of Ps. Syncyanea and S. lactis.
28. Slime production in milk is mainly caused by Leuconostoc genus of lactic acid bacteria.
29. Ropiness in milk is mainly caused by Alcaligenes viscolactis
DAIRY SCIENCE
30. Coliforms cause Early blowing in cheese.
1. Cottage cheese is a soft, unripened cheese usually made from Skim milk 31. The two types of materials responsible for ropiness are Gums, and Mucins
2. Operation flood was started in the year 1970 32. The three types of rancidity in milk are Hydrolytic, oxidative and ketonic
3. Plastic cream contains 65-85 per cent milk fat 33. The fruity aroma of milk produced by Ps. fragi is due to the production of Esters;
4. According to PFA Rules the milk fat content of khoa should not be less than 20 per cent of finished 34. Malty flavour produced by S. lactis var. maltigenes in milk is due to the production of Aldehydes .
product.
35. Unclean flavour in milk may be due to microbial production of Dimethyl sulfide by Gram-negative
5. The average specific gravity of skim milk ranges from 1.035 to 1.037 psychrotrophic bacteria.
6. According to the PFA Rules the mixed milk should contain minimum per cent of milk fat and milk SNF 36. Faecal coliforms in dairy products are detected by Eijkman test test.
respectively 4.5, 8.5
37. The common indicator organisms used for determining faecal contamination in frozen and thermized
7. The chairman of NDDB, has become the first Indian to be elected to the board of the International Dairy foods are Enterococci
Federation (IDF) Dr. (Ms) Amrita Patel 38. The tentative standards for bacterial count of environment in butter section are 300 cfu/m3.

8. Daily per capita milk consumption recommended by the Medical Authorities is 280g 39. The aflatoxin B1 in dairy animal feed is transformed into aflatoxin M1 and is secreted into milk.

9. According to the PFA Rules chhana should not contain more than 70 per cent moisture 40. The efficiency of dairy sanitizers is determined by Capacity and suspension tests.

10. The acidity in mastitic milk is Lower than normal milk 41. Food-borne intoxications through dairy products are mainly caused by [Link]

11. The starter organisms for yoghurt are Streptococcus thermophilus and Lactobacillus delbruekii 42. Widal test is used for the detection of Salmonella in dairy products.
subsp. bulgaricus 43. [Link] forms typical Dark centered with green metallic sheen colonies on Eosin Methylene Blue
12. Natural acidity of milk is due to casein,acid phosphates and citrates (EMB) agar.

13. Temperature and time of flash pasteurization 720Cfor 15 second 44. Indian Standards Institution (ISI) has been renamed as Bureau of Indian Standards

14. Pizza is prepared from mozzarella cheese 45. ICMSF stands of International Commission on Microbiological Specifications for Foods;

15. National Dairy Development Board, Anand ,Gujarat was set-up in the year1965 46. Indole is produced from tryptophan by the action of Tryptophanase enzyme of micro-organisms during
IMViC test.
16. Soft ice cream is usually drawn from the freezer at around - 8 to -7°C. The overrun may be in the range
of 30 to 50 per cent. 47. Milk with titratable acidity more than 0.17 % (LA) gives a positive COB test.

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48. A special pipette called Breed‟s pipette is used for performing direct microscopic count (DMC). available phosphorus, 0.5 0.5 0.5 0.5 0.5 0.5
percent by mass, min.
49. For staining milk smear during direct microscopic count, a special stain, a special stain called
Newman‟s stain is used.
metabolizable energy, 2800 2900 2600 2500 2600 2600
50. The oxidation-reduction potential of resazurin is 0.34 V whereas it is 0.1 V or les for dihydroresorufin. Kcal/kg, Min

POULTRY SCIENCE

1. Fibrous proteins contains the ............which are the main proteins of .............
2. The chemical name of vitamin D2 is ........whereas D3 is .......... ANIMAL NUTRITION
3. .............concerned with night vision is a ..........pigment
4. The enzyme like .........breakdown fat into ...........and.............. 1. Father of nutrition- Antoine Lavoisier
2. The yeast variety commonly known as ―fodder yeast‖-Torulopsis utilis
5. The inorganic element present in the arginase is .............. It splits arginine into .............and ..................
3. Water content in the body of new bone calf is-80%
6. Antivitamin K activity is exhibited by (a) biotin (b) dicumarol (c) sulfanilamide (d) caproic acid 4. In Van Soest method of feed estimation the ADF comprises of----cellulose and
7. Gossypol of cotton seed meal react with (a) zinc (b) manganese (c) iron (d) selenium 5. lignin
8. Nutritional roup is due to deficiency of (a) vit A (b) vit B6 (c) vit K (d) vit E 6. The only true ketogenicamino acid-leucine
7. Fat contains-----% carbon-77
9. Pastures are classified in (a) silage (b) roughage (c) additives (d) succulent forages 8. A dietry excess of Tyrosine cause-eye lesions
10. A calorie is the amount of heat required to raise the temperature of 1g water from (a) 12.5 to 13.5 (b) 9. Dietry excess of Methionine produces-inhibition of ATP synthesis
14.5 to 15.5 (c) 15.7 to 16.7 (d) 10.2 to 11.2 10. Zinc forms an integral part of enzyme- Carbonic anhydrase
11. About 96% of plasma copperis bound to an alpha-2 globulin called-
11. For determination of metabolizable energy instrument used is (a) metabolizable energy meter (b) bomb 12. Ceruloplasmin
calorimeter (c) barometer (d) energy thermometer 13. Organic acids promotes the absorption of calcium
12. Keratin are proteins of (a) arteries (b) DNA (c) hairs (d) connective tissue 14. Curled toe paralysis is caused by the deficiency of-Riboflavin
15. One IU of vitamin A is equivalent to 0.6mcg of beta-carotene
13. Protamines are basic proteins associated with nucleic acids are rich in (a) tyrosine (b) tryptophan (c)
16. Vitamin A promotesmuco-polysaccharide synthesis by- activating sulphate
methionine (d) arginine 17. molecule
14. weight gain per unit weight of protein consumed refers to (a) biological value (b) gross protein value (c) 18. ‗Ito cells‘ in the liver is the storage site of-Vitamin E
19. Vitamin E is involved in the synthesis of-Ascorbic acid and ubiquinine
protein efficiency ratio (d) essential amino acid index
20. Ascorbic acid was first isolated by-Szent Gyorgi
15. denaturation of proteins in chicken occurs in (a) oesophagus (b) proventriculus and gizzard (c) crop and 21. A dermin or vitamin H is-Pyridoxine
pancreas (d) small and large intestine 22. Niacin requirements can be compensated with-Tryptophan
16. vitamin E was discovered by (a) Funk (b) Hopkins (c) Evans and Bishop (d) Mc Collum and Davis 23. The entire process of citric acid cycle take place in side mitochondria-under
24. aerobic condition
17. Maintenance of normal cerebrospinal fluid pressure is physiological function of (a) riboflavin (b) 25. Branching enzyme in glycogen synthesis is- Glycosyl 4,6 transferase
pyrodoxin (c) retinol (d) folic acid 26. Rate limiting step in glycogen synthesis is-addition of activated glycosyl units
18. selenium is an essential component of enzyme (a) coenzyme A (b) D aminoacid oxidase (c) glutathione 27. Apart from liver cells which other body tissue is capable of producing glucoseintestinal
28. cells
peroxidase (d) choline esterase 29. ―Alkali disease‖ or ―blind staggers‖ is caused by the toxicity of-Selenium
19. "clubbed down condition" occur due to deficiency of (a) pterylglutamic acid (b) riboflavin (c) 30. Glutathione and insulin contains-Sulfur
menaquinone (d) cholecalciferol 31. Chromium deficiency may lead to- Impaired glucose tolerance
32. Nickel is essential for urease activity of rumen microbes.
20. vitamin H is the old name of (a) nicotinic acid (b) folic acid (c) tocoferol (d) biotin
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 33. Jerusalem antichoke contains the main reserve carbohydrate- Inulin c. Both 29. Which of the following is used as energy
34. The term―protein‖ is coined by-Mulder d. None source (not protein source)?
35. Who introduced the balance and thermometer in to nutrition studies for the first a. Linseed meal
36. time?-Antoine Lavoisier 23. Which of the following is common in nature? b. Salseed meal
37. Pinnaglobulin contains Manganese and hemocyanin contains copper a. D sugars and D amino acids c. Mustard cake
38. Legumes are exceptionally rich in- Calcium b. L sugars and L amino acids d. Sunflower cake
39. Germinating Barley contains a starch digesting enzyme called -Diastase c. D sugars and L amino acids
40. Skim milk is the feed ingredient which can said to be rich in both- Calcium and d. L sugars and D amino acids 30. All reactions in TCA cycle are reversible
41. Phosphorus except the formation of?
42. First accurate respiration calorimeter was constructed by-Rubner 24. The order of salt tolerance? a. Succinyl CoA
43. Starch equivalent system was designed by-Kellner a. Sheep>Cattle>Pig>Poultry b. Succinate
44. According to NRC, the ME=DE x 0.85 b. Sheep>Pig>Cattle>Poultry c. α keto glutarate
45. Physiological fuel values were devised by-Atwater c. Cattle>Sheep>Pig>Poultry d. Fumarate
46. Heat increment consists of-Heat of fermentation and Heat of nutrient metabolism d. Pig>Cattle>Sheep>Poultry
47. Feces is the main route of phosphorus excretion in herbivores and urine is in case 31. Which of the following cereal has more lysine
48. of carnivores. 25. Urea supplementation is not recommended if content?
49. Citrate ,lactate ,pyruvate ,ascorbate etc enhance the absorption of-Iron CP content of ruminant diet is above? a. Rice
50. RUMENSIN, MONENSIN modifies rumen fermentation by-promoting a. 18% b. Wheat
51. propionate producing microbes b. 25% c. Corn
52. In hibernating animals the RQ is- less than 0.7 c. 7% d. Oats
53. Whole blood contains from 35-45mg % phosphorus d. 13%
54. Glucosyl transferase needed in mucopoly sacharide synthesis depend on- 32. β oxidation can occur in?
55. Manganese 26. Which of the following deficiency contribute [Link]
56. ‗Degnala disease‘ is caused by-Selenium toxicity to perosis? b. Peroxisomes
57. Net gain of ATP while one mole of glucose is oxidized completely-36 a. Manganese and Choline c. Both
58. Scandinavian feeding system based on barley as the standard is introduced by- b. Biotin and Folic acid d. Endoplasmic reticulum
59. Hanssen c. Thiamine, Manganese, Choline,
60. Urea toxicity results when the rumen ammonia level exceeds-80mg/100ml Biotin and Folic acid 33. Glycosphingolipids and glycoproteins are
61. Leaves of plants containgalactolipid as the major lipid d. Vitamin B12, Manganese, synthesized in?
Choline, Biotin and Folic acid a. Golgi body
b. Mitochondria
27. Order of tolerance of aflatoxin? c. Endoplasmic reticulum
a. Chicken>Guinea fowl>Duck d. Glyoxysomes
[Link] True or False b. Duck>Guinea fowl>Chicken
c. Guinea fowl>Chicken>Duck 34. Rate limiting enzyme in cholesterol
1. Albumins are not soluble in water.- F d. Chicken>Duck>Guinea fowl biosynthesis?
2. Elastins are fibrous proteins. - T a. α 1-4 glucosidase
3. Triglycerides are known as fat.- T 28. Arrange the susceptibility to aflatoxin by b. HMG CoA reductase
4. G.E. content of fat is about 4 kcal/g.- F domestic animals in descending order? c. Squalene synthetase
5. Net yield of ATP per mole of glycerol is 21.--T a. Rabbit> Pig> d. 7 α hydroxylase
6. Thaer developed the first feeding standard.--T Cattle>Sheep>Chicken
7. Sucrose is sweetest of all the sugars. - F b. Pig>Rabbit>Sheep>Chicken>Cattl 35. For fatty acid synthesis, Acetyl CoA comes
8. Maltose is a reducing sugar. - T e from mitochondria to cytoplasm as?
9. Starch equivalent of wheat bran is 45. - T c. Chicken>Rabbit>Pig>Sheep>Cattl a. Carnitine
10. Antibiotics are essential for large ruminants in feed. -- F e b. Malate
11. NFE is determined by analysis. - F d. Cattle>Sheep>Rabbit>Pig>Chicke c. Citrate
n d. Oxaloacetate
12. BMR declines about 8% per year of age.T
13. Vitamin E deficiency causes crazy chick disease.-- T
14. VanSoest system of feed analysis was proposed in 1967.-- T
15. Activity increment of cattle, sheep and swine is less when compared to poultry. - T
BIOTECHNOLOGY
16. R.Q. for carbohydrate is 0.7. -- F
17. Blood meal is deficient in isoleucine but rich in lysine. -T 1. Chemical synthesis of DNA was devised by- H. G. Khorana
18. Soybean meal is rich in methionine.F 2. Most commonly used type of restriction enzymes are of- Type II
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 3. Major complement component present in serum is- C3 57. ‗Beta turn‘ is a secondary structure of protein.
4. PCR technique was developed by – Kary. B. Mullis 58. The most abundant amino acid present in collagen is- Glycine.
5. Major DNA polymerase involved in replication in prokaryotes is- DNAP III 59. Hershey and Chase first reported that DNA is the genetic material.
6. Most abundant polysaccharide among living system- Cellulose 60. In reversible competitive inhibition of an enzymatic reaction, Vmax remains
7. Recombinant DNA technology developed by – Cohen and Boyer 61. same but Km increases.
8. No: of assymetrical carbon atoms in Ribulose- 2 62. Co-factor for Glutathione peroxidase is – Selenium.
9. Semi-conservative replication of DNA was proved by- Meselson and Stahl 63. In Agarose gel electrophoresis the DNA is visualized using- Ethidium
10. Protein part of an enzyme is termed as- Apoenzyme 64. bromide.
11. During replication, the enzyme that prevents torsion by breaking DNA 65. Megaloblastic anemia often occurs due to deficiency of -Folic acid.
12. strands- Topoisomerase. 66. The prosthetic group present in amino transferases is- Pyridoxal phosphate.
13. Eukaryotic DNAP for mitochondrial DNA replication is- DNAP-gamma. 67. Reverse transcriptases are present in – Retroviruses and Hepadna viruses.
14. Monoclonal antibody technique developed by- Kohler and Milstein 68. A diploid cell line of human origin is- HeLa.
15. The most stable form of DNA and RNA seen under physiological condition is- 69. Vero cell lines are obtained from -African green monkey.
16. B-DNA and A-RNA respectively 70. Cell lines are commonly preserved in- Liquid Nitrogen.
17. Type II restriction enzymes were discovered by – Hamilton Smith (1970) 71. Viruses commonly used for production of vector vaccines are- Fowl pox virus,
18. In prokaryotes, the DNA polymerase having 5‘-3‘ exonuclease activity- 72. Retrovirus and Herpesvirus.
19. DNAP I. 73. Size of a prokaryotic cell generally ranges from- 1-10 microns.
20. Concept of Transformation was proved by- Griffith
21. During replication of DNA the separation of double strands is done by-
22. Helicases.
23. DNA replication takes place from 5‘-3‘ direction.
24. Cracking of genetic code was performed by- Nirenberg and Mathaei.
25. Nucleotide sequence within a gene that is transcribed into RNA but excised
26. before translation in called- Introns.
27. Jumping genes or transposons were first reported by – Barbara McClintock.
28. One gene-One Enzyme hypothesis was proposed by- Beadle and Tatum.
29. Operon concept was proposed by- Jacob and Monod.
30. The major form of super coiling found in chromatin is- Solenoidal.
31. Phenomenon of Conjugation was put forth by- Lederberg and Tatum.
32. Histones are rich in amino acids arginine and lysine.
33. Wobble hypothesis was proposed by- Francis Crick
34. Bacterial DNA is compacted in a structure called- Nucleoid.
35. Transfer RNA is produced by - RNApolymerase III.
36. Chemical method of DNA sequencing was developed by- Maxam and Gilbert.
37. ‗Molecular beacons‘ are probes used in detection system for - Real Time PCR.
38. Reverse transcriptase was first discovered by- Temin and Baltimore.
39. The enzyme employed for amplification of specific genes in PCR technique is-
40. Taq DNA polymerase.
41. In Agarose gel electrophoresis, the movement of proteins is based on-
42. Charge:Mass ratio.
43. Phenomenon of transduction was proposed by- Zinder and Lederberg.
44. The medium used for selecting myeloma cells in hybridoma technology is-
45. HAT medium. Solve it by own
46. Amino acid that does not exhibit optical activity is- Glycine.
47. In nucleotides, both types of pentoses are in beta-furanose form. 1. Which of the following inhibits aggregation of platelets
48. In alkaline conditions, RNA is rapidly hydrolyzed due to the presence of 2‘ - o Aspirin; Thromboxane A2; Urokinase; Streptokinase
49. OH group. 2. The longest muscle in animal body is:
50. Hinge region of IgG is rich in - Proline. o Biceps femoris; Longissimus dorsi; Longissimus costarum; Levator costarum
51. Imidazole group is present in the amino acid- Histidine. 3. Epithelial pearls are seen in
52. In SDS-PAGE, the movement of proteins is based on- Mass. o Basal cell carcinoma; Adenocarcinoma; Trichoepithelioma; Squamous cell Carcinoma
53. Separation of proteins in iso-electric focusing is based on- Isoelectric point of 4. Motility of bacteria is due to
54. the particular protein. o Plasmid; Flagella; Pili; None
55. The reagent developed by Sanger to identify the amino terminal amino acid is- 5. The organ needs to be examined for Trichinella spiralis in routine PM examination
56. 1-fluoro-2,4- Dinitrobenzene. o Lungs; Diaphragm; Spleen; Intestine
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 PHYSIOLOGY OF THE GASTROINTESTINAL TRACT (GIT) - aids subsequent digestion

Main function: The GIT provides the body with a supply of water, nutrients, electrolytes, SALIVATION
vitamines.
Actions: Ad 1 b) Adjustment of the food by the saliva
The salivary glands: - parotid
1) Digestion of the food - submandibular
2) Absorption of the products of digestion - sublingual
- buccal
Ad 1) Digestive processes: - mechanical
- chemical Secretion of the saliva: - basal - 800 – 1500 ml/day
Mechanical methods: - mastication (chewing) - during intake of food
- swallowing (deglutition) Regulation of salivary secretion
- movements of the GIT – nervous - parasympathetic
(motor functions) - sympathetic
Chemical means (secretions): - saliva Unconditioned reflexes:
- gastric juice Taste and tactile stimuli increase 8-20 times the basal rate of secretion
- pancreatic juice Conditioned reflexes:
- intestinal juice Visual, olphactoric, acoustic stimuli
- bile Centers: salivatory nuclei (at the juncture of the medulla and pons):
superior – submandibular (70%), sublingual (5%)
PHYSIOLOGY OF MOUTH inferior – parotid (serous saliva)
Functions:
1/ Mechanical and chemical digestion of the food Parasympathetic nerves: [Link], [Link] – stimulation of the salivation.
2/ The source of the unconditioned reflexes Parasympathetic nerves – acetylcholine – kallikrein – alpha 2
3/ Control of physical and chemical properties of the food globuline (plasma) – bradykinine – vasodilatation – stimulation
of the secretion of saliva (serous)
Ad 1 a Mechanical activity – mastication
The anterior teeth – a cutting action Sympathetic nerves: stimulation of the secretion of the mucinous saliva
The posterior teeth – a grinding action
Composition of the saliva
Thee maximal closing force - incissors 15 kg 99.5 % - water; 0.5 % substances – organic – 0.3 %
- mollars 50 kg - anorganic – 0.5 %
Inervations of the muscles of chewing – 5th, 8th, 12th cranial nerves
Centers – near the brain stem and cerebral cortex centers for taste Organic substances: Mucin, digestive enzymes – ptyalin, lingual lipase, proteolytic
enzymes, cytochromoxidase, carbanhydrase, phosphatase, IgA, lysozyme, blood groups s....
Act of mastication: Cells: leukocytes,epithelial cells,...
The movement of the lower jaw down: Anorganic substances: Na+, K+, Cl-, HCO3-
- Contraction of m. biventer mandibulae ([Link]), m.
pterygoideus ext., m.m. infrahyoidei →
The movement – up: the drop initiates a stretch reflex Functions of saliva
Contraction of m. masseter, m. temporalis, m. pterygoideus
Rebound of antagonists- inhibition – the jaw drops + Saliva - keeps the mouth moist, aids speech
compression of the bolus of the food against the linings of the mouth - rebound – repetitive - facilitates swallowing
actions..... - serves as a solvent for the molecules that stimulate
Mastication reflexive and voluntary the taste buds
Function of the mastication: - grinding the food - serves a solvent for irritating foods - helps wash away the pathogenetic
- mixing with saliva bacteria,
- prevention of excoriation of GIT - destroy bacteria (thiocyanate ions, proteolytic enzymes),by proteins
- makes easy swalowing antibodies

1 2
 can destroy oral bacteria, lysozyme = antibacterial - achalasia – weak oesoph. peristalsis, accumulation of the food in the oesophagus –
- keeps the mouth and teeth clean dilatation, increased tonus of cardiae. Pneumatic dilatation or myotomy
- lower oes. sphincter incompetence – gastrooesophageal reflux
Deficient salivation = xerostomia (GER). Surgical treatment.

Swallowing (Deglutition) STOMACH

Three stages:
1) oral – voluntary – the food is squeezed into the pharynx by tongue Anatomy and histology
2) pharyngeal – automatic – cannot be stopped (1 s) - Cardia
Involuntary contraction in the pharyngeal muscles – that pushes the food into the oesophagus. - Fundus
Concomitant actions: Inhibition of respiration, closing of the posterior nares by the soft - Corpus
palate, pulling the larynx upward (enlargement the opening of the oesophagus), glottic - Antrum
closure - Pyloric sphincter

Control of the pharyngeal stage of swallowing -swallowing reflex: The smooth layers: - longitudinal – ext.
Swallowing center – in the medulla and lower pons - circular - med.
Afferent nerves – Vth, VIIth, IXth, Xth - transversal - int.
Coordination of the swallowing with respiration
Each muscle layer functions as a syncytium – gap junctions
3) oesophageal stage of swallowing:
Innervation: - myenteric plexus – outer between the longitudinal and circular layers
Oesophagus - the first third striated muscle - submucosal plexus – inner
- the last third smooth muscle
- the middle – mixed Vagal and sympathetic control
Innervation – n. vagus, sympathetic nerves and others endings
Function – to transport food from the pharynx to the stomach by gravity and by Gastric motility
peristalsis The motor functions of the stomach:
1) storage of food
Peristalsis – primary = a continuation of the peristaltic wave 2) mixing – " – with gastric secretions – semifluid form – chyme
from pharynx 3) emptying of the food into duodenum
- secondary waves result from distention of the
oesophagus by the retained food. Speed 4 cm/s 1) Storage: receptive relaxation of the stomach (P = 6 mmHg) by
- a plasticity of the smooth muscle layers
The swallowing time – for a compact food 6-9 s - nervous action – reduction of vagal tone
a fluid 4-5 s - humorally (gastrin)

Regulation of the oesophageal peristalsis: Food forms concentric circles. A limit about 1.5 l.
- by intrinsic neural circuits – myenteric and submucosal plexus
- by vagal efferent fibers Storage time: Fats – 6 hours, proteins – 4 hours,
Functions of the upper and lower oesophageal sphincters sacharides – 2 hours
Upper – pharyngoesophageal junction – 3 cm segment – with high resting tone – relaxes
reflexly upon swallowing 2) Mixing: Gastric slow waves – basal electric rhythm – 3/min – pacemaker cells – the
Lower – cardia – sphincter cardiae – 2-5 cm above the juncture of the oesophagus with the circular smooth muscle of the fundus
stomach. Circular muscle – tonically constricted. Velocity – 1- 4 cm/s – weak propulsion to move the chyme toward the antrum.
Receptive relaxation – allows propulsion of the swallowed food into the stomach. The Raising intensity – peristaltic constrictor rings.
relaxation through VIP.
Hunger contractions – when the stomach is empty fora long time (12 hours ...) – intensive
Disorders of the swallowing: contractions – most intense in young people – feeling of hunger – regulation of the food
- dysphagia – pain intake.

3 4
3) emptying of the stomach 4) strong downward contraction of the diaphragm along with contraction of
all
Antral peristaltic contractions – P – 50-70 mmHg pressure against the pylorus. the abdominal muscles – squeezing the stomach, intragastric P to a high
Pylorus – circular muscle –sphincter – receptive relaxation - after passage of a bolus – level.
contraction – pyloric pump. 5) Contraction of the stomach, relaxation of the lower oes. sphincter –
expulsion of the gastric content through a passive oesophagus.
Regulation of the emptying:
Complications – alkalosis, dehydration ...
- Stretching of the stomach wall peristalsis inhibits the pylorus
- Gastrin – stimulates gastric motility. Acid in the antrum (G-cells) inhibits gastrin secretion Gastric secretion
– a negative feedback. It enhances the activity of the pyloric pump. 2.5 – 3 l of gastric juice daily
- Duodenal factors:
Enterogastric reflex – distention of the duodenum, activity of „duodenal osmoreceptors“ – Components: - Hydrochloric acid (HCl) – parietal cells
inhitition in gastric motility through the enteric nervous system - Pepsinogens – pepsins – chief cells
- Lipase
Hormonal feedback – the stimulus – mainly fats in the duodenum hormones: - Intrinsic factor – parietal cells
GIP, CCK – a competitive inhibitor of the gastrin - Mucus – neck cells

Disturbances of the gastric emptying 1) Hydrochloric acid secretion

Pylorostenosis – congenital – hypertrophy of the circular layer. Incidence 1:200- boys, 1:800- Acid solution containing 150-160 mmols/l, pH = 0.8 – 1.0
girls a) Cl- is actively transported from the cytoplasm of the parietal cells
Symptoms – vomiting – metabolic alkalosis, dehydratation Treatment – surgical – myotomy into the lumen of canaliculus
b) H2O is dissociated into hydrogen and hydroxyl ions in the cell cytoplasm. H+ ions are
Pylorospasm – functional – hyperexcitability of parasympathetics. Symptoms –like actively secreted into the canaliculus in exchange for potassium ions.
pylorostenosis
Treatment – anticholinergic drugs (atropine) H+ + Cl- ⇒ HCl

Vomiting HCl – free and attached to the mucin and proteins

Expulsion of the gastric – gut contents through oesophagus and mouth/nose out.
Vomiting: - peripheral Functions of HCl in gastric juice:
- central 1) Activation of pepsinogen
1) Peripheral: protective reflex against: 2) Coagulation of proteins
- a presence of irritants in the GIT 3) Change ferric state of iron (Fe3+) to ferrous form (Fe2+) – for absorption –
- an overdistention of GIT with
The most sensitive portion – duodenum ascorbic acid
4) Antibacterial effect
2) Central: effect of some drugs (emetic) – e.g. apomorphine, emetin, nikotine, digoxine or Pepsin:
hypoxia, ischemia, bacterial endotoxines on the cells of the chemoreceptor trigger zone (near The chief cells → pepsinogens (precursors) without digestive activity
the area postrema). Psychic influences. Pepsinogen + HCl – pepsin – active proteolytic enzyme (and + active pepsin); pH
optimum 1.8 – 3.5
The vomiting centre – CNS – RF lies near the tractus solitarius Derivates: - Pepsin C (gastricsin, cathepsin) – pH opt. 3.8 – 4.7 in newborns and sucklings
The vomiting act - Chymosin – pH 5.3 – milk
Nausea – subjective feeling – a necessity to vomit, pale, sweating, salivation – hyperactivity
of the autonomic nervous system Lipase:
Antiperistalsis of the small intestine, pyloroconstriction, stomach is relaxed. Carnivores – fatsplitting action
Intrinsic factor:
The vomiting act: 1) a deep inspiratory breath The parietal cells. Glycoprotein.
2) closing of the glottis Essential for aabsorption of vit. B12 from distal ileum. B12 – for erythropoesis.
3) lifting of the soft palate Pernicious anemia with megaloblasts.

5 6
Mucus: - a longitudinal muscle layer – myenteric nerve plexus
Neck and surface mucous cells (pyloric mucosa). Glycoprotein. - a circular muscle layer – Meissner´s plexus – the submucosa –
Film 0.5 – 1.5 mm. pH 7.0. HCO3- - the mucosa

Regulation of gastric secretion = 2 layers of the smooth muscles, 2 neural plexus

Local, neural and humoral mechanisms
Phases: Cephalic, gastric, intestinal Motility:
Local contractions: - segmentation – ring like – circular muscle layer
1) Cephalic phase: - pendular – circular + longitudinal muscles
Unconditioned reflexes – tactile and chemical stimuli in the mouth - villious
Conditioned reflexes – the sight, smell, acoustic stimuli, phantasy ...
via the dorsal motor nuclei to the vagi – vagal afferent pathway to the gastric glands
Cephalic phase is responsible for 1/3 –1/2 the gastric secretion
2) Gastric phase:
Contact of the food with the gastric mucosa
Intake ⇒ the distention – mechanoreceptors – release of the gastrin from G-cells Propulsive – peristalsis: Peristaltic waves – analward at a velocity
⇒ the increase of pH – the release of the gastrin 0.5 – 2 cm/s to 3.5 – 10 cm.
(The decrease of pH – inhibition of the gastrin secretion)
Transport of the chyme 1 cm/min = 3 – 5 hours for passage of chyme from the pylorus to the
3) Intestinal phase: ileocaecal valve.
Inhibitory influences: Rotation of the chyme.
The presence of AA, fats ... secretion of GIP, VIP and secretion – GIT hormones – blood –
inhibition of the gastric secretion Regulation of the intestinal motility

Drugs that influence gastric secretion Neural:

Histamine – (H2 receptors) – cAMP Myenteric reflex – mechanical stimulation of the duodenum – distention – serotonin
Alcohol, coffeine Gastroenteric reflex – distention of the stomach – through myenteric plexus
ACTH – glucocorticoids – stimulate secretion of HCl and inhibit secretion of mucus !! Parasympathetic +, sympathetic pars -

Disturbances of the gastric secretion Humoral:

Acetylcholine +
Hyposecretion - the decrease of the gastric functions – Pilocarpin, physostigmine (inhibitors of cholinesterase) +, serotonin +, thyroxine +, CO2 +.
- impaired storage and digestive and other functions
Secretion of the small intestine
Postgastrectomy syndrome – dumping – hyperosmolar chyme in the duodenum – Intestinal digestive juice: colorless, alkaline (pH 7-9) fluid
hypoglycemia Volume: 2 – 3 l per day
Product of: - Brunner´s glands – mucous glands secret mucus
Hypersecretion – dysbalance in HCl: mucus ratio – ulceration – autodigestion - the crypts of Lieberkühn

Enzymes:
Zollinger – Ellison sy.: Gastrinomas-tumors in stomach, duodenum, pancreas – secrete 1) Proteolytic – peptidases - for splitting small peptides into AA
gastrin – the increase in HCl production - ulcers (enteropeptidase – for activation of the trypsinogen)
2) Intestinal lipase – neutral fats into glycerol and FA
PHYSIOLOGY OF THE SMALL INTESTINE 3) Enzymes for splitting disaccharides – sucrase, maltase, isomaltase, lactase

Movements of the small intestine Regulation of small intestinal secretion:

1) Local stimuli – tactile, irritative, chemical (the presence of the chyme, HCl, saccharides ...)
Anatomy of the intestinal wall: 2) Neural – through parasympaticus
Layers (from the outer surface inward):
- the serosa Valve ileo – caecalis (ileocaecal sphincter)

7 8
Function: Prevention backflow of fecal contents from the colon into the small intestine. Prevention of autodigestion.
Sphincter slows the emptying of ileal contents into the caecum.
Receptive relaxation – neural + gastrin 2) The pancreatic lipase - steapsine – the most important lipase in the
GIT.
Feedback control of the sphincter by reflexes from the caecum: Secretion in active form – enhancement in the duodenum by Ca+2, amino acids...
The distention of the caecum intensifies the contraction of the sphincter. The necessity of emulsification of fat.
Patients with deficit of the p. lipase have impaired digestion and absorption of fat = fatty
An irritation of the caecum (inflammation of appendix) – can cause intense spasm and stool = steotorrhea.
paralysis of the ileum - by way of the myenteric plexus.
3) The pancreatic alpha-amylase – splits starch.

Movements of the colon Small amount in the blood – a rise – indicator of acute pancreatitis.

Movements: - mixing – haustrations – for better exposition of the fecal material to the Regulation of pancreatic secretion:
surface of the large intestine – neural,
- propulsive - 2-3/day – transport down the colon – hormonal

Gastrocolic and duodenocolic reflexes – distention of the stomach and duodenum – initiation 1st – neural – 1-2 minutes – after the start of the feeding – via n. vagus ⇒ the juice containing
of mass movements a high concentration of the enzymes - up 10%.

Defecation Unconditioned and conditioned reflexes from the mouth ...

Tonic constriction of 1) internal anal sphincter – smooth muscle Blockade with atropine.
2) external anal sphincter – striated muscle –under voluntary control S2
-S4 2nd – Neural + hormonal – gastric – distention – n. vagus
- gastrin – large quantities of the enzymes
Distention of the rectum P – 40-50 mmHg – defecation reflex
Center S2 –S4 : activation of parasympathetic nerve fibers (pelvic nerves) ⇒ intensification of 3rd – Hormonal – also in denervated pancreas - via GIT hormones:
the peristaltic waves, relaxation of the internal anal sphincter.
- Secretin – from „S cells“ – duodenum – stimulation of secretion of large quantities of fluid
Voluntary relaxation of the external sphincter. Deep breath, closing the glottis, contraction of with NaHCO3
the abdominal wall muscles – expulsion the fecal content.
- Cholecystokinin – pancreozynin – duodenum – by way of the blood to pancreas – causes
secretion of quantities of the pancreatic enzymes
PANCREATIC SECRETION
- Chymodenin – chymotrypsinogene
The pancreas: - endocrine portion – hormones
- exocrine portion – the pancreatic juice - VIP – NaHCO3

The pancreatic juice: 1-2 1/24 hours, colorless, viscous fluid

(1-2 % of substances), alkaline (pH = 7.5 – 8.5),with a high HCO3 – content – from gastric LIVER AND BILIARY SYSTEM
venous blood.
Blood Flow: 25 % of CO = 1.5 l/min
The most important pancreatic digestive enzymes: - Nutritive – a. hepatica (P = 100 mmHg)
- Functional – v. portae (P = 10 mmHg)
1) The proteolytic enzymes: Volume of Blood in liver = 20-30 ml/100 g
Insufficiency of RV – increase of the volume =
Proenzymes – in inactive form –initial step by enteropeptidase in the duodenum. Hepatosplenomegaly
Trypsin inhibitor – in the cytoplasm of the pancreatic cells. It prevents activation of trypsin Increase in P – ascites
both inside the secretory cells and in the acini and ducts. Regulation of the Flow and Volume –
Sympathetic nerves – Th3-11 – vasoconstriction

9 10
 reservoir function for blood volume – haemorrhage ... Daily amount: 700 – 1200 ml
Composition of Bile
Metabolic functions of the liver The bile secreted continually by the liver is stored in the
gallbladder (V = 20-60 ml) – where water, Na+, Cl- ...
1) Carbohydrates – storage of glycogen – are absorbed – concentrating the bile constituents.
1 – 4 % of the liver weight – glycogen Concentration about 5-fold up to 20-fold.
- Gluconeogenesis 1) Bile pigments – biliverdin + bilirubin
- Glycogenesis 1 g Hb → 40 mg Bi
- GLUCOSTATIC FUNCTION OF THE LIVER 2) Bile salts
- Cholic acid
2) Metabolism of fat – fatty acid oxidation - Deoxycholic acid
- formation of ketone bodies --
- formation of cholesterol
- formation of phospholipids bacteria - Chenodeoxycholic acid
- synthesis of lipids colon Lithocholic acid

3) Metabolism of proteins – oxidative deaminations Conjugation with glycine/taurine:

- urea formation Salts: Glycocholic acid form sodium and
- manufacture of plasma proteins Taurocholic acid potassium salts
(50 g/day)
- formation of the clotting factors (fibrinogen, prothrombin, 200 – 250 mg of the bile salts/day
proaccelerin, almost all – vit. K – II, VII, IX, X)
Actions:
4) Cholesterol metabolism – synthesis from acetate - Reduction of surface tension – a detergent function.
- excretion – in the bile – Breaking the fat globules into minute sizes = emulsifying function
in the free form and as bile acids. - Forming minute complexes – the bile salts + lipids = micelles – better
absorption of FA, cholesterol, lipids from intest. tract.
5) Metabolism of hormones – angiotensinogen
- inactivation of adrenocortical Without the presence of bile salts – up to 40 % of the lipids are lost
and gonadal into the stool = acholic stool -
steroid hormones -steatorrhoea
- inactivation of erythropoietin Enterohepatic circulation of bile salts
(3-10 x/day, lost 5-10 % per 1 circulation)
6) Iron and vitamins metabolism –
- storage of ferritin (apoferritin = globular protein) + iron – in ferric form) 3) Cholesterol (0.06%) – proportion
- Vit. A, B, B12, synthesis of 25-hydroxycholecalciferol (from vit. D3 – x CH: bile salts 1 : 20-30
reabsorption of Ca++ in kidneys) If the ratio is < 1 : 13 – formation
of the cholesterol gallstones
Detoxification function of the liver
x Inflammation of the gallbladder –
Excretion of bilirubin excessive absorption of water – CH begins
- "- of cholesterol → bile salts precipitate – small crystals
Detoxification of the ammonia, indole, skatole, alcohol, nikotine ...
x Ca2+ - bilirubinate gallstones - deconjugation
Thermoregulatory function of the liver of the Bi by beta – glucuronidase (bacteria) –
Heat production
4) Anorganic salts NaCl, NaHCO3 –
THE BILE pH – 8 – 8.6 - alkaline

- product of the liver modified by the gall-bladder

11 12
Regulation of Biliary Secretion Autonomic system Somatomotoric system

- Neural – parasympathetic + ß-receptors α1-receptors cholinergic

- Humoral – CCK – duodenum → blood → gallbladder receptors
Constriction + relaxation of Oddi sphincter
neuromuscular junctions
Functions of the bile
1) Neutralisation of gastric HCl
2) Help for digestion and absorption of fat and for metabolism brown fat vasomotoric sweat glands
of vitamins soluble in fat (A, D, E, K) reactions skeletal muscles
3) Excretory function – bile pigments, anorganic substances muscular activity
(copper, zinc, mercury), toxins, some (voluntary,involuntary)
drugs ...

THERMOREGULATION
Body temperature
- maintainance of the balance between heat production and heat loss. - manifestation of the thermoregulation efficiency
1) Heat production -
a) in chemical reactions – metabolism Species - poikilothermic – „cold-blooded“
b) during the contraction of skeletal muscles - homeothermic – „warm-blooded“
2) Transport of the heat – in the blood and tissues
Liver +1ºC, lungs -2ºC – of average temperature Temperatures:
3) Heat loss - 1) central – organs: brain, hypothalamus ...
a) Radiation – transfer of heat from one object to another at constant = 37.0 ˚C
a different temperature without direct contact (by infrared 2) core – skin – varies with the changes in environmental T +
electromagnetic radiation) changes in perfusion.
b) Conduction – heat exchange between objects in contact Average = 33.0 ˚C
c) Convection – the movement of molecules away from the area
of [Link], draught ... Diurnal rhythm – lowest at about 6 a.m.
d) Vaporization - perspiratio insensibilis (the insensible water Changes of the basal temperature (oral or rectal) in ovulation – the increase due to a secretion
loss) – 50 ml/h of progesteron (thermogenic effect).
- sweating
- increased ventilation (panting) Reactions of the adult humans in cold environment
A) The increase heat production and B) The decrease heat loss
Temperature – regulating mechanisms
Neural – reflexes – immediate responses Ad A)
Humoral – long-term adaptation 1. The increase in metabolic rate
2. Food intake (specific dynamic action – the obligatory energy
Neural thermoregulation expenditure that occurs during its assimilation into the body)
Center – hypothalamus – temperature-regulating centers 3. Muscular activity: a) Shivering – simultaneous contractions flexors
Afferents – temperature-sensitive cells in the anterior hypothalamus and extensors muscles, heat production.
- cutaneous temperature receptors Shivering pathways – hypothalamus – [Link] and
Efferents - autonomic nerves reticulospinalis
- motor neurons b) Voluntary skeletal activity
Ad B)
CNS 1. Vasoconstriction in the skin – alpha adrenergic sympathetic
nerves – the decrease in heat loss
Lewis´ reaction – during long-term cold application – vasodilatation – red color of the skin –
warming up - protective function

13 14
 Fever = the increase of the BT due to immunologic reactions, by the increase of the set
[Link] with the smallest body surface – quasi spheric shape point of the central thermostat with defensive role.

Hormonal changes: Mechanisms of the fever:

The thyroid gland – in long-lasting stay in cold – calorigenic effect
The adrenal medulla- noradrenalin – vasoconstriction PYROGENS = SUBSTANCES INITIATING FEVER
Hypothalamus – the posterior pituitary – vasopressin – vasoconstriction and water retention Microorganisms – viruses – protozoas
Pyrogens exogenous:
Reactions of the adult humans in hot environment Toxins from bacteria, necrotic cells, viruses,
A) The decrease heat production and B) The increase heat loss Cancer cells ... – exotoxins – exoproducts →
Ad A) 1. The decrease in metabolic rate – T = 25 – 30 ˚C Monocytes, macrophages, lymphocytes – production of
(higher temperatury – a rise of the metabolic rate) Pyrogens endogenous:interleukin-1 (IL-1); IL 2; IL 6; TNF alpha, beta; CSFs
2. Reduction of the muscular activity PGE2 – a direct action on the hypothalamus -adjustation of a new set point for temperature.

Ad B) Effects of the pyrogens

1. Vasodilation in the skin (BF through a-v anastomosis) via the decrease of the sympathetic
tone Haematologic – immunologic effects:
2. Sweating – vaporizaton – 1 l of sweat → 500 kcal. Maximal volume of the sweat = 3 l/h
→ 1500 kcal/h - CSFs - lekocytosis
3. Panting – dogs. - Stimulation of the lymphocytes activities (LyT,B,NK)
- Increase in phagocytic activity
Heat dissipation and loss in newborns
- by peripheral vasodilation – the increase of cutaneous BF Metabolic effects:
- sweating – evaporative loss – in newborns less effective than adults. - negative N2 balance
Capacity of the sweat glands = only about 1/3 of adult values. - catabolism of muscles
- increase in metabolic rate
In preterm infants, the maximal rate of sweating is less, and it is minimal or nonexistent - decrease in iron and zinc concentration level in plasma
in infants of less than 30 week´s gestation – inadequate development of these glands.
- Increase of set-point of the central thermostat
Prevention of cold stress and hypothermic for neonatal care –
- clinical implications: Effector mechanisms
Exposure to cool environment – cold stress often result in pathophysiological changes.
Lowered body temperatures are inversely correlated with survival.
Increase of metabolic rate Heat preservation
Neutral Thermal Environment = a range of ambient temperatures within which the metabolic Shivering Vasoconstriction
rate is minimal and thermoregulation is achieved by basal physical processes alone.
In adults 25 – 30 ˚C – in newborns at higher temperature. Increase in Body Temperature - FEVER
Prevention of heat loss – incubators ...

Physiology of the fever Role of the fever

Fever = only the increase in body temperature (BT) - hyperthermia? Defensive mechanism – Hipocrates (400 BC.) – „fever is a helpful mechanism in the fight
Hyperthermia can exist when heat production exceeds heat dissipation = disequilibrium against toxins in a body“
Variety of reasons: An increase in metabolic heat production, an impairment of heat
dissipating mechanisms, a decrease in the heat –absorbing capacity of the environment due to Activation of the immune system: phagocytosis, T and B lymphocytes,
high ambient temparture - stimulation of the antibodies production
- inhibition of the growth of some microorganisms (due to the decrease of the iron and
Exogenous hyperthermia, enormous physical effort...evoke the BT increase – is not fever! zinc in plasma)
- slowing the growth of some tumors

15 16
 - unspecific discomfort
Quantification of exercise intensity
Positive efects up to BT 40º C
Hyperthermic devices Energy consumption:
Mild exercise: 120-450 kcal/hod, heavy: 450-600, super heavy 600 and more kcal/hod.
Negative effects of the fever
- Increase in metabolic rate, sweating, loss of minerals, dehydration Oxygen consumption:
- Load of the cardiovascular system (mainly in elderly) O2consumption at rest approx 250 ml/min, max. up 3 000 ml/min
- Musle´s catabolism, hyperglycemia, metabolic acidosis
- Headache, pain in joints, musles – hyperalgesia (PGE – vs endorphins) O2consumption maximum = VO2 max.
- Somnolence, apathy – substance „S“ produced in the brain by the pyrogen´s effect Mild exercise – VO2 max. to 33%
- Decrease of the diuresis Moderate = VO2 max. approx. 50%
- Decrease of the gastrointestinal functions
- BT higher than 41 C – decrease in immonologic reactions- possible damage of some Heavy = VO2 max. approx. 70%
central proteins – neurons in CNS Super heavy – VO2 max. 70 – 100 %
-
Physiological Antipyretic Mechanisms PULSE OXYGEN (PO) = volume of the oxygen transported by 1 pulse (SV)

Fever Consumption/intake of O2 (at rest) = 250 ml/min

Heart rate (at rest) = 70/min
Hypothalamus PO = 250:70 = 3,5 ml /pulse
PGE2 - During exercise up 20 ml O2/pulse

Regulation of physiological function in exercise

Neural regulation:
+ - Vasopresin (ADH) Autonomic nervous system (ANS)
Changes in ANS before exercise – start
Corticoliberin 1st phase: Parasympathetics – reduction in tone (tachycardia)
2nd phase and endurance exercise: Sympathetics – activation in co-operation with endocrine
system.
Adenohypophysis MSH Humoral regulation in exercise
Adrenal medulla: Catecholamines: Adrenaline – positive effects on heart and liver
ACTH (mobilisation of glycogen and free fatty acids).

Hypophysis (anterior pituitary):

Cortisol Increase (20- to 40 – fold after 20 min of exercise) in growth hormone secretion . Stimulation
of anabolism – strengthening muscle ligaments and tendons, increasing bone thickness.
ACTH –glucocorticoids – cortisol (rises in heavy and prolonged exercise)– hyperglycemia, it
Inhibition of the lymphoid tissues – immune reactions mobilizes both fat and proteins.
Prolactin – increased blood levels following exercise –mobilizes fat + antidiuretic effect upon
kidneys
Decrease in BT Endorphins: similarity to the opiates. Increased secretion by endurance exercise.
Psychological effects – depression of sensation of fatigue, euphoria. Together with prolactin
can be factor responsible for exercise-induced amenorrhoea.
EXERCISE PHYSIOLOGY Pancreas:
Insulinemia drops by about 50% during and immediately after exercise. (A decrease in
investigation of the effects and their mechanisms of: insuline secretion + increased uptake of the hormone by muscles.) Hypoglycemic effect
- physical exercise on systems, organs combined with higher consumption of glucose.
- training Glucagon level rises – mobilization of hepatic glycogen.
- relaxation after exercise

17 18
 EXERCISE AND CARDIOVASCULAR SYSTEM Pulmonary: +/- During isometric exercise (stretching)- impairment of the venous return =
pooling of venous blood – an increase in venous pressure.
Heart rate:
- Mild exercise: rapid-onset increase of heart rate by a reduction of vagal [Link] exercise Distribution of Blood Flow
recovery in 3-5 min. Muscle Blood Flow:At rest-open 200 capillaries/ mm2, in working muscle 10-15x more. BF
- Heavy exercise: tachycardia by the reduction of vagal tone + activation of the sympathetics 2-5ml/ min/100g in comparison to 120.
and adrenal medulla (catecholamines). Higher values of HR, recovery time up hours. Neural regulation through noradrenergic system (reduction of activity) and specific
cholinergic sympathetic vasodilatory system.
Limit for the sympathetics activation is individual – on average in exercise with 50 – 60 % of Humoral regulation (a decrease in pO2, adenosine, increased content of potassium,
maximal oxygen consumption. hyperosmolarity, NO, histamine + metabolites).
Different BF during static (isometric) and dynamic work, contraction/relaxation.
Calculating Heart Rate Training Zones: There are a number of ways to estimate maximum
heart rate. Realize that we are estimating maximum heart rate not measuring it so it is not an Blood Flow to Other Organs
exact science. Splanchnic circulation: A decrease in BF through splanchnic organs - redistribution of the
Two methods of Estimating Maximum Heart Rate blood to skeletal muscles. Visceral BF drops to only 25-30% of the resting [Link]:
1. 220 - Age = Maximum Heart Rate Cerebral BF remains constant during exercise. However, BF is redirected from one part of the
Example: 40 year old 220 - 40 = 180 beats per minute (bpm) Max Heart Rate brain to another – motoric zone, visual etc.
2. 217 - (0.85 x Age) = Maximum Heart Rate Bone: BF to bone can be increased up to 40% in response to mechanical loading.
Example: 40 year old 217 - (0.85 x 40) = 217 - 34 = 183 bpm Max Heart Rate
BLOOD
Recommended HR according to age for long-lasting exercise (LLE) and maximal HR for During exercise - increased hematocrit, viscosity due to higher exsudation (filtration) of
short-lasting exercise (SLE) plasma in capillaries of skeletal muscles + higher production of erythrocytes.
Leucocytosis – through demargination. Mainly neutrophils and lymphocytes – defensive role.
HR changes in recovery phase (after exercise)
1st min: An imediate exponential decrease in HR. 2nd min continuation + exponential drop Plasma
of noradrenaline plasmatic level. Reactivation of vagal nerves + progressive reduction of the Glycemia: Short-lasting exercise – an increase up + 60%, long-lasting – endurance training –
sympathetic and hormonal activities. a drop
HR changes in recovery phase – used in performance testing (Ruffier´s test, Flack´s test) Lactate: after 15 min lasting exercise up 15-fold rise (from 1 to 15 mmol/l)
FFAs: heavy exercise – an increase 4x
Stroke volume and cardiac output:
Increase by 20-30% (from 80 to about 110 ml at 40-50% of maximum oxygen intake) - Ventilation and Metabolism:
followed by steady state - constant. SV and CO reflects HR up to some limit. Exceeding of
the limit (critical HR value) - accompanied by a drop in the cardiac pumping efficiency. Ventilation: an increase by rising of VT and respiratory rate. During mild exercise –
Tachycardia - shortening of the diastole (ratio St:Dt at rest = 1:2, in maximal tachycardia
proportionally to the oxygen intake – [Link] heavy exercise – the ventilation is
up 1:1) = a decrease in diastolic refilling of the ventricles.
„overproportional“ – additive stimulus - metabolic acidosis (lactic acid) via central
The increase in stroke volume with exercise is accomodated by both – an increase of EDV
chemoreceptors.. Ventilation is not limiting factor for maximum effort. Ventilation at 80% of
and an increase of ejection fraction (normally 55-60%). The Starling relation curve is shifted
MMV covers needs of the maximum effort.
to the left and up (effect of sympathetic stimulation, catecholamines).
Oxygen consumption: At rest 250 ml/min,during maximum efforts up 3000
Cardiac Output ml/[Link] limit value. An increase to steady state in 3-5 min.
The product of HR x SV. CO at rest = 3-3.5l/min/m2 = 5l/min. Maximum CO = 19 l in
young woman and 25 l in man. Endurance athletes up to 35 l/min. Maximum aerobic capacity
Increasing of a loading – a linear rise of oxygen consumption to a individual maximum –
further increasing – disproportion between requirements and intake = exhaustion - fatigue.
Blood Pressure Plateau = maximum oxygen intake/consumption = maximum aerobic capacity.
Systemic: - syst: rises sharply during isometric and sustained rhythmic exercise. Function of Oxygen Debt
the stroke volume. 200-220 mmHg.
- diast.: +/- influenced mainly by peripheral vascular resistance – vasodilation in skeletal Aerobic resynthesis of ATP in working muscles cannot keep pace with their utilization. The
muscles circulation anaerobic pathway is limiting – during a work – oxygen debt comes. After a period of
exertion is over, extra O2 is consumed to remove the excess of lactate, replenish ATP and CP,

19 20
and replace O2 that have come from myoglobin. The amount of extra O2 consumed is COrest (l/min) 5,6 5,6
proportionate to the extent to which the energy demands during exercise exceeded the CO maxim. 18 35
capacity for the aerobic synthesis of energy stores. Heart weight (g) 300 500
The O2 debt is measured by determining O2 consumption after exercise until a constant, basal Ventilation max (l/min) 100 200
consumption of O2 is reached. O2 consumpt max (l/min) 2,8 5,2
After mild exercise the debt is about 4, after heavy 20 l of O2.
Bradycardia in subjects under endurance training:
Blood gases Mechanisms:
Predominancy of vagal central tone – dynamic balance of the ANS shifted toward PS –
- mild exercise – unchanged enhanced RSA - Reduction of intrinsic heart rate of the sinoatrial (SA) node (rate of the spont
- heavy – a decrease in paO2 (approx. by 8%). Enhancement of a-v difference O2from 5% to diastolic depolarization). - Reduction of beta-adrenergic receptors in the right atrium -
Changes in compliance of the heart – morphological adaptation
15%.
A drop in paCO2 (approx. By 10%) due to hyperventilation
Morphological adaptation of the heart
Physiological hypertrophy of myocardium and dilation of the heart cavities. Hypertrophy of
Acid-base balance: -heavy exercise: metaboli acidosis partially compensated by hypocapnia left ventricle, less of the right ventricle, atria and of pulmonary veins.
(tendency to the respiratory alkalosis). Reflection in ECG curves – mainly over LV (V3-V5).
Adaptation hypotony – tracking“ to elderly.
Metabolism of the skeletal muscle cell
Effects of training to the respiratory system
- Very short-lasting performances (to 20 second): utilization of the intracelular ATP a CP
Increase in volumes/capacities (VC, FVC) – by 20-30%
stores. (In some seconds are exhausted ATP stores.)
Ventilatory reserve – rise from 1:5-7 to 1:9-15
Longer voluntary apnoic pauses
-Exercise duration to 6 min: In the 1st min – anaerobic glycolysis, lactat accumulation.
Increase in max. O2 intake/consumption (from 3 to 7 l/min)
Anaerobic glycolysis -maximum in 45 seconds. Aerobic metabolism starts again after 2
minutes.
Bone system
- Endurance performances: Aerobic metabolism – glycogen stores + O2. Time of the exercise Load – remodelation
Activation of the osteoclasts and osteoblasts.
is limited mainly by exhausting glycogen stores.
Fatigue
Termoregulation
Limitation of the performances
Muscular work – increase in heat production - central temperature.
1)Peripheral, physiological (in muscles): Exhaustion of metabolic reserves,accumulation of
Sweating rate up 1 l / hod. Throgh sweat - excretion of lactic acid.
metabolites.
Long lasting sweating – fatigue of sweating glands – arrest of sweat production/evaporation –
hyperthermia.
2)Psychological (central): CNS – protective mechanism, a subjective feeling, deceleration of
the signal transmission, inhibition of thinking and decision processes, sensoric function,
If exercise/heavy muscular work is performed in hot environment – redistribution of blood to
anxiety, emotional lability.
skin circulation – limited skeletal muscles perfusion and physical output.
1)Physiological: Tachycardia, tachypnoe...
Effects of training on physiological parameters
2)Pathological: + spasms of musculature, tremor, hyperemic skin (+ white spots), nausea,
headache, hypotension, cyanosis, dyspnoe...shock.
Training = regular exercise, repetition of sport activities
Reactions to non-physical forms of loading
Without training After training
Psychological and emotional load
Blood volume (l) 5,6 5,9
Reactions similar to physical exercise effects: Tachycardia, hyperventilation, sweating,
HRrest/min 80 40
cutaneous hyperperfusion, sympathoadrenal system activation, increasing of energetic
HR max 180 180
substances concentration in plasma – without increased consumption....
SVrest (ml) 70 140
Stress – alarm reaction. Civilisation - psychosomatic diseases.
SV max 100 190

21 22
 PHYSIOLOGY OF MUSCLES Neurotransmitter - Acetylcholine – synthesized in the cytoplasm
of the terminal of an end – plate. Enzyme acetylcholinesterase –
1) Skeletal for destruction of Ach.
2) Cardiac
3) Smooth Action: When the action potential spreads over the terminal, the voltage – gated calcium
channels open and large quantities of Ca++ diffuse to the interior.
1) Skeletal Muscle
The calcium ions exert an attractive influence on the Ach vesicles and these vesicles empty
Anatomy and Histology their Ach into the synapsis – by exocytosis.

Muscle fibers (10-80 microns in diameter) = extrafusal fibres – Ach – opens Acetylcholine – gated ion channels – it allow to
surrounded by the sarcolemma. Each fiber contains several large amount of Na+ ions to pour to the inside – carrying large
hundred – thousand myofibrils. Each myofibril has about 1500 numbers of positive charges = local end-plate potential 50-75 mV – which initiates an action
myosin filaments and 300 actin filaments. potential.

The filaments are in a matrix – sarcoplasm, in the sarcoplasm Action potential of the skeletal muscle
- sarcoplasmatic reticulum.
Resting membrane potential = - 80 mV to - 90 mV
The T-system – is continuous with the sarcolemma = the transverse tubules – run transverse Duration of action potential = 1-5 ms (five times as long as in large
to the myofibrils, branch among themselves. myelinated nerves)
Velocity of conduction = 3-5 metres/s
Striations:
Bands „I“ – light bands contain only actin filaments – isotropis Depolarization is a manifestation of Na+ influx, repolarization
Bands „A“ - dark bands – myosin + actin filaments – anisotropic of K+ efflux – like in nerves.
Zone „H“ – lighter band in the bands „A“
Line „Z“ – dark – in the bands „I“ Transmission of the action potentials along transverse tubules.
It causes the release of Ca+2 ions form the sarcoplasmatic reticulum –
The area between 2 „Z lines“ = sarcomere calcium ions cause contraction.

Biochemical characteristics This overall process is called excitation – contraction coupling

The myosin filament – multiple myosin molecules–each m.w. 460 000 Ca++ initiates contraction by binding to troponin C - the binding
1 molecule = six polypeptide chains – 2 heavy chains of troponin I to actin is weakened, tropomyosin moves laterally and uncovers binding sites for
- 4 light chains the myosin heads.

The actin filament – complex of 3 different protein components: - When the head attaches to an active site, this attachment causes
- actin, changes in the intramolecular forces between the head and arm.
- tropomyosin,
- troponin The head is tilting toward the arm and the actin filament is moved along with it.
Hexagonal arrangement of actin and myosin filaments =
1 myosin surrounded by 6 actin filaments. After tilting, the head automatically breaks away from the attach site. The head returns to its
normal direction. The head combines with a new active site ...next step- „walk – along“
Mechanisms of excitation and contraction of skeletal muscle theory of contraction or „sliding“ mechanism of contraction.

1) Mechanisms of excitation

The skeletal muscle fibres are innervated by alpha – motoneurons

(myelinated) – from the anterior horns of the spinal cord.
Neuromuscular junction – the „motor end – plate“

23 24
Sequence of events in contraction and relaxation of skeletal Mechanisms of excitation and contraction of smooth muscle
muscle. Regulation:
Autoregulation – myogenic – pacemaker cells
Steps in contraction: Humoral - catecholamines, estrogens, oxytocin ...
only unvoluntary control
1) Discharge of motor neuron.
2) Release of transmitter (acetylcholine) at motor end-plate. Neuromuscular junctions of smooth muscle:
3) Binding of acetylcholine to nicotinic acetylcholine receptors. Autonomic nerve fibres – diffuse junctions – secretion of a transmitter substance into the
4) Increased Na+ and K+ conductance in end-plate membrane. interstitial fluid – diffusion to the muscle cells.
5) Generation of end-plate potential.
6) Generation of action potential in muscle fibers. Terminal axons have varicosities are vesicles containing transmitter
7) Inward spread of depolarization along T tubules. substance – Ach/NA.
8) Release of Ca2+ from terminal cisterns of sarcoplasmatic
reticulum and diffusion to thick and thin filaments. The most SM cells are innervated by parasympathetic + sympathetic
9) Binding of Ca2+ to troponin C, uncovering myosin binding nerves.
sites on actin. Exceptions: m. arectores pilorum – only sympathetic
10) Formation of cross-linkages between actin and myosin and m. ciliaris - only parasympathetic nerves
sliding of thin on thick filaments, producing shortening.
Summation of contractions
Steps in relaxation: All /or none law – valid only for 1 fibril but not for whole skeletal
muscle. Muscle as a whole has not a refractory period. Repeated
1) Ca2+ pumped back into sarcoplasmic reticulum. stimulation – summation of contractions – tetanic contraction.
2) Release of Ca2+ from troponin.
3) Cessation of interaction between actin and myosin. Tetanic contractions: - complete tetanus
- incomplete tetanus
Manifestations of the skeletal muscle activity
Mechanisms of gradation of muscle response:
1) Electrical - polarisation, depolarisation, repolarisation – the increase of discharge frequency in individual motor nerve.
The stimulation frequency for complete tetanus (summation of
Recording of the electrical activity = electromyography. contractions) - in cold-blooded e.g. frogs = 20 Hz
Surface EMG – by using metal disks - in mammals + humans = 50-100 Hz
Deep EMG – needle electrodes in a single muscle – the recruitment of motor units (MU) = more MU are activated
e.g. with increasing voluntary effort.
2) Chemical - three pH changes:
- a decrease – dephosphorylation of ATP Receptor of the skeletal muscle
- an increase - - “ - of phosphorylcreatin –
- formation of basic creatine Muscle spindles – consists of 2-10 muscle fibres = extrafusal fibres + endings (primary,
- a decrease – acumulation of the lactic acid secondary)

3) Mechanical Innervation (motor) of the skeletal muscle

Record = myographic curve - alpha motoneurones – extrafusal fibers
- gamma motoneurons – intrafusal fibers
Latency time for transmission of the action potential through motoneuron, end – plate (2-2 Both from spinal cord.
ms), T – tubules – EC coupling
The motor unit (MU) = all muscle fibers supplied by a single motor neuron (3-6 muscle
Types of contraction: fibers/motoneuron – in muscles for precise movement – hand, eye ..., 100-500 in the leg, back
- isometric (same length) ...)
- isotonic (same tone)

25 26
 Skeletal muscle blood flow Cori cycle
muscle Blood
2
2000 – 2500 capillaries/mm area
In resting muscle – open only 100/mm2. BF of resting skeletal muscle 2-4 ml/100 g/min
During contractions BF is stopped – between contractions is increased as much as 30-fold – glucose
50-100 ml/100 g/min ↓ ← ↑
Rhytmic exercise. glycogen glycogen
↓ ↑
Physical manifestations of the skeletal muscle activity lactic acid → liver

1) The strength (force) = maximal weight held against the gravity Muscle fatigue
(maximal contraction against a maximal load):
- in cold-blooded animals 3-4 kg/cm2 Prolonged and strong contractioins - depletion of glycogen
- in humans 3-10 kg/cm2 - exhaustion of metabolic sources
Dynamometers. - accumulation of metabolites

2) The work – a) positive – during isotonic contraction – against Neuromuscular junction – muscle – nerve
gravity (force/weight/times distance) Central fatigue – synapses of motor area – protective effect
b) negative – when weight is lowered – the muscle Orbelli effect – sympathetic and/or catecholamines – put off fatigue
actively resists the descent of the object –
but weight x distance (negative) is done Contracture:
c) static – during isometric contraction – a muscle - long-lasting contraction – if transport of Ca2+ into the reticulum
generates force but cannot shorten or lengthen is inhibited – a relaxation does not occur.

The overall mechanical efficiency of skeletal muscle (work done/total ATP is necessary for re-transport of Ca2+ - lack of ATP
energy consumption) = 0% during isometric contraction up to 35%
(isotonic contraction) Rigor mortis:
After death – complete depletion of ATP and phosphorylcreatine –
3) Heat production accumulation of lactic acid – a decrease of pH – katabolic without
- Resting heat – at rest – in basal metabolic processes anabolic processes.
- Initial heat - 1) activation heat – also without contraction The myosin heads attach to actin in fixed way.
2) shortening heat – only in isotonic
- Recovery heat – for restoration to muscle´s precontractory state Nysten law – in order:
- Relaxation heat - after isotonic contraction for return of the heart (1-2 hours), skeletal musculature (3-6 hours):
muscle to its previous length. diaphragm – head – neck – trunk – arms – hands – legs.
Changes in temperature 10-3 to 10-4 ºC
The relaxation in the same time order – after 1-5 days.
Energy sources for skeletal muscle contraction Proteolytic enzymes.

ATP – for transport Ca++ and „head“ myosin movements SMOOTH MUSCLE
Resynthesis of ATP – from phosphorylcreatin
Resynthesis of phosphorylcreatin – from glycogen ← phosphorylases a,b – cca 3% of b.w.
Morphology
Another sources – free fatty acids, acetoacetate acid, amino acids SM lacks visible striations – only „A“ substance – anisotropic.
FFA – the major substrates for muscle at rest Thin membrane, central localized nucleus, fibres 120-380/2-10 microns.
Poorly developed a sarcoplasmatic reticulum, a few of mitochondria.
Actin, myosin, tropomyosin – but without troponin

27 28
Types: Sequence of events in contraction and relaxation of the smooth
muscle.
1) Visceral – syncytial smooth muscle – because of its
interconnections among fibres. In the walls of most hollow 1) Ca2+ ions come from the membrane
viscera: the gut, the bile ducts, the ureters, the uterus, the 2) Ca2+ bind with calmodulin and activate myosin
bronchi, the bladders, the blood vessels ... (= single – unit-SM) kinase – a phosphorylating enzyme
3) Myosin kinase phosphorylates one of the light
Control of visceral SM by humoral – non-nervous + nervous chains of myosin head (regulatory chain) – head
signals. achieves the capability of binding with the actin
filament.
2) Multi-unit – each fibre operates independently of the others –
is often innervated by a single nerve ending. Their control is Differences between skeletal and smooth muscles
exerted mainly by nerve signals. Like skeletal – but without
voluntary control. Morphology Skeletal Smooth

M. arectores pilorum, m. ciliaris. - fibres long short

- nuclei many 1
Physiological properties of the smooth muscle - sarcomere + -
- syncytium - +
1) Plasticity – adaptation to volume – without the increase of the tone - sarcoplasmatic good developed poor developed
(e.g. receptive relaxation ) reticulum
- ATP-ase many a few
2) Electrical activity – in the resting state the membrane potential - the motor end - + -
about -50 to –60 mV (less than in skeletal muscle). Unstable plate
potential – changes in potential itself without an extrinsic - innervation motoneurons autonomic nerves
stimuli. - distensibility limited high – plasticity

Often associated with a basic slow-wave rhythm. Function

Spike potential – in single-unit SM (10-15 ms) - pacemaker cells - +

Action potential with plateau – onset – similar but repolarization - resting potential stable unstable
is delayed for several hundred to several thousand ms - prolonged
periods of contraction (the uterus, the vascular smooth muscle ...) - action potential uniforme (like nerve) low amplitude with
superpone spikes,
3) Excitability – high – labile. SM cells react to different stimuli: plateau
mechanical, humoral, temperature changes
- mechanisms of Ca+2, troponic C, Ca+2, calmodulin
4) Contractility – long latency, the prolonged periods of contraction. contraction
Slowness of onset of contraction and relaxation.
Often rhythmic contractions. Smooth muscle fatigue – - sensitivity to humoral low high
relaxation – no contracture. substances

4) Excitation – contraction coupling – slow process. Long latency – - duration short long-lasting up to
- 50-100 ms after excitation – full contraction about ½ s latter. of contraction permanent
Smooth muscle does not contain troponoin - but another
regulatory protein – calmodulin.

29 30
 RENAL PHYSIOLOGY
Glomerular filtration (GF) – due to a work of heart – energy of cardiac systole –
Organs with excretory function: kidneys, lungs, liver, GIT, skin also energy for GF
Renal functions: 1) Excretory Filtration pressure (FP) = BP – (Poncotic + Phydrostatic) = 60 – (25 + 15) = pribl.
2) Control of the concentrations of the body fluids 20 mmHg – but only at the afferent end of the
3)Endocrine glomerular capilaries. Fluid leaves the plasma,
Physiological anatomy and histolog ofthe kidney oncotic pressure rises, FP decreases to zero → GF
Nephron = functional unit only in the beginning of the glomerular capillaries.
One kidney contains about 1 million nephrons, (2 millions together).
Basic anatomy of the nephron: Regulation of GF = Regulation of the RBF
Glomerulus afferent arteriole, capillaries, efferent arteriole, Changes in GF:
Bowman´s capsule - In newborns – 20 % GF/100 g in comparison with adults
Proximal tubule – in cortex - Decrease inthe night, during sleep by 30 %
Loop of Henle – descending limb - thick and thin segments - Decrease in orthostasis, excessive physical effort
- ascending limb (in medulla) - Stop if BP will decrease under 40 mmHg
Distal tubule – in renal cortex
Collecting duct – cortical The glomerular filtration rate (GFR)
- medullary
Large collecting ducts (250), each transmits the urine from about 400 nephrons = quantity of glomerular filtrate formed each minute in both kidneys
The sum of the inner surfaces – total excretion and resorption surface = 5-7 m2. = 120-125 ml/min in men
Renal calyces, renal pelvis, ureters, urinary bladder. = 110 ml/min in women
The toal quantity per day = 180 l (over 99 % of the filtrate is reabsorbed)
The glomerular filtration The filtration fraction (FF) = the fraction of the renal plasma flow that becomes
Glomerular filter: glomerular filtrate.
Glomerular membrane – 3 major layers: The normal plasma flow through kidneys = 650 ml/min, normal GFR = 125 ml/min = >
1) Capillary endothelial layer FF = 16-20 % (0.16 – 0.20)
2) Basement membrane
3) Layer of epithelial cells Composition of the glomerular filtrate
Glomerular filtrate is the same as plasma, except that it has no significant amounts of proteins
Permeability of the glomerular filter (0.03 %).
- Capillary endothelial layer – fenestrae – 100 nm in diameter
- Basement membrane – meshwork of collagen and proteoglycans fibrilae In increased glomerular permeability (e.g. nephrotic sy.)
- Epithelial cells – podocytes with pseudopodia – filtration slits – 25 nm wide - loss of plasma proteins into the urine
The glomerular filter permits the free passage of substances to 4 (40 angstroms)
nm in diameter, 4-8 nm – selectively, > 8 nm totally excludes. Renal circulation
Molecular weight: substances < 70 000 D – pass through GF
> 90 000 D – do not pass Renal BF = 1300 ml/min = 20-25 % of CO = renal fraction of the CO
70 – 90 000 – by the molecules shape (400 ml/min/100 g)

The plasma protein albumin molecule is only about 6 nm and it does not Renal artery – small arteries – afferent arterioles – glomerular capillaries –
pass ← the basement membrane with a complex of proteoglycans has - efferent arterioles – peritubular capillary system – venules – veins – renal vein
very strong negative electrical changes – like plasma proteins = electrostatic Two cappillary beds
repulsion of the molecules. Pressures in the renal circulation:
High capillary pressure in glomerulus
Summary: 2 basic regulatory limitations for filtration:
1) The sizes of the pores in the membrane Regulation of the renal blood flow
2) Its negative electrical charge Autoregulation
– myogenic (Bayliss, l902) – the ability of organs to regulate their own BF. Intrinsic
contractile response of smooth muscle to stretch. The increase intramural P → distention of
the smooth muscle → depolarization of the muscle cells → contraction.

31 32
The wall tension is proportionate to the distending pressure times the radius of the vessel.
Angiotensinogen
- metabolic – through vasodilator substance. (tetradekapeptide – liver, plasma)
When BF increases → vasodil. substances are washed away → vasoconstriction; vice versa.
- tissue pressure hypothesis of autoregulation: Kallikrein + Heparin -
When BF increases the accumulation of interstitial fluid → compression ↓
of the capillaries and venules. Prorenin → Renin →
Angiotensin I (dekapeptide)
Neural: sympathetic nerves (Th6 – L3) – vasoconstrictioin, only during orthostasis,
physical effort, stress. The resting tone does not exist. Captopril -
Humoral: Angiotensin converting enzyme →
- catecholamines – vasoconstriction (ACE) lungs
- renin-angiotensin aldosterone system – vasoconstriction
- system kallikreins – bradykinin Angiotensin II (oktapeptide)
- kalidin ← Endopeptidase
Hageman f. Aminopeptidase → ← Karboxypeptidase
↓
Prekallikreins → Kallikreins (glycoproteins – liver, kidneys)
Angiotensin III (heptapeptide) Angiotensin 1,7
Kininogens → kalidin + bradykinin - vasodilatation, (aldosteron) (inactive metabolic)
(alpha2 plasma proteins) ↓ PVR, ↑ diuresis,
natriuresis
Stimuli that increase renin secretion.
- prostaglandins – PGE – vasodilatation,↓ PVR Sodium depletion, diuretics, hypotension, hemorrhage, upright posture, dehydration,
constriction of renal artery or aorta, cardiac failure, cirrhosis, various psychological stimuli.
System kallikreins, prostaglandins = counterbalance to the RAA system Hypotension, hypovolemia, hyponatremia

- Adenosine – ATP → AMP → adenosine → vasoconstriction in afferent Actions of RAA system

arterioles → ↓ GF 1) Vasoconstriction – mainly in vasa efferens – increase in BP in glomerular capillaries and
- Bacterial pyrogens – vasodilatation GF
- Drugs – hydralazines, coffein etc. – vasodilatation Effect – direct/ indirect – through catecholamines (NA)
- Hypoxia – under 50% sat. O2 – vasoconstriction 2) Positive inotropic effect
3) Facilitation of the release of – noradrenaline
The Renin – Angiotensin – Aldosteron System (RAR) - vasopressin
- ACTH
Tigerstadt l898 – kidney extract ––––– hypertension - aldosterone
The substance – renin 4) Dipsogenic effect – through subfornical organ –
Renin – product of the granula – juxtaglomerular (JG) cells - synthetized and stored in - increase in water intake
an inactive form – prorenin.
Stimuli – intrinsic reaction – prorenin molecules are converted by tissue kallikrein – renin. During hypotension and/or hypovolemia and/or hyponatremia:
1) Vasoconstriction and improvement in cardiac function
Renin = a proteolytic enzyme. 90 % in kidneys, 2) Sodium and water retention
10 % brain, heart ... 3) Increase in water intake

Regulation of Renin Secretion

1) Autonomic nervous system – beta sympathetic + through beta 1 and cAMP

- alpha - " –
Inhibition of renin secretion by beta adrenergic blocking agents (propranolol)
2) Baroreceptors in vasa afferens – decreased afferent arteriol pressure →

33 34
 stimulation of renin secretion
3) Chemoreceptors in the macula densa. Renin secretion is inversely proportionate to
the rate of transport of Na+, Cl- to the distal tubules → increased renin secretion
4) Humoral factors – Prostaglandins stimulate renin secretion Functions of the Collecting Ducts
- Catecholamines stimulate renin secretion Changes in osmolarity and volume mainly by means of the countercurrent multiplication
- Vasopressin inhibits - " - system:
- ACTH
5) Negative feedback – increase concentration of angiotensin II – inhibits renin secretion Fig.
Two tubes separated by semipermeable membrane – with ability to transport molecules of
a substance in one-way. If the tubes are fulfilled with a stationary fluid – the activity of the
Tubular Functions membrane increases the concentration of the substance in tube A. When the fluid flows – the
mostly concentrated fluid will be accumulated at the beginning of the tube B.
The glomerular filtrate = 170-180 l/day – definitive urine = 1 – 1.5 l After connection of the next tube C – separated from the tube B by a membrane permeable
Modifications of the volume and composition of the filtrate in the tubules. for water – the solution flowing in C will become gradually more concentrated by the osmotic
The glomerular filtrate flows through: forces acting between B-C.
1) the proximal tubule
2) the loop of Henle Application of the countercurrent system in kidneys
3) the distal tubule
4) the cortical collecting duct - Descending limb of the Henle´s loop is permeable for water and Na+
5) the collecting ducts - The ascending limb of the loop is relatively impermeable to water and permeable to Na+,
Cl-,
The tubules may a) remove some substances from the filtrate = reabsorption urea. Accumulation of the solutes → hypertonicity of the interstitium.
b) add some substances to the filtrate = secretion/excretion - The collecting duct is relatively impermeable to urea but permeable to water (in the
c) both actions presence of
vasopressin). Interstitial hypertonicity is supported also by active resorption of Na form the
Functions of the Proximal Tubule duct to the interstitium.
Efect: the absorption of water = concentration of urine.
Reabsorption – passive absorption – water – 60-80 % = obligatory absorption
- active transport – glucose + Na+ co-transport The role of vasa recta = additional countercurrent exchanger.
- Na+, K+, AA, acetoacetate ions, vitamins Descending vasa penetrate to the hypertonic portion – there water diffuses out of the vessels –
and in the hypotonic portion – water diffuses into the vessels. The way of the solutes is in
Active transport – limited – by the ability of the energy and transports = transport opposite direction. Recirculation of the water and the solutes from and into vasa recta helps to
maximum maintain hypertonicity.
of the absorption (Tm). After exceeding of Tm – the transport mechanism is saturated and the
substance occurs in the urine. URINE

Glycosuria – in hyperglycemia > 10 mmol/l = renal threshold for glucose Volume:1000 - 1500 ml/24 hours - in adult
TmG in men = approx. 375 mg/min Vary with fluid intake and withfluid output form other routes - skin, lungs, gut.
in women = approx. 300 mg/min (Volume reduced during sleep and muscular exercise).

Secretion – when the concentration of the substance is higher in the loops of Henle than Specific gravity: 1010-1035 kg/m3. (Specific gravity greater on protein diet.)
in glomerular filtrate. Mostly – active:
- heterogenous substances – penicilin, phenol red and sulphonphtalein dyes, sulphonamides, Reaction: Usually slightly acid- pH 4.5-8 – average 6.0
PAH – exogenous (Varies with diet- acid on ordinary mixed diet, alkaline on vegetarian diet.)

Colour:
Functions of the Distal Tubules Yellow due to urochrome pigment –probably from destruction of tissue [Link]
Length cca 17 mm – 40 l of fluid/day comes to the tubules and darker in early morning –less water excreted at night but unchanged amounts of urinary
Absorption of the water (about 5 – 15 %), Na+ (regulated by aldosterone). solids.

35 36
Odour: Aromatic when fresh → ammoniacal on standing due to bacterial decomposition of - activation of sympathetic → Relaxation of bladder wall.
urea to ammonia.

MICTURITION

COMPOSITION of the urine: = stretch reflex – carried out through centres in spinal cord. In older children and adults –
reflex can be controlled and inhibited voluntarily.
Water - - - - - 1000-1500 ml/24 h
Inorganic substances millimols excreted in 24 h Stimulus: Distension of the receptors in smooth muscle
Sodium - - - 200 When empty, pressure in bladder is [Link] 50 ml urine collect→pressure ↑ to 10 cm H2O
Chloride- - - 200 up to 300 or 400 ml → little increase in pressure.
Calcium - - - - 5 (As bladder distends, walls of ureter are pressed together preventing regurgitation of urine.)
Potassium - - - 50
Phosphates - - -25 Afferent pathways to the higher centres through pons and midbrain. Sensations to
Sulphates - - - 50 consciousness

Organic substances Micturition center: Parasympathetic S2 – S4

Urea - derived from breakdown of protein – therefore varies with protein in diet. Sympathetic efferents L1-3 - inhibits ganglia
Uric Acid - comes from purine of food and body tissues.
Creatinine - from breakdown of body tissues; uninfluenced by amount of dietary protein. Efferent pathways: Impulses in parasympathetic nerves (pelvici)and in somatic nerves
Ammonia - formed in kidney from glutamine brought to it by blood stream; (pudendal).

[In the newborn, volume and specific gravity are low and composition varies.] Effectors: Smooth muscle in BLADDER WALL - contraction, sphincters smooth muscle –
internal + striated muscle external -relaxation

Effect = Urination – micturition

PHYSIOLOGY OF THE URETERS AND URINARY BLADDER

URETERS convey urine from kidneys to bladder: Long, narrow muscular tubes. Smooth
muscle coats with outer fibrous tissue coat and inner mucous membrane. PHYSIOLOGY OF THE NERVOUS SYSTEM
Slow waves of contraction (every 10 seconds)propel urine along ureter. 1-5 small ´spurts´
enter bladder per minute. RETICULAR FORMATION, EEG, SLEEP

URINARY BLADDER acts as reservoir for urine: Hollow muscular organ. (Size and RETICULAR FORMATION
position vary with amount of urine - stored (120-320 cc). RF = reticular-diffuse connections of neurons, cells don't form obvious nuclei
Smooth muscle coats –distend as urine collects: contract periodically to expel urine to urethra. - med. oblongata, pons Varoli, thalamus
Smooth muscle of bladder wall runs down into urethra.
Internal shincter. → analyzer
External sphincter. → integrator
Circular striated muscle (under voluntary control – CNS). → „control“ of CNS
STORAGE AND EXPULSION OF URINE → concentration of various information from CNS and receptors to small number of neurons -
general system for controlling the level of activity of the brain and the spinal cord
Urine is formed continuously by the kidneys. It collects, drop by drop, in the urinary bladder
which expands to hold approx. 300 ml. When the bladder is full the desire to void urine is Functions of RF:
experienced. - regulator of ANS (heart rate, breathing rate, GIT)
- sleep, fatigue, control of consciousness
When bladder is empty and beginning to fill – - modulation of pain
- motivation to perform any activities
- inhibition of parasympathetic - control of walk, eating, urination, defecation, sexual activity...

37 38
 - control of some forms of behavior
- predisposing factor for personality: introvert/extrovert ... Activity of Reshaw cells:
Spinal motoneurons give off a recurrent collateral - synapse with an inhibitory motoneuron
→ coordination of somatic and autonomic ff. (Renshaw) - terminates on the cell body of the same spinal neuron or other SN - inhibitory
→ coordinator of efferent info → organism as a whole synapse with mediator (glycine) → inhibition of discharge of the SN

RF: → desc. system of RF acts on motoneurons of extensors

ascendent neurons → cerebral cortex → RAS (control by cerebellum and cerebral cortex)
descendent neurons → spinal medulla
- facilitation - decerebration rigidity: transsection at the level of lamina quadrigemina → elimination of
- inhibition inhibitory influence from CNS – predominance of facilitation - ↑ tone, spasticity of extensors
(opistotonus)
Ascendent system:
- activates cortex, hypothalamus, limbic sy Descendent system of RF:
↓ Facilitation area Inhibitory area
reticular activation system (RAS)
↓ dorsolateral – MO, PV, ventromedial - MO
RAS + thalamus (non-specific nuclei) mesencephalon, diecephalon
↓ bigger area – small cells smaller area – big cells
keep consciousness mostly crossed fibres mostly uncrossed fibres
Activation: Activation:
- el. stimulation of RAS: → „arousal“ reaction on EEG statokinetic receptor spinal cerebellum
vestibular cerebellum basal ganglia
- non-specific system collaterals of specific sensor cerebral cortex
pathways
- activation influence on RF: cerebral cortex
important for entrance of info into consciousness, formation of temporary connections
Function: Function:
→ higher forms of behavior (learning, memory...)
↑ excitability of spinal centers of ↓ spinal reflexes
- RAS acts on the level of concentration on sth. somatic reflexes (especially tone of extensors)
- modulation of afferent information from receptors (vision, hearing, proprio) acts on reflex tone antigravitation ↓ voluntary movement
- stimulation of RAS: muscles
• epinephrine ↓ tone of flexors
• mild hypoxia Importance:
• hypercarbia keeping posture and position of the
• impulses from proprioreceptors and nociceptors body

- destruction of RAS („cerveau isolé“) → deep sleep, miosis, Ø response to stimulation Gama system and RF: 2 types of pathways to γ neurons

Descendent system: [Link] fascicles of thicker fibers with rapid conduction of excitation
- via tr. reticulospinalis → spinal interneurons → coordinate fast movement and setting the tone
- effect on motoric function: 2. disperse thin fibers with small speed of conductivity
tone and movement → set muscular tone of large areas
↓
control of voluntary and involuntary movement RF:
- regulates muscular tone and motility
- descendent neurons act: - influences autonomic ff. (body temperature, sexual ff., water metabolism...)
a. on α and γ spinal motoneurons - continuous activity (10-20 excitations/s)
b. on Renshaw interneurons - control of vigility and sleep – hypotonia, depressed motility

39 40
 - related to RAS and non-specific thalamic system

ELECTROENCEPHALOGRAPHY (EEG): → functional neuronography: maping of cortical areas according to the projection of
= recording of electrical activity of the brain individual receptor areas

→ EEG (electroencephalography) – recording from surface of the skull Ontogenesis of EEG:

→ ECoG (elektrocorticografia) – recording from surface of the brain - newborn: delta 1-3/s, but with low ampl. (50 µV)
- in 2.-3. year: beginning of theta
- changes of summation potential of huge number of neurons (depolarization: deviation ↑, - in 3.-4. year: beginning of alpha in occipit. leads
hyperpolarization: deviation ↓) - after 10. year: well-formed alpha rhythm (delta-theta-alpha)
- after 60. year: less alpha, more theta (alpha-theta)
- electrodes (10-20): unipolar, bipolar (longit., transvers., circul. arrangement)
- change in potential → wave: frequency and amplitude
SLEEP:
Rhythm: Vigility:
alpha (Berger rhythm): 8-13 Hz, ampl. 30-50 µV = situation when organism dinamically and knowingly communicates with his environment
→ rhythm at rest, vigility with closed eyes
- role of RF:
beta: 14-30 Hz, ampl. 5-10 µV → afferent information from receptors
→ rhythm of activity → efferent impulses from cerebral cortex
→ influence on adrenal medulla
Desynchronization: transition of alpha into beta rhythm
→ opening the eyes, sensoric stimulus, mental activity Sleep:
arousal response: RAS, non-specific nuclei of thalamus - unconsciousness from which the person can be aroused by sensory or other stimuli
(compared to coma)
theta: 4-7 Hz, 50 µV
→ vigility in children - sleep centers: hypothalamus
→ emotional stress in adults nuclei of thalamus
reticular formation
delta: 1-3.75 Hz, 100-150 µV telencephalon
→ deep sleep
Hypotheses of sleep:
- ancient (Greece) – soul (consciousness) goes away from the body during sleep –
Clinical importance of EEG:
Thanatos (God of death), Hypnos (God of sleep), Oneiros (God of dreams)
- neurology (pathological conditions, hematoma, epilepsy)
- psychiatry (depressive disorders) - circulatory hypothesis: ↓ blood flow in brain → sleep
- depth of anesthesia, determination of biological death, research (in space)... - ↓ activity of RF (RAS) – non-specific thalamic nuclei (stereotypes to decrease
activity of RAS)
EEG investigation: - chemical hypothesis: hypnotoxines – DSIP (delta sleep inducing peptide), PG D2 ↑
- rest rhythm + activation methods to change the rhythm, resp. to provoke pathological sleep, PG E2 ↑ vigility
discharge in the brain (opening the eyes, hyperventilation, photostimulation...) - humoral theory – serotonine ↑ sleep, noradrenaline ↑ vigility, fight or flight

Investigation of evoked potencials: A. Non-REM sleep: 4 stages

- EP = potencials evoked by a stimulus (light, sound...) [Link] of vigility to snooze:
- muscle tone decreased, slower breathing
1. Primary EP: - EEG: waves with ↓ ampl. and ↑ frequency (beta)
- potential from specific cortical structures
- highly specific by its localization – recorded over endings of sensoric pathways 2. snooze:
- relaxed position
2. Secondary EP: - EEG: sleep spindles (similar to alpha rhythm, but RF not completely supressed), ampl. 50
- without specific localization µV, freq. 10-14/min.

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 autonomic“ – involuntary (independent on a human will)
3. light sleep: - the portion of the nervous system that controls the visceral functions of the body helping to
- hypotonia of muscles maintain a dynamic and static conditions in the internal enviroment
- EEG: ↑ ampl., ↓ freq. ↓
- homeostasis
4. deep (delta) sleep:
- slow breathing, ↓ heart rate, total regeneration, synchronization ANS reflex:
- EEG: ↑ ampl., very low freq. (delta waves) Receptors:
chemoreceptors, baroreceptors, mechanoreceptors....
B. REM sleep: Afferent pathway:
= paradoxical sleep: originally depressed higher etages of CNS (areas of cortex) now active Sensitive fibers
(„watch points“), older parts inhibited Centers:
- characterized by dreams In spinal cord, medulla oblongata, hypothalamus...
- hypotonia of muscles Efferent pathway:
- rapid eye movements Interrupted in autonomic ganglion → preganglionic and
- EEG: similar to vigility postganglionic neurons = two neuronal pathway
Effectors:
Organization of sleep stages: Visceral organs – heart, smooth muscles, glands
1. falling asleep
2. non-REM Efferent pathway of the ANS
3. REM - preganglion neurons:
the cell bodies are located in the intermediolateral gray
- non-REM and REM sleep (2. + 3.s.) repeat 4-6 x per night column or the motor nuclei of the cranial nerves
- 1 period = 90-100 min. - the axons – preganglionic fibers (myelinated slow-conducting B fibers)
- at the end of night ↓ 3. and 4. s. non-REM and ↑ REM - postganglion neurons
- REM is about 25 % of sleep – important for IQ (fixation of information in the memory) - the axons – postganglionic fibers (mostly unmyelinated C fibers)
- visceral effectors
→ sleep per day:
newborns 16-20 h. - each preganglionic axon diverges to an average of 8-9 postganglionic neurons → autonomic
adults 7-8 h. output is diffused → principle of divergency
older people 5-6 h.
Reflexes
Changes in sleep:
Non-REM sleep: SOMATIC AUTONOMIC
- predominancy of parasympathetic tone – predominant anabolic processes
- ↓ heart rate, f. of breathing and blood pressure Receptors: proprio-, exteroreceptors special rp.
- ↓ metabolism Afferen. In sensoric nerves in all types: symp.,pasy...
Centers spinal cord spinal cord, medulla oblongata,
- ↓ excitability of nervous system
pons, hypothalamus
- release of gonadotropines and STH (growth)
Efferent. one-neuronal two-neuronal
Effector skeletal muscles heart, smooth muscles, glands
REM sleep:
Reflex time short longer (neurotransmitter sec.)
- improved blood flow in brain stem and hypothalamus
Effect duration short longer
- ↑ local temperature and O2 consumption – ↑ brain metab.
Purpose control of posture control of autonomic functions
- ↑ synthesis of RNA and proteins (wound healing) locomotion
- ↑ excitability of receptors
- ↑ heart rate and breathing – „guard of the organism“

THE AUTONOMIC NERVOUS SYSTEM (ANS) The transmisson at the synaptic junctions in the ANS

43 44

autonomic synaptic junctions: 1. diffusion to the blood (capillaries)
 pre - and postggl. neurons 2. active reuptake mechanism (taken up to the noradrenergic neuron up to 70%)
 postggl. neurons and effectors 3. Inactivation of NA:
 by COMT (catechol-O-methyltransferase) - normetanephrine,
- chemically mediated by transmitter agents: and conjugates
principal transmitter agents: acetylcholine (Ach), noradrenaline (NA)  by MAO (monoamine oxidase) – 3methoxy-4-hydroxymandelic
 cholinergic fibers - Ach acid (VMA) and glycol
 noradrenergic (adrenergic) fibers – NA (A)
 nonadrenergic noncholinergic system (dopamine, VIP...) the effect duration is longer than Ach

Cholinergic neurons: Receptors of sympathetic nervous system:

all preganglionic neurons (sy + pasy !)

the anatomically postganglionic parasympathetic neurons  α – α1, α2

the anatomically sympathetic postganglionic neurons which innervate sweat glands  β – β1(cardiac rp.), β 2 (bronchial)
and which end on blood vessels in skeletal muscles (sympathetic cholinergic
vasodilator system) The influence:
α: vasoconstriction, intestinal relaxation....
Noradrenergic (adrenergic) neurons: β : ↑HR, ↑ contractility, vasodilatation, lipolysis...
- the remaining postganglionic sym. neurons
- the adrenal medulla – sympathetic ganglion Sympathomimetic drugs: NA, A, phenylephrine....
Sympatholytic drugs: phentolamine, propranolol
The transmitter agents:
I. Acetylcholine Physiological anatomy of the sympathetic nervous system
- synthesis: cholin+acetylCo A (acetyltransferase)  thoracolumbal division of the ANS
truncus sympaticus + sympathetic ggl
- inactivation: acetylcholinesterase: cholin+acetate  pregg. fibers – short
Cholin – the uptake for the resynthesis Ach  postggl. fibers – long
very short effect duration
Physiological anatomy of the parasympathetic nervous system
Receptors for Ach  craniosacral division:
- nicotinic (N) receptors  cranial outflow: III., VII., IX., X. (75-80%)
- in the synapses between the pre- and postganglionic  sacral outflow: S2-S4
neurons, in the neuromuscular junction  preggl. fibers – long
 postggl. fibers – short (located on or near the visceral struc.)
- muscarinic (M) receptors:
postggl. PS neurons Function of ANS subsystems
 M1 – Gp protein
 M2 – Gi protein SYMPATHETIC NERVOUS SYSTEM:
Parasympathomimetic drugs: Ach, methacholine...  emergency situations, predominant in conscious state
Parasympatholytic drugs: atropin, scopolamin...  stress
 increase of energy release – catabolic reactions
 positive trophic effects on the heart, hypertensive reaction
II. Noradrenaline (Norepinephrine)  bronchodilatation
- transmitter of postggll. sympathetic endings  inhibition of GIT activity
- CNS  mydriasis
Phenylalanine→Tyrosine→DOPA→Dopamine→Noradrenaline→ Adrenaline  glycogenolysis, ↑ glucose blood,, lipolysis
 ....
The terminations of the NA effects: PARASYMPATHETIC NERVOUS SYSTEM

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  recovery processes
 decrease of energy consumption – at rest, sleep... - many aff. and eff. connections among hypothalamus and other parts of CNS
 anabolic reactions
 negative trophic effects on the heart Functions of hypothalamus
 hypotension  integration with autonomic nervous system („center“)
 bronchoconstriction sympathetic – in dorsal (lateral) region
 Increase of GIT activity parasympathetic – in anterior region
 miosis....  temperature regulation (cutaneous cold receptors, temperature sensitive cells in
hypothalamus; anterior h.- heat; posterior h. - cold
Autonomic tone and excitability  endocrine control
Tone – there are discharges in autonomic nerves at rest  water balance and food intake
 reflex: (stimulation of baro-, chemoreceptors)  thirst (osmoreceptors, lateral superior hypothalamus)
 central (hypothalamus)  hunger: „glucostat“ cells sensitive to rate of glucose utilization
ventromedial satiety center
 sympathetic (e.g. smooth muscles in vessels) lateral hunger center
 parasympathetic (e.g. heart)  emotional (behavioral) and sexual functions
 biological rhythms (lesion of the suprachiasmatic nuclei disrupt the circadian
Excitability: - the ability to change the autonomic tone rhythm)

Autonomic reflexes Examination methods of the ANS

I. Classification by localization of receptors and effectors:
1. viscero-visceral I. Cardiovascular system
2. viscero-cutaneous  the variability of cardiovascular parameters
3. cutaneous-visceral  short-term, long-term
4. viscero-motoric
Ewing battery of cardiovascular tests
[Link] by organs and systems  deep breathing
[Link] – control of the HR, BP, barorp. reflexes....  orthostatic test
2. Respiratory – (e.g. H-B reflex...)  Valsalva manoeuvre
3. Gastrointestinal: (e.g. defecation)  hand-grip test
4. Urogenital system: (e.g. micturition)
5. others.... (e.g. eyes r.) other cardiovascular tests
 oculocardiac test, diving reflex, mental and physical load...
Regulation of the ANS  pharmacological tests...
 baroreflex sensitivity: simultanous continual recording of heart rate and blood
 spinal cord: (micturition, defecation....) pressure
 medulla oblongata (more complicated rr. – cardiovascular,  electrodermal activity (skin sympathetic response)
respiratory, salivation...)  MSNA (muscle sympathetic nervous activity) – microneurographic m.
 midbrain - eyes rr. - accomodation, pupillary
 HYPOTHALAMUS – center of the ANS Other systems:
 - “head ganglion of the ANS“ (Sherrington)  GIT: (e.g. evoked oesophageal potentials...)
 CAN - central autonomic network  eye reflex...
medial prefrontal cortex, insula, gyrus cinguli....
The cardiac activity – extreme sensitive to modulation of the ANS!

HYPOTHALAMUS Psychosomatic relationships

Connections:  cerebral cortex – the influence on the respiratory, cardiovascular, immune, autonomic
- with the posterior pituitary by neural fibers – hypothalamo-hypophyseal tract and other systems

- with the anterior pituitary by blood vessels – portal hypophyseal vessels (system)  relationships - cortex - organs

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 organs - cortex A: OPTIC SYSTEM
1. Lens system: 4 refractive interfaces:
 efferent influences of the cerebral cortex: air / cornea / aqueous humor / crystalline lens / vitreous humor
1. inducing - to provoke organ activity (e.g. cephalic influence of gastric secretion)
2. modulating - adjustment of the function (e.g. HR before work) ACCOMODATION:
= the process by which the eye increases optical power to maintain a clear image on the retina
 afferent impulses: from organs to the CNS (for far and near objects)
- disturbance of visceral functions → disturbance of cerebral cortex function
(pathological dominant) – nonadequate efferent impulses to the organs – Mechanisms: contraction of ciliary muscle (pasy, [Link]) → relaxing of suspensory ligaments
circulum vitiosus → convex lens with ↑curvature (elasticity) → higher refractive power (children: 20 → 34 D
..power of accomodation)
The principles of psychotherapy:
 the therapy of mental and physical disorders using psychological methods Presbyopia – in elderly people
(dialogue, communication, relaxation...)
relaxation method: Errors of refraction: - spherical (emmetropic, myopic, hyperopic eye)
 autogenic training (Schultz, 1932) - aspherical - astigmatism
 relaxation and concentration method
 the state of internal mental concentration and maximal somatic relaxation → 2. Pupil:
conditioned reflex - variable aperture system (1.5 – 8 mm)... miosis, mydriasis
 autosuggestion
Function: - to adapt the diameter of aperture to light conditions
mental concentration → somatic relaxation - relation to depth of focus

music therapy, meditation, yoga, hypnosis...
B: RECEPTORS AND VISUAL PATHWAYS
The physiological effects of relaxation methods
- the principle: to restore the balance between the activity of the sympathetic 1. Retina:
(F/F) and parasympathetic (rest and digest) branches of the ANS - light-sensitive portion of the eye, several layers

 CVS: ↓HR, ↓BP (ECG, FINAPRES) aa) Pigment layer (melanin prevention of reflection inside eyeball,
 respiratory system: ↓respiratory rate, slow and deep breathing (Respitrace) storage of vitamin A- exchange with outer segment of photoreceptors
 cerebral activity: alpha rhythm (EEG)
 muscle activity: ↓muscle tone (EMG) a) rods and cones: real photoreceptors of an eye - in outer segment- photosensitive pigment
 lower oxygen consumption (R: scotopsin, C: 3 types of photopsins I,II,III 30-300x less sensitive, differential spectral
 improvement of self-control, self-confidence.... sensitivities)

Biofeedback Photochemistry of vision:

 continual monitoring of several physiological parameters Rhodopsin (protein scotopsin + 11-cis retinal) light Reformation
(HR, BP, breathing, muscle tone, EEG...) trans-retinal scotopsin + [Link]
 voluntary influence on the followed parameters Retinal isomerase
 biofeedback + relaxation therapy cis-retinal
trans-retinol cis-retinol

THE SENSES Electrical changes: in conductance for Na+ and AP

THE SENSE OF VISION - distribution of photoreceptors

Vision: an ability to receive, process and interpret an information in the form of visible light - photopic and scotopic vision
to perceive the form, color, size, movement, and distance of objects
-eye: optic system - creation of an image on retina Dark adaptation:
-receptors and visual pathways - analysis of an image - biphasic time course: During the first phase, the light sensitivity threshold decreases
sharply before stabilizing after a few minutes. This first phase represents the

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adaptation of cones. 1. Floaters (muscae volitantes)
- After about 5 minutes, sensitivity increases again and stabilizes once more after about -slowly drifting transparent blobs of varying size and shape
20 minutes. This second phase represents the adaptation of rods. -particularly noticeable when lying on the ground
- mydriasis, ↑synthesis of photosensitive pigments looking up at the sky
-caused by imperfections in the fluid of the eye
Visual acuity: sharpness of vision
- Best developed in central fovea region (35.000 C, slender body, [Link] acuity- 25-60”) 2. Scheerer`s phenomenon = blue field phenomenon
- outside the foveal area - ↓density of receptors, ↑convergence) -noticeable when viewed against a field of pure blue light
- tiny bright dots moving rapidly along squiggly lines in the visual field
Testing of visual acuity - optotypes -caused by leucocytes moving in the capillaries in front of retina

b) bipolar cells 3. Phosphenes

-perception of light without light actually entering the eye
- depolarizing/hyperpolarizing on receptors stimulation -caused by mechanical, electrical, magnetic stimulation of retina

c) horizontal cells
THE SENSE OF HEARING
-lateral inhibition of bipolar cells – enhancing and detection of visual contrast
The importance of hearing:
d) amacrine cells
- orientation
- many types, various means of stimulation - warning against danger
- at communication
e) ganglion cells -transmission of signal to CNS – AP - speech self-control

-convergence (R: 60:1, C: 2:1)

-3 types: W (40%)- from R, broad fields, directional movements X (55%)- from C, small Anatomical notes:
receptive fields, color vision; Y (5%)- broad fields, to rapid changes of image
1. External ear – the pinna (helps to direct sounds), the external auditory meatus, auditory
2. Visual pathways: Canal – transmits sound waves to the tympanic membrane
2. Middle ear – separated from extrenal ear by tympanic membrane (called eardrum), chain
Collaterals of optic tract: of ossicles – the malleus, the incus, and the stapes. They connects the TM to the oval
Hypothalamus (circadian rhythm) window (an opening into the inner ear). Striated muscles: [Link], [Link] tympani.
Pretectal nuclei (accomodation, pupillary light reflex) Eustachian tube – connects middle ear to the pharynx and equilizes pressure differences
Superior colliculus (eye movements) between external and [Link] (flying, diving)
3. Inner ear – bony and membraneous labyrinth (cochlea and vestibular apparartus),
Field of vision: receptors for two sensory functions. Cochlea – spiral-shaped organ, divided by basal and
-visual area seen at given moment Reissneri membranes to three parts – scala tympani and scala vestibuli – by perilymph
- monocular, binocular (helicotrema), between – scala media – by endolymph). On basal membrane – organ og
- blind spot (15 deg. lateral to central point of vision) Corti with receptors – hair cells

Abnormalities: Adequate stimulus for auditory receptors – sound

-scotomata
-hemianopsia bitemporal (longitudinal lession of chiasm) - sound is produced by waves of compression and decompression transmitted in air (or
homonymous (lession of optic tract) other media such as water), propagation in the air – 335 m/s
- sound composed of many unrelated frequencies - noise
Entoptic phenomena:
- visual effects whose source is within the eye itself - frequency ([Link] waves per time) – gives height of the tone
- amplitude of the sound vawe – gives colour of the tone
- intensity of the sound in decibels (dB) – over 100 dB can damage organ of Corti, over 120

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 dB can cause pain
Basilar membrane serves as frequency analyser – it distributes the stimulus along the organ of
- normal human ear is sensitive to pure tones with frequencies between 16 Hz and 20 kHz Corti so, that different hair cells will respond to different frequencies of the sound – place
- less than 16 Hz – infrasound, over 20 kHz – ultrasound theory of hearing
- highest sensitivity of human ear – at 1-3 kHz - waves at high tones (high frequency sounds) activate the basilar membr. near the base of the
- speech – at frequencies 250 – 3000 Hz (about 65 dB) cochlea
- waves at low tones (low frequency sounds) – max. of the amplitude – at the top of cochlea
the phenomenon of masking
– the presence of one sound decreases the ability to hear other sound - the sound causes deformation of basal membrane, deformation of the hairs and occurence of
- absolute and relative refractery period of auditory receptors and nerve fibres beiing receptor (generator) potencial. If the RP is of a high intensity, it excites the cochlear afferent
stimulated before [Link] ⇒ elicits action potencials
- sound background – increases hearing threshold - frequency of AP in the auditory nerve is related to the sound volume

Sound transduction – the functions of external and middle ear Central auditory mechanisms
- the ear transformates sound vawes of external environment 1st neuron in ganglion spirale – axons of these bipolar afferent neurons form the auditory
to the action potencials of auditory nerves part of [Link] ([Link]), they end in [Link] dorsalis et ventralis between pons
and MO
1. transmission of souns through the ossicular system
- vawes cause the tympanic membrane to oscillate. The ossicles are connected to the TM by 2nd neuron – in cochlear nuclei, through crossed and non-crossed pathways to the sub-cortical
handle of the malleus, which is taughtly bound to the other bones. The vibrations are centers – colliculi inferiores (for acustic-motor reflexes)
transferred by the ossicular system through the oval window on the structures of inner ear some neurons – to the different nuclei in pons, FR, cerebellum
(by the vawe movement of perilymph)
- stimulation of the organ of Corti – causes action potencials in nerve fibres 3rd neuron – in corpus geniculatum mediale – to the projection neocortical field in gyri of
Heschl in temporal lobe, in Brodmanns area 41
function of [Link] and tensor tympani: when loud sounds are transmitted to the CNS - connection with other auditory cortical centers in temporal lobes – for further processing
through the ossicular system ⇒ reflex contraction of both muscles occures – attenuation of auditory information (auditory memory, understanding of the speech, …)
reflex – protect cochlea from damaging vibrations caused by excessively loud sounds
- importance of fasciculus olivocochlearis – efferent fibres, to hair cells, decreases the
2. transmission of sound through the bone response to the auditory stimuli - damping effect

- vibrations are transmitted by the bones of the skull on the fluid of inner ear Deafness – the loss of the ability to hear
- because the cochlea is embedded into the bony cavity
- (tuning fork or very loud sounds, especially the mastoid precess) Two most important types:
1. conduction loss (external and middle ear, foreign body in canal, infection)
3. transmission of the sound by the air 2. sensorineural loss (damage of organ of Corti, nerv – drugs ATB, tumor,…)

- through the TM, the air in the middle ear, oscillations of the round window membrane - if the cochlea and nerve are still intact but the ossicular system has been destroyed, sound
- of a little importance, mostly under pathological conditions waves can still be conducted into the cochlea by means of bone conduction
- tuning forks – Weber and Rinne tests
Function of inner ear

Organ of Corti – the neural apparatus responsible for transduction of sound The Chemical Senses
- receptors in two lines – outer and inner hair cells, at the apex of the cells – stereocilia, - the senses of gustation (taste) and olfaction (smell) depend on chemical stimuli
touching the tectorial membrane - they contribute considerably to the quality of life (in animals – have survival value)
- at the base of the hair cells terminate the nerve fibres of neurons from ganglion spirale
OLFACTION (SMELL)

Stimulation of auditory receptors Nasal mucosa:

- olfactory receptors – chemoreceptors in olfactory mucosa (regio olfactoria)
- movement of the stapes causes waves in perilymph of scala vestibuli (area of 3-5 cm2), in humans around 107 recep., replaced every 60 days

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- other cells: free nerve endings of trigeminal nerve – responsible for nonspesific afferent 3. stria [Link] – axons of mitral cells – to the [Link], to prepyriform and pyriform
inform. (pain), or for reflex responses – coughing, sneezing, + basal and supporting cells cortex and the cortical portion of the amygdaloid nuclei ⇒ the primary cortical center
(mucus) for olfaction. Secondary center – area enthorinalis

Of an importance are : conections to the limbic system, to the hypothalamic autonomic

Olfactory receptor: bipolar cell, on its apical surface – cilia (10-20) detecting odorants centers, reflex centers in RF and thalamus
dissolved in overlying mucus layer. They are unmyelinated, 2 µm long, called olfactory
sticks. Axons penetrate the base of the skull through openings in the cribriform plate of the The function of the CNS in olfaction:
ethmoid bone as olfactory nerve filaments (fila olfactoria) to olfactory bulb. 1. for perception of odor modalities as information to consiciousness and memory
2. affective quality of smell ( pleasant or unpleasant feelings)
Stimulation of the olfactory cells
- olfactory receptors – telereceptors - resulting in autonomic responses: 1) „fight or flihgt“ responses
- they response to the odorant substance (gas) in inhaled air dissolved in the mucus 2) reflexes of food intake (salivation, gastric
- chemical interaction with the membrane of the cilia juice secretion
- they evoke receptor (generator) potencial by changing permeability of membrane for Na+
- fast adaptation e.g. vomiting – by central mechanisms due to unpleasant smell and taste stimuli
- in humans – ability to distinguish between 2 – 4000 different odors
- the olfactory cells – the highest degree of chemical discrimination
THE SENSE OF TASTE
Intensity of the stimulus – depends on concentration of the odor substance (the number of
stimulated receptors and the number of moleculs reaching the cell) - taste is a function of taste buds (9000) in oral cavity
- epiglotis, palate, pharynx and papillae circumvallatae et foliante
Quality of perception depends on concentration: at low c.– pleasant, at high c. – unpleasant - in taste buds – receptor and supporting cells
Threshold of the smell – very small amount of stimulating agent is necessary to evoke smell - receptors are covered by unmyelinated endings of sensory nerves fibres
sensation - fast adaptation
- depends on interindividual and sexual differences, hunger, diseases (e.g isufficiency of
suprarenal cortex – decreases the threshold) Taste stimuli
- substances dissolved in saliva and liquids
anosmia – inability to smell - 4 basic primary sensation of taste
hypoosmia – decreased ability to smell - the tip of the tounge: sweet (sacharides, lead) and salty (anions of inorganic salts)
odor „blindness“ – inability to detect special odor (deficiency of appropriate receptor protein - two lateral sides: sour (high concentration of H+)
in olfactory cells for that substance - the root: bitter (heterogenous group of substances)

Sniffing – half-reflex response provoked by presence of a new odor - sour and sweet – at the palate as well
- increases the ventilation of the upper part of nasal cavity
- contraction of lower parts of nostrils towards the septum followed by series of fast and Ability of different taste sensations: function of CNS
shallow inspirations and expirations - combination of 4 primary taste sensations + smell sensation + temperature and
composition of the food
Central olfactory pathway
ageusia – inability of taste sensations
1st neuron – cells in regio olfactoria hypogeusia – decreased ability of taste sensations
2nd neuron – mitral and tufted cells in olfactory bulb forming synapses (called olfactory - for sweet and salt – damage of the tongue
glomeruli) with first neurons. Axons – tractus olfactorius - for bitter and sour e.g. prosthesis covering the palate
taste blindness – for certain substances
Tractus olfactorius:
1. stria olfactoria medialis – axons of tufted cells, passing middle line in commisura anterior Central pathway of taste
and entering contralateral olfactory bulb. They connect both bulbs, gyri parahypocampales
and corpora amygdaloidea - information from 2/3 of tounge – by sensory fibres of chorda tympani,
2. stria [Link] – terminates in substantia perforata anterior, responsible for olfactory from last third – with n. glossopharyngeus
reflexes – to limbic system and hypotalamus - areas other than tongue - [Link]

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 - orbital area
- the taste fibres form tractus solitarius
- effer. pathways → into limb. sy, hypothalamus and mesencephalon
1st neuron – receptor cells – axons terminate in [Link] (medulla oblongata), there is → important for behavior
2nd neuron – axons by tr. Solitario-thalamicus to the thalamus – there is 3rd neuron – and to the - destruction: hyperreactivity, disorders of behavior and intelect, disorder of personality
cortical taste center in gyrus postcentralis
b. temporal areas:
The importance of CNS - fronto-parietal
1) perception - consiciousness and memory - fronto-temporal
2) affective evaluation - parieto-temporal
3) regulation of metabolism (after stress – increase in intake of sweet food - parieto-occipital
4) reflexes of food intake (salivation, swalloving, gastric juice secretion, defensive reflexes - - temporo-occipital
vomiting)
→ participate in processes of learning and formation of memory traces
→ temporal areas → important for development of ff. associated with the speech

HIGHER NERVOUS FUNCTIONS, CONDITIONED REFLEX, MEMORY, LEARNING Cortical structures determining speech:
Broca motoric centre od speech: – dorsal part of gyrus frontalis
HIGHER NERVOUS FUNCTIONS Wernicke sensoric centre od speech: – between parietal and occipital lobe
Thalamus: system of nuclei in diencephalon
→ integration of sensoric, motoric and autonomic activity Disorders:
- together with limbic sy and hypothalamus regulates autonomic ff. in emotions - sensoric agnosia: = inability to distinguish subjects according to sensoric modalities (visual,
(pale face in shock, red face in happiness...) auditive,...)
= „gate to consciousness“ - apraxia: = inability of voluntary movement (in intact automatic movements and motoric
– all info from the peripheral receptors into the cortex cross the thalamus innervation of muscles)
- aphasia: = disorder of speech functions (sensoric, motoric, conductive, sub-cortical, global)
Neocortex: - agraphia: = inability to write
- exceptional role in regulation – integration of most motoric and sensoric functions of CNS - alexia: = inability to understand written text („word blindness, destruction of occip. lobe)
- determines the human being - acalculia = inability to count (destruction of gyrus angularis and marginalis)
- possibility to live without neocortex, but human loses his identity
LATERALITY OF HEMISPHERES:
Functional classification of neocortex: Left hemisphere (causal):
1) Sensoric areas: → speech ff.
- somestetic analyzer → reading, writing, arithmetic tasks...
- analyzer of vision → control of voluntary movement
- analyzer of hearing
⇒ analytic gradual processing of information
- analyzer of smell
- pathology: disorder of speech with intact emotional characteristics, problems with abstract thinking
- analyzer of taste
Right hemisphere (intuitive):
2) Effector areas:
→ other ff. than speech
- primary motoric area
- premotoric and secondary motoric area → complex processing of visual, auditive and other stimuli, space perception...
⇒ complex and simultaneous processing of information
3) Association areas: - pathology: no disorder of speech ff., speech without intonation and emotions
- multiple connections with sensoric and effector
areas of cortex and subcortical structures sexual dimorphism:
= differences between genders in specific cognitive and motoric abilities and skills
a. prefrontal
- frontal pole of frontal lobe Women:
- Brodman. area 8 a 9 - better verbal abilities (women more talkative)
- spacial remembering the subjects

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 - precise manual skills - originated during development
= mechanisms for assurance of ability to survive and live
Men:
- spacial tasks (rotation in the space) classification:
- logic-mathematic tasks - apetitive
- motoric tasks associated with spacial orientation - protective
- orientation
→ women less lateralised than men - sexual
- better connections between hemispheres
- testosterone stimulates predominantly development of the right hemisphere Innate mechanisms:
1. Simple unconditioned reflexes:
SPEECH: - somatic and autonomic – salivatory r., spinal r.)
= verbal or written means of communication between people
- complex mechanism ([Link], thalamus)
- [Link] areas allow the process of thinking
- ideas are transformed into sentences in gyrus front. inf. (Broca centre)
Components of speech: 2. Drive:
1. sensoric: - processes which represent an immediate response to fundamental necessities of the body
- understanding of verbal and written speech - they force the human to fill the needs
- intact auditive and visual sensoric organs - after filling the needs - antidrive
- transmission of info by affer. pathways into prim. cortical areas and to assoc. areas of cortex (gyrus
temp. sup.) 3. Emotions
- destruction of Wernicke's area ⇒ misunderstanding of heard or written speech; 4. Instincts:
perception (sensoric) aphasia (fluent speech, but without sense) - complex of motoric activity and complicated forms of behavior typical for any species (instincts of
birds)
2. motoric: - requires the same order of actions
– intact association areas allowing the process of thinking - gyrus [Link]. - Broca's area - supply the existence of species, make easier orientation in space, teritorial instincts, social instincts
- destruction: → Broca expressive (motoric) aphasia (agrammatic speech) → hierarchic relationships (relationships between individuals), sexual (supplies next generation)

conductive aphasia: dysfunction of the pathway connecting Broca's and Wernicke's areas MECHANISMS OF COMPLEX AND INTEGRATIVE FUNCTION OF CNS
(fasciculus arcuatus) without dysfunction of centers
CONDITIONED REFLEX:
global aphasia: dysfunction of both centers of speech (dysfunction of perception and production of - acquired response to originally indifferent stimulus, which was repetitively combined with natural
speech) stimulus leading to this response
- elementary physiological mechanism of higher functions of CNS (formation of temporary
Primary motoric cortex: connections)
→ commands for activation of articulation muscles - as basis for these reflexes: unconditioned reflexes and keeping activation of neocortex
- time dependance, changes in intonation and sound → cooperation with cerebellum, basal
ganglia and sensoric cortex Origin:
- conditioned stimulus: biologically indifferent stimulus (ringing bell) → goes before unconditioned
Thalamus: stimulus (food)
→ assurance of cooperation of physiological processes associated with speech (breathing, - conditioned reflex: repetitive connection of conditioned and unconditioned stimulus
[Link], ...)
- dysfunction of subcortical structures (thalamus) → disturbed continuity of speech Conditioning:
- formation of temporary connection
INNATE MECHANISMS OF ASSOCIATIVE AND INTEGRATIVE FUNCTION OF CNS - complex of biochemical, neurophysiological and ultrastructural changes in the brain
→ in neocortex and in subcortical structures (RF, limb. sy)
UNCONDITIONED REFLEXES:
= innate reflexes with structural basis caused by action of adequate stimuli on specific receptor area Conditioning:
([Link]) a. classical (Pavlov) (dog, food and light/ringing bell)

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b. operational (Skinner) 2) balance between excitation and suppression
3) functional mobility – dynamics of alternation (change) of excitation and suppression
e.g. rat in new box with small lever
conditioned stimulus (CS) = pressing the lever  melancholic - weak type
unconditioned stimulus (US) – food ⇒ if hungry, press the lever  phlegmatic - strong, balanced type with low mobility
 sangvinic - strong, balanced, mobile type
c. discrimination conditioning:  choleric - strong, non-balanced, mobile type
testing of discrimination abilities of animals
CS: metronom sound with rate 120/min MEMORY:
US: painful stimulus, dog takes away the leg = ability of CNS to code, to store and to evoke information in the form of memory traces
- engrams - and their use in the process of learning and formation of temporary connections
conditioning – changing the rate of metronom: 60/min without painful stimulus – in changing of
these two rates – taking the leg away just in rate of 120/min ⇒ differenciation inhibition - human uses just about 4-5 % of the memory capacity

Central inhibition and excitation: Memory:

 active processes in CNS - according to time of storing information:
 depolarization of postsynaptic membrane → excitation - ultra-short (immediate) → fractions of s.
 hyperpolarization → inhibition - uhort-term → s. - min.
- intermediary (medium) → min. - hours
Dynamic stereotype: - long-term → months - years
- DS is a temporary unchanged complex of conditioned and unconditioned reflexes originated on the
basis of stereotypes of repeating activities - according to emotional and rational form of knowledge:
- sensoric – imagine, experience, shape ...
Formation of DS: - symbolic – terms, words, numbers ...
- precise and unchanged order of repeating stimuli
- requires unchanged quality and quantity of stimuli - according to the process of memory formation:
- constant and unchanging intervals between the stimuli - primary
- secondary
Advantages of DS: - terciary
- automatization of nervous activity, more effective
- lower consumption of oxygen Processes of memory:
- without voluntary effort [Link] of information:
- storing the sensory and other experience
Disadvantages of DS:
- inertion of processes – neurons may react non-adequately, they don't accept changed conditions of → RF: selection of info and concentration of attention
environment (car drivers) (orientation reflex)
- possibility of in-built mistake – its elimination then complicated (in children) → talamus: „gate to consciousness“
→ limbic sy: emotions, motivation
TYPES OF HIGHER NERVOUS ACTIVITY: → sensoric-association areas of neocortex:
HNA = complex of acquired reflex mechanisms (conditioned reflexes), which dynamically change - lateral cortex – analysis and differenciation of info
under the influence of various relationships - temporal lobe – storing and connection of info - „key“
→ hippocampus:
Classical classification of people according their temperament: - transmission of info from short-term to long-term memory → „index of space and time“
Hippocrates, Galenos:
melancholic, phlegmatic, 2. Storing of encoded information
sangvinic, choleric – biochemical, biophysical and electrophysiological processes
Pavlov: suggested physiological typology of individuals according to 3 basic properties of excitation 3. Reccurent evokation of information in case of need
and suppression
1) strength = intensity of response to stimulation Short-term memory:

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 → transition of excitation via circuit of
reverberating neurons between cortex and thalamus LEARNING:
(1 circuit = 1 wave α on EEG) - ability to remember new information and its storing (formation of engrams and their fixation)
→ spreading the impulses into neo- and paleocortex
↓ → repetition of information
after entrance into hippocampus the impuls (perceived phenomenon) circulates in Papez circuit → motivation

→ during the circuit of info we realise the phenomenon and place it into the memory (fixation of - elicitation of engrams from memory: U shape
impulses) (the best immediately after entrance of information and then 24 hours later)
- space and time summation of stimuli - process of fixation – biochemical transcription in 30-60 min.
- conditions which block elec. activity of brain ([Link], coma, anesthesia) erose this memory =
retrograde amnesia In process of learning – 4 integrated circuits:
[Link] senso-motoric areas of cortex:
Intermediary (medium) memory: → analysis and differenciation of stimuli

thalamo-cortical reverberation leads to production of other structure of RNA in several neurons of 2. non-specific sub-cortical system (RF):
neo- and paleocortex (during non-REM sleep) → keeps consciousness
↓
changes on synapses of neurons - new stimulus → orientation reflex („arousal phenomenon“ on EEG) – concentration of attention to
(change in shape, size, number of synapses, perforations) the stimulus, via RF suppressed realisation of other stimuli
but: repetition of the same stimuli → weaker OR → stimulus must contain „new component“
- about 15 % plastic synapses in the brain, the rest is built-in in circuits
3. limbic system:
Long-term memory: - emotions (positive stimuli – stronger trace, negative stimuli – weaker trace)
changed proteosynthesis on the basis of changed RNA (in interaction with intermediary memory) - motivation (positive motivation more effective)
↓
synthesis of specific and non-specific proteins 4. temporal lobe:
(protein S-100, scotophobine....) → deposition of information (traces) and their connections with already encoded information
stored in the memory – function of „key“
- hippocampus – deposition of engrams into the long-term memory - according to the similarity, ability to „un-lock“ engrams stored in other areas of the brain

Role of sleep: Forgetting:

- REM sleep:proteosynthesis and fixation of engrams → change of medium to long-term memory - negative phenomenon with positive importance
- non-REM sleep: synthesis of RNA - ability to remember important information
- speed of forgetting – highest in the first 2 days, then slower
- selection, elimination and abstraction of information - residuum: depending on the repetition (cca 25 %)
- drugs suppressing REM sleep reduce also memory (barbiturates) and vice versa
- organization of sleep in children – prognosis of intelligence of the child (↑ REM - ↑ IQ) PHYSIOLOGY OF THE E N D O C R I N E SYSTEM
Relationship between memory, EEG and sleep:
EEG rhythm alpha – theta:
- first stages of formation of temporary connections in the process of learning (hippocampus, RF) Regulation of functions: - neural
- manifestation of reverberation processes between cortex and sub-cortical structures (thalamo- - hormonal (endocrine) – via chemical
cortical reverberation) messengers - hormones

Ontogenesis of memory:
- fetus in utero (voice, music, languages) Hormone = substance produced by specialized cells, mediated via circulating blood to
- perinatally – imprinting (first percept after labour) target cells (organs) to affect (control) their activity
- childhood – great development of memory Bayliss, Starling (1902)
- adulthood – well-balanced memory
- old age – predominance of engrams from the youth History:

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Prehistory: - 3000 (B.C.) – China – eating of sea-weed against a goiter The anterior, intermediate and posterior lobes
- 400 (B.C.) - India - eating of animal testes against
impotency Histology: on the bais of the staining reactions:
- Castration of animals and men (eunuchism)
In the anterior pars:
Modern history:1775 – De Bordeau: „testes produce not only - chromophobe cell (50%)
ejaculate but also some substances to the blood...“ - chromophile cells (50%)
1849 – Berthold – castration of the cocks and - acidophils (40%) – eosin –
transplantation of testes back (evaluation - basophils (10%) – haematoxylin
of effects by size of their crests)
1902 – Bayliss, Starling – secretin In the intermediate pars: basophils
1919 – thyroxin
1920 – insulin (Banting, Best, McLeod) In the posterior pars: neural fibrea, neuroglia
1930-40 – steroid hormones
1944 – GH Hypophysis = mixture of more or less separate endocrine organs
1979 – DeBold – ANH that contain 14 or more hormonally active substances

Mechanisms of hormonal action Hormones of anterior lobe

Hormones → hormone receptors on the membrane surface of the cells or inside the cells →
cascade of reactions in the cell. 1) Growth hormone
2) Hormones stimulating „target glands“ (the thyroid, the adrenal
Hormone receptors = very large proteins. Each receptor is highly specific for a single cortex, the ovaries, the testicles, the mammary glands)
hormone
Growth hormone (GH)
Principal mechanisms:
- somatotropic h. – product of the acidophilic cells
1) Confirmational changes of the receptor – alter the membrane permeability to ions.
2) Increase transcription of selected mRNA. Protein hormone: 191 AA in a single chain, two forms:
3) Activating the cAMP system (the second messenger) which activates other enzymes.
4) Activating the genes of the cell – the formation on intracellular proteins that initiate 1) m.w.: 22000,
specific cellular functions. 2) m.w.: 20000
– both active
Properties of the hormone effects:
The basal GH level in adults = in average less than 3 mg/ml, in the children about 5 mg/ml.
1) Target effect – hormone acts on target cells – organ (estrogen –
uterus, mammary gland etc.) Pulsatile secretion of GH – in 3.5 hours intervals.
The half-life = 6-20 minutes
2) Specificity – effect of the hormone is specific – it is irreplaceable
by other hormone Diurnal rhythm – in NREM sleep – increase the GH level.

3) High effectiveness – small quantities of a hormone are effective. The increase during a physical effort, after stress.

THE PITUITARY GLAND Physiological functions of GH

(Hypophysis)
1) Stimulation of cartilage and bone growth:
Morphology small gland - d = less than 1 cm, weight = 0.5 – 1 g.
It lies in the sella turrica at the base of brain and is connected with In young beings in which epiphyses have not yet fused to the long bones - growth is
hypothalamus by the pituitary (hypophyseal) stalk. stimulated by GH.

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GH does not have direct effect – but it acts indirectly by causing the liver to form small Stimuli affecting GH secretion: Figure
proteins = somatomedins.
Abnormalities of GH secretion
GH → liver receptors → proteosynthesis →somatomedins A,C →
cartilage, bone receptors → growth to the length 1) Deficiency of GH effects during childhood results in dwarfism:

2) Metabolic effects of GH: - with deficient secretion of GH

- with normal/hypersecretion of GH in order to receptor deficiency
A) Effects on glucose metabolism
a) Decreased glucose utilization – antiinsulin effect mainly in 2) Hyperfunction:
muscle.
b) Enhancement of glycogen deposition – glucose is rapidly - in children gigantism (giantism) – large quantities of GH are produced – symmetrical
polymerized into glycogen and deposited (because of a.) growth
c) Diminished uptake of glucose by the cells and increased blood
glucose concentration. The cells become saturated (because of b.) - in adults acromegaly – after the epiphyses of the long bones have fused with the shafts
(diaphyses) – the person cannot grow taller, the bones and soft tissues can continue to grow
GH = diabetogenic effects in thickness
enlargement in the small bones (hands, cranium, nose, supraorbital ridges, jaw
2) Effects on fat metabolism ...).
GH releases fatty acids from adipose tissue and increases the FA
concentration in the body fluids = ketogenic effect. Thyroid-stimulating hormone (TSH, thyrotropin)
Fat is utilized for energy in preference to both – glucose and
proteins under the influence of TH – a source of energy during Glycoprotein hormone.
fasting and stress.
Effects:
GH → receptors of f. cells → cAMP → phosphorylation → lipolysis TSH stimulates:
- thyroid secretion and growth of thyroid gland
3) Effects on proteins - increases – uptake of iodide, synthesis of 3-Monoiodotyrozine (MIT)
- BF in thyroid gland
Proteoanabolic effects – via:
Whenever TSH stimulation is prolonge, the thyroid becomes enlarged = goiter
a) Enhancement of AA transport through cell membranes – directly
b) - “ - of protein synthesis by the direct effect of GH on Adrenocorticotropic hormone (ACTH, corticotropin)
ribosomes. Positive N2 balance.
c) Increased quantities of RNA promotes protein synthesis Polypeptide (39AAs).
d) Decreased catabolism of protein and AAs. GH mobilizes FFA (2.)
for supplying of the energy and by this effect acts as a „protein Effect:
sparer“. ACTH – stimulates: growth and function of adrenal cortex (mainly zona fasciculata and
reticularis).
Control of TH secretion
The effect - through cAMP: The increase in intracellular cAMP activates protein kinase A
Hypothalamus → growth hormone – releasing hormone (GHRH) stimulation of corticosteroids production.

→ - “ - - inhibiting - “ - (GHIH) = Abnormalities of ACTH secretion:

= somatostatin
Hypersecretion:
Feedback control – GH increases circulating insulinlike growth factor (IGF-1 = Hypersecretion of ACTH in adrenocortical insufficiency – Addison´s
somatomedin C) and IGF-1 inhibits secretion of GH and stimulates secretion of the disease (by autoimmune disease or by desruction of the adrenal glands - tuberculosis, cancer).
somatostatin.

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Symptoms: Hyperglycemia (through) increased glucocorticoid activity), negative during lactation is inhibited – 50% nursing mothers do not ovulated.
nitrogene balance, fat infiltration of the liver.
Hyperpigmentation (ACTH has MSH – melanocyte – stimulating Beta – lipotropin (beta – LPH)
hormone activity because of MSH is made up of AA residues of ACTH molecules).
Polypeptide. 13 AAs the same as in MSH.
Effect: Lipolysis
Follicle – stimulating hormone (FSH
Control of anterior pituitary secretion
Glycoprotein hormone.
Before puberty only in small concentration – then it increases. 1) Feedback control – hormone of the peripheral gland (adrenal
Without diurnal rhythm. cortex, thyroidea ...)inhibits in the adenohypophysis secretion of
the trophic hormone
Effects:
2) Control by hypothalamus – through hypophyseotrophic
FSH stimulates - in male: testicle growth and spermatogenesis hormones - stimulating - releasing hormone
- in female: ovarian follicle growth, it controls - inhibiting hormones
secretion of estrogens from the follicles...
GH ← GH – releasing (GHRH),
Luteinizing hormone (LH, ICSH) GH – inhibiting hormones (GHIH) = somatostatins

Glycoprotein hormone TSH ← thyrotropin – releasing hormone (TRH)

Effects:
LH stimulates - in male: growth of the interstitial cells of testicles, ACTH ← corticotropin – releasing hormone (CRH)
testosterone secretion
- in female: ovulation and luteinization of ovarian LH + FSH = gonadotropins ← gonadotropin – releasing hormone
follicles (GnRH)

Prolactin (LTH – luteotropin) PL ← prolactin – releasing (PRH),

prolactin inhibiting hormones (PIH)
Protein.
Basal level 1-20 mg/ml. HORMONES OF INTERMEDIATE LOBE
During gestation, progressive increasing of the level-- at he end – up 200 mg/ml.
Gamma-lipotropin (gamma LPH)
Effects (three main):
Polypeptide – like beta LPH.
1) Mammotrophic effect – development of the breasts at puberty Effect: Lipolysis.

2) Luteotrophic effect – stimulation of the corpus luteum, γ – LPH arises from β – LPH ← proopiomelanocortin (POMC)
stimulation of the progesteron secretion
POMC is synthesized in the hypothalamus, lungs, GIT, placenta.
3) Role in secretion of milk - producing effect. It is hydrolyzed to ACTH, beta-LPH, beta-endorphin, and MSH.

Suckling stimulates prolactin secretion. In mothers who do not Melanocyte – stimulating hormones (MSHs)
nurse their baby – a decrease in prolactin level to basal value in 2-3 weeks.
alpha, beta, delta ...
Prolactin and estrogen synergize in producing breast growth, but estrogen antagonizes the
milk-producing effect of prolactin on the breast. Estrogens may be administered to stop MSHs are made up of AA residues of the ACTH molecules –
lactation. - (also ACTH has MSH activity)

On the other side – prolactin inhibits GnRH secretion – the ovulation Action on - melanophophores in the skin of fish ...

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 - melanocytes in mammals.
Effects of oxytocin
Melanocytes synthesize melanins –transfer to keratocytes in skin – for pigmentation of hair
and skin – darkening in 24 hours. 1) Contraction of the smooth muscle of the uterus.
The sensitivity of the uterus to oxytocin increases during gestation. It is inhibited by
HORMONES OF THE POSTERIOR LOBE progesteron. During labor – descent of the fetus down → impulses in the af. nerves to
hypothalamus → secretion of oxytocin → contraction of uterus.
Hypothalamo – hypophyseal system
Peptidic hormones: Arginine - Vasopressin (ADH= antidiuretic h.) During coitus – contraction of uterus facilitates sperm. transport.
Oxytocin
2) Contraction of the myoepithelial cells in the ducts of breast –
Biosynthesis – in the supraoptic and periventricular nuclei - during lactation – milk ejection.
(bilaterally) in hypothalamus. In different cells.
The milk – ejection reflex = neuroendocrine reflex.
Transport - intraneural – in the axons of neurons to their endings Receptors = touch r. around the nipple in the breast.
- in the posterior lobe. Velocity = 0.25 mm/hour Impulses → hypothalamus → secretion of oxytocin →
→ contraction of the ducts.
Secretion – from the posterior lobe in pulses
3) Effects on the memory – negative.
Metabolism: - Vasopressin – half-time cca 18 min in humans.
Destruction in the liver and kidneys. THE THYROID GLAND

Morphology: 2 lobes + thyroid isthmus in front of the larynx.

Effects of Vasopressin (ADH) Histology: The thyroid is made up of follicles. Single layer of cells – filled with colloid

1) Regulation of hydration - of body water Production of thyroid hormones:

Regulation of vasopressin secretion through osmoreceptors – mainly in hypothalamus – - thyroxine (T4),
vesicular cells – in [Link] and through volume-receptors - low – pressure - triiodthyronine (T3)
baroreceptors in RA.
Biosynthesis:
Diminishing of the circulating volume by 6-10 % and more ––
stimulation of LP and HP baroreceptors. Vasopressin through V2 Processes: 1/Iodination, 2/ condensation of tyrosine molecules
receptors in the nephrons – in the thick ascending limb of Henle and 3/ binding in peptide linkage in thyroglobulin 4/secretion
the collecting duct – increases cAMP and the permeability of the membrane to water, urea,
solutes – absorption – antidiuretic effect. 1/ Iodination – Iodide – trapping mechanism (iodide pump) – active
transport against a concentration and electrical gradient. Iodide is oxidized to iodine.

2/ Synthesis = condensation – Iodine is bound to the 3rd position of thyrosine molecules - by

2) Regulation of systemic (peripheral) vascular resistance (SVR) enzyme „thyroid peroxidase“. T4 and T3 are synthetized in the colloid.
Vasopressin increases BP by an action on the smooth muscle of the arterioles – increase in
SVR – through V1 receptors. MIT – DIT
2 x DIT = T4 + alanine
Vasoconstriction in splanchnic, renal, coronary, cutaneous and MIT + DIT = T3 + alanine
uterine circulation.
3/ Thyroglobulin = the biggest protein molecula in human body.
Hemorrhage = a potent stimulus to vasopressin secretion. m.w. = 660 000 (2 subunits) – synthesized in the thyroid cells

3) Effect on memory 4/ Secretion of the hormones: During secretion – colloid is ingested by

the thyroid cells, the peptide bonds are hydrolyzed by peptidases –
Vasopressin – neurotransmitter- facilitation of the memory. free T3 and T4 are secreted to the capillaries.

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 cells, enhanced glycolysis
In normal human thyroid - 23% MIT, 33% DIT, 35% T4, 7% T3, - proteins – T4 and T3 - in small doses – proteoanabolic effect
traces rT3 - in higher doses – proteokatabolic effect - fat – lipolysis, but
a decrease in circulating cholesterol level. Loss of
Per day – T4 – 80 microgramms weight.
T3 – 4(20) microgramms
c) Effect on O2 transport – thyroid hormones increase the dissociation
Transport: of O2 from Hb by increasing red cell 2,3-DPG
T4, T3 are bound to plasma proteins: - albumin
- prealbumin (TBPA) d) Effects on heart – th.h. increase the number and affinity of beta-
- globulin (TBG) Adrenergic receptors in the heart – they increase sensitivity of the heart to
catecholamines. Increase in CO.
99.98 % - of the T4 in plasma is bound – only 0.02 % - free T4
99.8 % - of the T3 - “ - - 0.2 % - free T3 e) Different actions: - cutaneous vasodilatation – decrease in SVR
- hepatic conversion of carotene to vit. A
Latency and duration of action: (in hypothyroidism – carotenemia)
After injection of thyroxine – long latent period (2-3 days). Once activity does begin, it - stimulation of milk secretion
increases – maximum in 10-12 days. - normal menstrual cycles and fertility
Half-time – 15 days. - mentation, irritability of CNS
Some of the activity persists 6 weeks to 2 months. - effect on catecholamines
- respiration – increase the rate and depth
Metabolism: Deiodination in the liver, the kidneys ... of respiration
T4 to T3 (up 33 % of T4) and to RT3 (45 %). - GIT – increase appetite and food intake,
secretion juices, motility – diarrhea
Enzymes: 5´ – deiodinase (T3), 5 – deiodinase (rT3), diiodothyronines
Regulation of Thyroid Secretion
In the liver T4 and T3 – conjugation to sulfates, glucuronides → the bile → the intestine.
Reabsorbtion/excretion. Stool, urine. I. Pituitary TSH – its specific effects are:

Effects of thyroid hormones 1) increased size, number and secretory activity of the thyroid cells
2) increased activity of the iodide pump
1) Effects on growth and development: General and specific effects. 3) increased iodination of tyrosine and coupling
Growth and differentiation of the tissues – proteosynthesis. 4) increased proteolysis of the thyroglobulin in the follicles –
- release of thyroid hormone into the blood
In cold-blooded animals – metamorphosis (tadpoles to frogs).
II. Feedback mechanisms through the hypothalamus and TSH
In mammals and humans– bone growth, maturation of CNS (synapses, myelination) and
peripheral nervous system Hypothalamic hormone – thyrotropin releasing hormone (TRH) –
- direct effect on the secretion of TSH.
(The reaction time of stretch reflexes – e.g. Achilles reflex). The negative feedback effect of thyroid hormones on TSH
secretion – through hypophysis and also through hypothalamus.
2) Effects in adults:
a) Calorigenic action – increase in heat production. Abnormalities in thyroid gland functions
Increase the O2 consumption (exceptions: brain,testes, uterus,
lymph nodes, spleen, anterior pituitry). Hyperthyroidism
Effect lasts up to 6 days.
Causes:
Metabolic effects: Thyreoidal: toxic adenoma, thyrotoxicosis, Graves´s Disease
(autoimmune)solitary toxic adenoma,Toxic multimodular goiter,
- carbohydrates – increase of absorption from GIT,uptake of Co by the TSH-secreting pituitary tumor,thyroiditis, ektopic thyroid tissue

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Extrathyroidal: Administration of T3 or T4 ( iatrogenic hyperthyroidism) - a decrease the absorptive activities of the osteoclasts
(the immediate effect)
Symptoms: - intolerance to heat - a prevention of a formation of new osteoclasts
- weight loss (hyperphagia) (prolonged effect).
- diarrhea
- nervousness Mainly in children.
- psychic disorders yet inability to sleep, In adult only a weak effect.
tremor of hands
- goiter Effects – exactly opposite that of parathyroid hormone.
- exophtalmus (due to swelling of the retro-orbital tissues)
- sweating Regulation – increase in plasmatic Ca++ causes an immediate increase in the rate of
- a warm, soft skin calcitonin secretion.
- increased pulse pressure
- increased cardiac output Therapeutic application – synthetic, human, salmonic – against osteoporosis.
- tachycardia – thyrotoxic heart
- drop in SVR (cutaneous vasodilation)
The Parathyroid Glands
Hypothyroidism
Morphology – 4 glands – located immediately behind the thyroid gland. Each 6 x 3 x 2 mm
Causes: in adults.
Lack of iodine (endemic goiter), idiopathic nontoxic colloid goiter, goitrogenic substances in
some foods (thiocyanotes in cabbage, turnips – Brassicacea family vegetables) – progoitrins Two types of cells: - chief cells – secrete parathyroid hormone
– - oxyphill cells – unknown function
- active antithyroid agents, secondary – hypothalamic hypothyroidism, pituitary
hypothyroidism ... Parathyroid Hormone (PTH)

Symptoms: small protein – 84 AAs, m.w. 9500. Activity depends on the first 34 AAs.
in infancy and childhood – cretenism – failure of growth
- mental retardation The normal plasma level = 10-55 pg/ml. Half-time less than 20 minutes.
- protruding tongues
in adults – goiter – endemic (lack of iodine – need 50 mg/day,iodized salt) – due to Effects:
hyperproduction of TSH
- somnolence In the bone - osteoklasts – bone destruction – absorption
- muscular and mental sluggishness - osteoblasts – bone deposition
- bradycardia, decreased CO, blood volume - osteocytes – stabilization
- increased weight
- constipation PTH:
- depressed growth of hair – in the bones: - stimulates osteoklasts – releases Ca++ from the bones = mobilization of
- frog-like husky voice the Ca++ → the increase to the plasma Ca++.
- myxedema – edematous appearance the body
- in the kidneys: PTH – increases phosphate and decreases calcium excretion in the urine
Hormone of the thyroid parafolllicular C - cells = Calcitonin (increases reabsorption Ca++ in the distal tubules).

C-cells – 15-20 % of the thyroid gland volume – in the interstitium between the thyroid - in the GIT: PH increases Ca++ absorption from the intestine.
follicles.
Regulation of PTH secretion
Calcitonin – 32 AAs, m.w. 3500
1) Decrease in Ca++ concentration in the extracellular fluid causes the increase in PTH
Effects: Calcitonin – decreases blood calcium ion concentration secretion. Feedback – opposite effect – increase the Ca++ concentration –– decreased activity
(in minutes after injection) by two ways: of the parathyroid glands. E.g. – excess Ca++ or vit. D in the diet.

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 = group of sterols produced by the action of UV light on provitamins.
2) Increased plasma phosphate stimulates PTH secretion. Chemoreceptors – the secretion
cells in parathyroid glands. Vit. D3 (cholecalciferol) is produced in the skin from 7- dehydrocholesterol by sunlight.

Abnormalities It causes formation of a calcium binding protein in the intestinal epithelialcells = prolonged
effect on calcium absorption - plays a role in promoting calcium absorption by the formation
PTH – essential for life. of a Ca++ - stimulated ATP-ase and by formation of an alkaline phosphatase in the epithelial
cells.
Hypoparathyreoidism – after parathyreoidectomy – decrease in Ca++ plasma level – signs of
neuromuscular hyperexcitability: Negative feedback control – Ca++ - vit. D.

Hypocalcemic tetany: The Adrenocortical Hormones

Chvostek´s sign – contraction of facial muscles elicited by tapping over the facial nerve.
Morphology: Two adrenal [Link] (1): 3-7 grams.
Trousseau´s´ sign – a spasm of the hand muscles by occluding the circulation. Size: 4 x 2.5 x 0.5 cm

Hyperparathyreoidism – Hypercalcemia. Renal stones. Histology: Two parts – two separate organs:
If Ca++ more than 4 mmol/l – a danger of the calcium rigor of the heart. - the adrenal medulla
Demineralization, osteoporosis, pathological fractures. - the adrenal cortex
M. Recklinghausen.
The adrenal cortex: - Zone glomerulosa:
Calcium Metabolism Product: mineralocorticoids

Ca++ - in the human body about 1100 g – 99 % in skeleton - Zone fasciculata:

Product: glucocorticoids
The plasma Ca++ - 2.25 – 2.75 mmol/l – partly bound to protein and partly free – ionized
Ca++ (1.25 – 1.5 mmol/l). - Zone reticularis –
Product:androgenic hormones
Absorption – from the GIT
Mobilization and deposition – in the bones Hormones - steroids
Excretion – urine, stool, sweat
A) Glucocorticoids:
Roles of the hormones in the Ca++ homeostasis with action on: - GIT Cortisol (hydrocortisone) and cortisterone
- bones Prednisone (synthetic, 4x as potent as cortisol),
- kidneys Dexamethasone (30 x)

Summarization: Effects on:

1) Calcitonin - inhibition of osteoklasts – hypocalcemic effect Carbohydrate Metabolism:

- inhibition of the renal resorption of Ca++ 1) Decreased glucose utilization by the cells
- inhibition of GIT activity
2) Stimulation of gluconeogenesis (formation of glucose from proteins
2) Parathyroid hormone – stimulation of osteoklasts – hypercalcemic effect and other substances). Mobilization of AAs from the extrahepatic tissues.
- inhibition of the Ca++ renal excretion
- stimulation of Ca++ resorption in the GIT → Elevated blood glucose concentration (50% and more
above normal) - (adrenal diabetes)
3) Hormone – vitamin D
Protein Metabolism
Vitamin D
1) Reduction in cellular protein stores (except those of the liver)

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 Increased catabolism of protein. Cortisol depresses the formation in hypophysis∧ blood ∧ adrenal cortex.
of RNA in tissues (including lymphoid tissue) Cortisol – direct negative feedback effects on:
1) hypothalamus
2) Increased blood amino acids and enhanced transport into hepatic 2) anterior pituitary gland
cells –– expanded utilization of AAs by liver; increased protein
synthesis in the liver including plasma proteins, increased Mineralocorticoids
conversion of AAs to glucose (gluconeogenesis)
Stimuli:
Fat Metabolism 1) Increased K+ concentration increases secretion
2) Decreased Na+ - “ - - “ -
1) Mobilization of fatty acids – from adipose tissue. 3) Activation of RAA system -“ -
Increased FFA concentration in the plasma. Shift the metabolism from the utilization of 4) ACTH
glucose to FFA in starvation, stress.
Abnormalities of adrenocortical secretion
Other Effects of Glucocorticoids Hypoadrenalism – Addison´s disease
(autoimmunity, tuberculosis, cancer, haemorrhage)
1) Antiinflammatory effect - stabilization of the intracellular lysosomal membranes and Signs and symptoms: Hypoglycemia, hypotension, weakness, hyperpigmentation (ACTH)
inhibition of lymphoid tissue. Substitution th.
2) Function in stress
3) Increased SVR, BP. Hyperadrenalism
Hypersecretion of cortisol = Cushing´s disease – motilization of fat
B) Mineralocorticoids – aldosterone (95% of all m. activity) from lower part of the body, with deposition of fat in the thoracic
region, edematou face, hyperglycemia, (androgens – acne,
1) Renal effects: hirsutism), osteoporosis, supressed immune system – death of
Transport of Na+, K+ and H+ through the renal tubular walls. infection

Aldosterone increases - absorption of Na+ (and H2O) Hypersecretion of aldosterone = Conn´s syndrome – depletion of K+,
- excretion of K+ (H+) increase in blood volume, hypertension.
in the distal tubule, collecting tubule and duct. Muscular weakness, even paralysis caused by the hypokalemia.

2) Circulatory effects: Adrenal virilism – excess growth of facial hair, in women – men´s type of figure, muscles.
Maintaining of extracellular fluid volume. Hypoplastic uterus – female pseudohermaphroditism.
In boys before a puberty – precocious pseudopuberty
In the absence of aldosterone secretion – a decrease in EFV –
- circulatory shock

In the hypersecretion of aldosterone – an increase in EFV and CO. STRESS

C) Adrenal androgens and estrogens (dehydroepiandrosterone, H. Selye

testosterone...) Stress = complex of reactions to external or internal changes which
Androgens - masculinizing effects disturbe normal action of the organism or threat its existence
- promoting protein anabolism, growth = stimuli (stressors) which cause increase in ACTH level

Estrogens - converted from androgens in the circulation Stress: - eustress - positive

- distress - negative
Source of estrogens in men and postmenopausal women.
Stressors:
Regulation of adrenal cortex hormones secretion 1) Intensive mental activity
Glucocorticoids + androgens: 2) Emotions
Hypotalamus: corticotropin – releasing factor ∧ ACTH 3) Physical – intense heat or cold, noise, vibration

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4) Chemical – inflammation, burn, thirst, hunger Connecting peptide = C-peptide
5) Exercise, effort Secretory granules contain insulin, C peptide, zinc (to join 6 insulin molecules into hexamers)
6) Immobilzation Secretion by exocytosis via contraction of microfilaments (myosin+actin) through
7) Trauma, surgery microtubules and plasma membrane – equimolar amounts of insulin and C-peptide.
8) Infection, diseases
Regulation of secretion
Function of adrenal cortex in stress The most important stimulator of insulin secretion = GLUCOSE (phosphorylated - by
Selye: After stress – enlargement of adrenal cortex, hypertrophy of cortex, involutioin of glucokinase).
lymphoid tissue, ulcerations in GIT – from the Feedback relationship – the lower is glycemia – the lower is insulinemia.
hyperproduction of adrenocortical hormones.
Action of GIT hormones:
Almost any type of stress (physical or neurogenic), causes an immediate and marked increase Stimulatory: GIP, gastrin, secretin, CCK-PZ and glucagon-like polypeptide from intestinal
in ACTH and cortisol. cells
AAs – stimulate
Activation of the axe: Hypothalamus – hypophysis – adrenal glands.
EFFECTS OF INSULIN
Effects:
Rapid mobilization of AAs, FFA - energy Anabolic hormone
Maintaining of blood volume and BP. The major sites of insulin actions: liver, muscle, adipose tissue
Result of insulin action – decreases the plasma concentrations of
At the beginning of stress:mobilization of glucose by catecholamines, - glucose
glucagone - free fatty acids
- ketoacids
Latter – mobilization of AAs, FFA, by glycocorticoids - essential AAs (leucine, isoleucine, valine)
Lipolysis – glycerol and FAs – main source of energy for muscles and liver in stress
Positive inotropic effect Carbohydrate metabolism
Hyperreactivity of vessels
Analgetic effect Insulin stimulates:
- the transport of glucose from the plasma, across the cell membrane to cytoplasm
PANCREAS – ENDOCRINE FUNCTION for rapid phosphorylation (hypoglycemic effect of insulin)
- glycogen formation from glucose-6-phosphate (muscle,liver)
Pancreas - exocrine (pancreatic juice) - glycolysis and oxidation (less)
- endocrine - production of alpha-glycerol phosphate – used to esterify FFA, thus storing them
as triglycerides (in adipose tissue)
Endocrine – hormones
Effect of insulin – the main hormone enabling metabolism glucose in cells
Cells – producers – in anatomic islets – 1-2% of the mass of pancreas (1-2 million islets)
Fat metabolism
Islets composed of A-cells - 25% (glucagon) Insulin
B-cells 60 - 75% (insulin) - facilitates transfer of circulating fat into the adipose cell in adipose tissue
D–cells (somatostatin) - inhibits lipolysis of stored triglyceride – FFA releas is suppressed
PP (F) - cells (pancreatic polypeptide) - stimulates synthesis of cholesterol from acetyl CoA
- stimulates de novo synthesis of FFA
Secretion to pancreatic veins – portal vein (higher concentration of insulin in liver 2-10x
higher than in the peripheral circulation) Effect of insulin – an increase the fat content of the liver

Protein metabolism
INSULIN
Insulin
Peptide m.w. 6000 – 2 chains of AAs - linked by disulfide bridges

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 - stimulates the transport of Aasfrom plasma, across the cell membrane into Glucagon actions on adipose tissue or musles – non significant
cytoplasm
- increases overall synthesis of proteins – anabolic effects Glucagon deficiency - hypoglycemia
- anticatabolic effect – inhibition of the enzymes of proteolysis Glucagon excess – makes diabetes worse

Effect of insulin – important contributor to growth, the tissue regeneration, bone remodelling. INSULIN/GLUCAGON RATIO
The usual molar ratio in plasma I/G = 2.0
The key metabolic role of insulin means that its absence causes distortion of homeostasis.
Plasma levels of glucose, FFA and ketoacids rise to extreme heights. Plasma pH and In circumstances that require mobilization and utilization of substrates – I/G = 0.5 and less (in
bicarbonate [Link] loss of adipose mass and lean body mass occurs. fasting, prolonged exercise) due to a decrease in I and increase in G.

Insulin deficiency – diabetes mellitus Conversely, in circumstances in which substrate storege is advantageous – after
a carbohydrate meal – I/G rises to 10 and more (I)
Insulin excess – hypoglycemia – convulsion, coma.
Without insulin replacement – death.

Insulin substitution – beef, pork, human insulin (recombinant technology). SOMATOSTATIN

Application – subcutaneous way – intensified therapy – simulated physiological secretion.
Insulin pumps. Neuropeptide (hypothalamus)
D-cells - preprohormone – 2 somatostatin peptides 28 and 14 AAs.
GLUCAGON
Regulation of secretion
Important regulator of intrahepatic glucose and FFA metabolism Stimulated by G, AAs, FFA, glucagone, CCK-PZ, VIP, mixed mealk.
Catabolic hormone Inhibited by insulin.
A-cells - single chain peptide m.w. 3500
Preproglucagon – proglucagon – glucagon Effects of pancreatic somatostatin
A decrease the rate of digestion and absorption of nutrients from GIT and utilization:
Regulation of secretion Inhibition of GIT motility, secretion of juices and GIT hormones (gastrin, secretin)

In contrast to insulin – glucagon synthesis is inhibited by high glycemia and stimulated by Inhibition of the absorption of glucose and triglycerides across the intestinal mucosa.
low glucose level (2-4-fold Inhibition of insulin and glucagon secretion
increase – from basal level of about 100 pg/ml).
Feedback regulation – entrance of food into GIT stimulates the release of the GIT hormones
Insulin directly inhibits glucagon secretion – paracrine action of islets and actions – somatostatin – prevent rapid nutrient overload
The major energy substrate (FFA) also suppresses glucagon release
A protein meal and AAs – substrates for glucose production stimulate glucagone secretion. Pancreatic somatostatin excess – hyperglycemia and other manifestations of diabetes.
Prolonged fasting and exercise, stressful condition etc. – requiring glucose mobilization –
increase glucagon secretion – through sympathetic (alpha receptors) nervous system.
THE GONADS
Glucagon is extracted by the liver – short half-life. The male reproductive system
As with insulin, glucagon is dewgraded in the kidney and liver Morphology:
Testes – pair organ. 1 testis volume = 20-30 ml, weight 10-16 g
Effects of glucagon Scrotum – temperature about 32 ˚C. Regulation of T by contraction / relaxations of m.
cremaster.
Opposite to those of insulin:
Glucagon promotes mobilization of fuels – mainly of glucose Histology:
Hyperglycemic effect - interstitial cells of Leydig (5% of V, 450 millions)
Profound glycogenolytic effect – activation of glycogen phosphorylase and inhibition of - Sertoli cells
glycogen synthase - seminiferous tubules
Stimulation of gluconeogenesis

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Hormones of the testes Male hypergonadism in
The principal hormone - testosterone – steroid - praepubertal – pubertas praecox (precocious puberty)
- dihydrotestosterone (DHT) - postpubertal – rare – androgen secreting tumors – Leydig cells
tumors
Producer: Leydig cells
Synthesis: from cholesterol (adrenal cortex 5%, testes 95%)
Secretion: 7 mg/day in normal adult males in pulses Endocrine functions of the ovary
Diurnal rhythm – highest concentration between 4 – 8 a.m. Hormones of the ovary - steroids
Transport - free form – 2% (in puberty more) - non-steroids
- binding form – SHBG (sex hormone binding globulin)
Degradation – liver Steroid hormones: - estrogens – secreted in follicular and luteal phase
Elimination – kidneys – urine - progesterone – in luteal phase

Regulation: Non-steroid hormones: - inhibins – inhibition of the FSH

Hypothalamus (GnRH) ∧ hypophysis (LH – ICSH) ∧ testes - activins – activation - “ -
- relaxin
Effects of the testosterone:
Fetal period – responsible for development of the male type of gonads Transport - estrogens – 2% free form, 38% SHBG, 60% albumin
Childhood - behaviour – more agressive play in boys - progesterone – 2% free form, 18% CBG, 80% albumin
Puberty – growth and development of the primary and secondary sex characteristics: - gonads Degradation – liver
- anabolic effects, hair growth (beard, pubic and Elimination – kidneys (urine), liver (bile)
axillar hair, enlargement of the larynx – voice
becomes deeper, sebaceous thick secretion – acne)
Adulthood - maintaining of the sex characteristics Regulation
- stimulation of the erythropoeisis Hypothalamus (GnRH) ∧ hypophysis (FSH – estrogens, LH – progesterone) ∧ ovary
- directly and indirectly through erythropoetin Ovarian hormones – effects
- anabolic effects
- behaviour Estrogens - growth and maintaining of the primary and secondary sex
characteristics
Another hormones of testes - metabolism of Ca++ – antagonistic effect to PTH
Sertoli cells – producers of: inhibins – (alpha ...) - responsibility for prolipherative phase
effects: inhibition f the FSH - sexual behaviour – libido (with testosterone)

actins – stimulation of the FSH Progesterone - responsibility for secretory phase

- growth and differentiation of the mammary glands
Abnormalities of testicular function - rise in body temperature
- natriuretic effect (antagonistic to aldosterone)
Male hypogonadism in
- embryonic period – malformation of the gonads The ovarian cycle
- praepubertal – eunuchoidism –
epiphyses remain open – tal stature, undeveloped musculature, Cyclic changes in ovary for ovulation
voice high-pitched, pubic and axillary hair - normal (adrenal cortex In the ovary at puberty 300 000 ova – in the course of a reproductive life only about 300 –
androgens) 500 will maturate.
- postpubertal - regression of the sex characteristics
- sterility Phases: 1) Follicular phase – formation of an ovum – growth of the
- voice remains deep follicles – production of estrogens
- loss, or declination of libido
- ability to copulate persists longer 2) 14th day – distended dominant follicle ruptures – ovum
is extended – ovulation

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 3) Luteal phase – production of the estrogens and hypothalamus → thoracic spinal cord → sympathetic nerves → cervical ggl. superior →
progesterone by corpus luteum. postggl. sympathetic neurons → pineal → beta - adrenergic receptors → cAMP → N-
acetyltranferase activity → melatonin (from serotonin)
Corpus luteum - corpus luteum graviditatis
- corpus albicans Diurnal rhythm – night – stimulation of the synthesis and secretion
- daylight hours - inhibition
The menstrual cycle
Cyclic changes of the uterine mucosa Effects

- In follicular phase – maturation of the follicles – estrogens – increase in the endometrium Amphibian – contraction of melanophores – melanin pigments – it lightens the skin (e.g. in
thickness – proliferative phase tadpoles)
Mammals and humans
- After ovulation – in luteal phase – under the influence of estrogens Synchronization of circadian rhytmicity:
and progesterone – uterine glands begin to secrete fluid – secretory - inducing effect on sleep
phase - induction of seasonal responses to changes in day length
- cyclic fluctuations of the awake/sleep states
- Regression of the corpus luteum – decrease of the progesterone secretion and local ischemia
by PGF2alpha – endometrial necrosis – bleeding - menstruation. Effects on reproducibility – gonads:
Inhibition / facilitation
Loss of 50 – 80 ml – art. blood (75%), venous (25%). Seasonal breeding animals - responding differently to the changes in day-length.
In rats/hamsters etc. – with a short duration of gravidity – activation of gonads in the spring
Abnormalities of the endocrine ovarian functions In animals with longer gravidity – (e.g. a doe – hind/ deer) – activation gonads in the automn
(shortening of the day-lights hours).
Fermale hypogonadism in
- childhood – sex characteristics undeveloped - late puberty – pubertas tarda - sexual Effects on immune processes – immunomodulatory role:
infantilism - Stimulatory effect on the processes and lymphoid cells, thymus, spleen
- adulthood - amenorrhea – absence of the menstruation - Antioxidative effect – scavenger of some reactive forms of oxygene. The most
- regression of the female sex characteristics effective lipophilic antioxidant.
- osteoporosis - Oncostatic effect

Female hypergonadism in Therapeutical use - treatment of:

- childhood – pubertas praecox - jet lag syndrome – circadian clock – hypothalamus – superchiasmatic ncl. Jet lag –
- adulthood – abnormalities in cycle, amenorrhea, menorrhagia, from moving to a different time zone (W-E – shortens, E-W – lengthens day. The
metrorrhagia. coordination of the biological clock – melatonin
- sleep-disorders – sleep promoting effect
PINEAL HORMONE – MELATONIN - some types of depression – seasonal affective disorder
- imunomodulans/prevention. (Trials – treatment of malignancies and AIDS).
The pineal – epiphysis – between 3rd ventricle – cerebellum
Neuroglia, parenchymal cells, highly fenestrated capillaries NATRIURETIC PEPTIDES
Inervation: cervical ggl. superior, sympathetic nerves – beta receptors
Product – hormone: Melatonin 1956 - granular cells in atria
Biosynthesis: Tryptophan – serotonin – melatonin 1981 – de Bold (Canada) extract from the atria (rats) – an increase of natriuresis and diuresis
(30 x) – atrial natriuretic peptide ANP
Lynch et al. (1975): melatonin is secreted in humans at night (dark) in 10-40 times higher
amounts than at mid – day. Atriocytes → pre-pro-hormone ANP (149-153 AA) →
→ pro ANP (126 AA) → ANP (28 AA)
Exposition to a permanent light – suppression of the melatonin production
Activation of the synthesis during the dark period – night Half-time: 1-5 min
Rapid distribution and action
Light information (dark/light)→ retina → [Link] → Elimination – endopeptidases – splitting

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 Inhibition of the smooth musculature of vessels – protective effect against hypertrophy (in
Stimulus: Distension of the atria – the right (klinostasis, volume -expansion – hypervolemia, hypertension)
failure of the right ventricle...)
Therapeutic application of the natriuretic peptides:
Physiological effects of the ANP: Indications: hypervolemic overloading of the heart, pulmonary edema, hypertension...
Apllication: isolated ANP and/or apllication of an inhibitor of the endopetidases
Regulation of the intravascular volume and of natremia
Effects: natriuresis, diuresis, vasodilation, a decrease of aldosterone level ....
- Increase of natriuresis and diuresis – through an increase in perfusion and glomerular
filtration
- Inhibition of the natrium reabsorption in collecting ducts PREGNANCY
- Decrease in blood pressure through:
- diminishing of the blood volume and cardiac output Fertilization – of the ovum – in the uterine tube
- vasodilation Physiological functions of pregnant woman:
- inhibition of secretion: aldosterone, vasopressin, Endocrine changes:
catecholamines Corpus luteum graviditatis – estrogens, progesterone, relaxin
- Enhancement of capillary permeability – peripheral edema Decline in function after 2 months of pregnancy

Neurotransmitter in CNS – in the nuclei for regulation of blood pressure and volume Placenta: – human chorionic gonadotropin (hCG) - luteinizing and
luteotropic activity
Clinical aspects:
Indicator of pregnancy - in blood (RIA) – 6th day
Hypertension – expected a decrease in ANP concentration – results of the studies: opposite - in urine – after 14 days
findings – in hypertonics ussually hypersecretion of the ANP – compensatory changes
- human chorionic somatomammotropin (hCS) – maternal
Congenital heart failure – increase in ANP level – indicator of the severity growth hormone - positive N2 balance, retention of Ca2+

Another natriuretic peptides: - relaxin – relaxation of pelvic ligaments

Natriuretic peptide type B = BNP - beta – endorphins – unknown function (a change of behavior)

Secretion in cardiomyocytes of the ventricles - prorenin

Stimulus – pressure in the ventricle wall (hypertrophy of the left - inhibin, placentar GnRH – paracrine regulation of placentar
ventricle) hormonal activity

Half-time 20 min

Effects: Natriuresis, diuresis, vasodilation, inhibition of renin and aldosterone secretion PHYSIOLOGICAL FUNCTIONS IN PREGNANT WOMAN

BNP – indicator of: TBW – increase by 4-6 l (mainly in ECF compartment)

- the ventricles failure – correlation with ejection fraction of the LV
- LV hypertrophy BLOOD
Blood volume: a rise from 4 up to 5.5 l
Natriuretic peptide C = CNP Plasma volume – an increase up by 1.2 l. Maximum in 34th gest. week
Plasma proteins – a decrease (from 70 to 60 g/l) – in particular
Synthesis in the brain (cerebrospinal fluid) and in endothel albumins. Fibrinogen concentration rises.

Autokrine/parakrine regulation in the brain/vessels Erythrocytes and haemoglobin concentration – a decrease

Htk – a decrease (from 0.44 to 0.33)

89 90
Viscocity – a decrease from 4.6 to 3.8
Leukocytes – leukocytosis – neutrophilia
Thrombocytosis PHYSIOLOGICAL FUNCTIONS IN NEWBORNS AND CHILDREN
ESR – FW acceleration (fibrinogen, less ery)
Coagulation ability – an increase Total body water (TBW) – increase – mainly ECF

CARDIOVASCULAR SYSTEM Blood

Blood volume – increase
Heart Plasma - relative hypervolemia
- HR + by 15/min - plasma proteins – decrease – from 60-70 g/l, mainly
- SV from 80 to 95 ml albumin. Rise in fibrinogen level.
- CO from 4.5 to 6 l/min
Red blood cells count - in newborns up 7.7 x 1012/l
Blood pressure - in suckling – lowest
- arterial BP syst. slight increase
- arterial BP diast. in pregnancy lower Haemoglobin – (HbE), HbF, HbA (2,3 DPG)
- venous – depending on location – in upper part – unchanged, in lower parts increased Leukocytes – lymphocytosis in childhood
Blood groups - antigens – weaker activity
Blood flow – rise through kidneys, liver, skin - aglutinins – absent

RESPIRATORY SYSTEM Platelets, clotting – without abnormalities

Volumes and capacities

– rise in VT by 40% Cardiovascular System
– decrease in VC and FRC (by 20-30%)

Ventilation – increase from 7 to 8 l/min FETAL CIRCULATION

Increase in oxygen consumption
Hypokapnia Placenta - 1 umbilical vein (oxygenated blood - 80% O2)
[Link] -[Link].+ blood from systemic arteries (70%)
RENAL PHYSIOLOGY RA + [Link]. (sat.30% ) -
RV + through foramen ovale -LA -LV(sat.62%) -
Renal blood flow, filtration fraction, glomerular filtration - rise upper extremities and head (brain)- [Link].
Increased diuresis
RA- RV - PA - [Link] (sat. 52%) - descendent aorta -
GASTROINTESTINAL TRACT abdominal organs,lower extremities
- 2 [Link] - placenta
Increase in food intake - [Link].
Slowing of GIT motility, peristalsis (mainly gastric), obstipation, a decrease of the digestive
juices secretion
First breath - start of breathing
Parturition - labor
Occlusion of [Link] – musculature:
Duration of pregnancy – 40 ± 2 lunar weeks (270 ± 14 days from fertilization) circular - sensitive to oxygen increase
During pregnancy – increasing in number of oxytocin receptors in the myometrium and the longitudinal - mechanical stretching
decidua (influence of estrogens and distension of uterus) spiral - decrease in temperature
In early labor – uterus starts to react yet to normal concentration of oxytocin
Dilation of the cervix, mechanical stimulation by fetus – increase in oxytocin secretion.
Role of prostaglandins – evidence – prolongation of parturition after PG inhibitors. Stimuli initiating breathing after birth:
Role of spinal reflexes and voluntary contractions of abdominal muscles.

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 possibility of a reopening
Hypoxia -hyperkapnia-acidosis - stop of the oxygen supply,
elimination of carbon dioxide,resp.-metabolic acidosis. Closure of the ductus venosus
PO2 decreases with rate 10 mmHg/min –stimulation: Passive - reason - blood flow is stopped
- peripheral chemoreceptors (aortal) Active - contraction of a smooth muscle sphincter
- central - pH decrease.
Closure of the ductus arteriosus
Another stimuli: Diameter 0.5-0.6 cm length 1.25 cm - like aorta,PA
• Cooling of the newborns body
• Tactile and pain stimuli Factors for closure:
• Stimulation of proprioceptors • The increase in PaO2 - functional constriction
• Reflexes of airways and lungs • Vasoactive substances
Diving - Vasoconstrictors : serotonin,NA,angiotensin
Hering-Breuer deflation reflex - Vasodilators :Prostaglandins - PGE2
[Link],vestibular receptors
• Humoral effects -catecholamines During intrauterine life - balance between vasoconstrictors and
vasodilators - after birth - placenta as a source of the PG
production is eliminated - predominancy of the vasoconstrictors
Definitive closure up in 3rd month.
AERATION OF THE LUNGS
Clinical aplication : [Link] (open) - application of a
cyxclooxygenase - PG blockers:
Lung fluid elimination  aspirine - acetylosalicylic acid
 Indomethacine
Lung fluid - during fetal life volume 30-35 ml/kg - the same like total lung volume in
postnatal life Changes in pulmonary circulation
Fetal life - only 3 - 10% of the [Link] birth the pulmonary bed must be adaptade to
Delivery - compression of the chest - 80-90 mmHg - 40 ml of the fluid capacity 100 % of the CO RV.
is squeezed out from the upper airways.
The first breath - strong negative pressure up - 75 mmHg - to overcome the resistance of the Vasodilation:
airways and viscosity of the lung fluid. • Oxygen - an increase in satur.O2 - vasodilation
The first expirium - positive - a cry - pushes the fluid to alveolocapillary membrane - • Substances - acetylcholine,bradykinin,PG
resorption. • Mechanical changes - aeration of the lungs
Repetitive respiratory actions. • Morphological changes - involution of the smooth musle layer in
the vessels of the pulmonary bed
Elimination of the pulmonary fluid - 2 ways:
Changes in cardiac output
• resorption to lung capillaries blood (2/3) Existence of the 2 pumps in series - shunts are closed functionally -
• lymphatic vessels (1/3) possibility of the reopening = transitory circulation

Consumption of the oxygen 2x higher than in adults = higher CO up

200 - 300 ml/min/kg
TRANSITORY CIRCULATION
Heart rate
Closure of the foramen ovale in newborns - mature - 110-130/min
Elimination of the inflow through [Link] premature - 120-140/min
 venous return decreases, including BP in RA,RV,PA
 systemic circulation becomes shorter - BP rises
 BP in LA exceeds BP in RA -FO closes - functionally

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 Existence of a special reflex – suckling reflex (non-conditioned, inborn, however unstable)
Blood pressure in newborns Salivation: low volume and a weak alpha-amylase activity in saliva
Swalowing – deglutition – well developed

Methods for measurement of BP Stomach:

• Invasive -catheterization - Volume: in newborns 5-10 ml, 1st year 250 – 300 ml
• Noninvasive - ultrasound tonometer - Secretion: less HCl, higher pH (3-4)
-infrasound tonometer chymosin
fetal pepsin (higher pH optimum)
Normal values of BP in newborns: mature - 90/60 mm Hg intrinsic factor – gradual increase in postnatal life
premature - depending on gestation age (together with pH decrease)
lowest 40/20 mmHg - Motoric activities: lower, emptying of stomach in 2-3 hours

Physiological changes of BP in newborns: Small intestine:

Cardiovascular reflexes - functioning: - thinner muscular layer
• baroreflexes - ability of the bigger molecules absorption, penetration of potential antigens
• oculocardiac reflex
• Cushing reflex Colon: well developed functions, more frequent defecations
• Cold reflex
• Kratschmer,diving reflexes Liver
• ....
In fetal life – important function – condition for optimal development
Diurnal rhythm - day-night fluctuations in BP
Formation and storage of different nutrients – for immediate utilization after birth
Crying - increase in BP by 30-40%
Food intake - increase in BP by 30%
Formation of plasma proteins, synthesis and excretion of the cholic acids, enterohepatic
circulation – in utero
Respiration
Conjugation and detoxification functions – active – relative insufficiency after birth – in early
postnatal life – for detoxification and elimination of the great pool of bilirubin.
Respiratory muscles – lower tone, fatigue
Thorax – less mineralized, compliant
Low capacity of the oxidative metabolism in newborns
Airways – small diameter
Alveoli (size: d – only 20-50 µm, in adults up 300 µm)
Gradual maturation after birth
Count: 20 millions versus 300 millions
Compliance – in absolute values low, specific the same
Resistance – up 10 x higher
Metabolism
Regulation of breathing - chemical – biphasic response to hypoxia
BMR/kg increased in newborns (up 3x)
- neural – HB reflex well developed.
Predominancy of proteoanabolic processes
Gastrointestinal Physiology
Metabolic pathways the same, immaturity of enzyme systems
Intrauterine nutrition:
- histotrophic
The main source of energy – glucose and free fatty acids
- haemotrophic
Protein minimum in the 1st year up 2.5 g/kg (vs. 0.6 in adults)
Postnatal nutrition:
- lactotrophic
- mixed
Renal Physiology

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 - monokinetic – from the end of the 2nd month – movement by
Fetal period: Excretory organ – placenta one extremity
Formation of urine and micturition influence a - dromokinetic - from 5th month – targetted movement
composition of amniotic fluid - kratikinetic – after the 1st year – voluntary/involuntary movements

Newborns: Glomeruli size: smaller, less permeable (cubic epithelium) Developments of the dynamic stereotypes
Shorter proximal tubules Conditioned reflexes/learning/memory/speech
Longer Henle´s loops (relatively) Ability of the memory formation – since intrauterine life.
Development of the speech – best from the end of the 2nd year.
Decreased renal perfusion - lower BP.
Thermoregulation
Renal fraction 5-6% (in adults 20%) Fetal
The temperature of the fetus is approximately +0.5 ºC due to fetal metabolic activity.
Low sensitivity to ADH, decreased ability to concentrate urine – bigger diuresis for Heat generated by fetal metabolism is dissipated by the amniotic fluid
elimination of the metabolite pools. or the placenta to maternal blood in the intervillous spaces.
Mother – fetal temperature gradient.
Endocrine System Newborns – heat losses are greater, more rapid and can easily exceed heat production.
Fetal period: Because of the newborn´s larger surface area – to body mass ratio, decreased insulating
subcutaneous fat, increased skin permeability to water.
Axis: Hypothalamus – adenohypophysis – target glands – in functions
After birth – transitional events:
Parathormone – secreted by fetus – however maternal parathyreoidea – the main source of the The newborn losses heat rapidly after birth, especially through
PTH evaporative losses.
The newborn´s skin temperature (at T = 25 ºC in delivery room) decreases with the rate 0.3
Thyreoidal hormones ºC/min – central T – 0.1 ºC/min.
The infant´s T may fall 2 to 3 ºC after birth. In 6-12 hours – restoration of the temperature.
Adrenal cortex hormones – predominancy of the sexual hormones – androgens
Consequences of the temperature change:
Pancreas – fetal insulin – important for keeping normoglycemia - Positive: - the initiation of the breathing
- peripheral vasoconstriction – closing of the foramen ovale
Early postnatal period: - stimulation of the thyroid gland

Thyreoidal hormones – necessary for physiological development of the nervous system – - Negative: The increase in oxygen consumption.
brain
Heat production in newborns
Adrenal medulla – firstly predominancy of NA, latter of A Physical methods:
- Shivering – not important in the newborns
- Muscular activity – crying, restlessness
Nervous system
Chemical methods:
Metabolism: Ability of the anaerobic metabolism - Metabolic processes – the greatest amount of metabolic energy is produced by the brain,
heart and liver.
Hematoencephalic barreer: Development after birth: Increased permeability in the early
phases of postnatal life – penetration of different substances to the brain tissue (bilirubin – - Special method of heat production in newborns = nonshivering thermogenesis – brown
kernicterus) adipose tissue (BAT) metabolism.
In the term newborns BAT accounts for 2 to 7 % of the infant weight.
Development of the movements: In the midscapular region, around the neck, under the clavicles, in the mediastinum, around
Fetal period: since 6th - 7th gestatuional week the trachea, esophagus, heart, lungs, liver, kidneys, adrenal glands.
Postnatal period – phases:
- holokinetic – generalized movements

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 PHYSIOLOGY OF EMOTIONS talamus

DEFINITION Hypotalamus – reactions through ANS

 Strong urgent condition of the instinctive feeling related to the certain target activity.
 Emotions are demonstrated by Cortex – mainly prefrontal......
- appetitive or
- aversion behaviour Emotions are not product of 1-2 CNS structures – they are result of coordinated
activities of many of them.
Apetitive behaviour
Recently – very important structures: prefrontal cortex and amygdala
Physiological needs
Looking for pleasant sensoric experiences (taste, visual, acoustic), new positive stimuli, sport  Prefrontal cortex belongs to the places controlling emotions – mainly positive
etc. emotions – happiness, pleasure...

Psychic needs  Amygdaloid ncl. are responsible for anger, fear, sadness and other negative emotions
Looking for social contacts, self – application and social social acknowledgments.
Looking for situations reinforcing self-esteem and self-respect. Amygdala
Looking for sympathy, mutual understanding, love etc. Temporal lobe
Corticomedial part – direct relation to autonomic functions and to smell
Aversion behaviour Basolateral – to cognitive activity – to frontal and temporal lobe

Physiological needs Afferent pathways

Avoidance of the hunger, thirst, pain, fatigue, too hot/cold environment... bulbus olfactorius....see Fig.

Psychic needs Efferent pathways

Avoidance of the social isolation, abortion, non-success, loss of social status, loss of self- Reciprocal to afferents (see Fig.)
esteem, etc. - hypothalamus
- thalamus- prefrontal cortex - cognitive emotional experiences
Regarding to behaviour: - hipocampus
- subst. grisea – brain stem, RF and parasympathet. nuclei – important for autonomic
Emotions = affective component of interaction between important stimulus and the response and somatic expressions of emotions and on emotions based behaviour.
⇒ determinant of the behaviour of the individual
Amygdala Functions
Components of the behaviour:
 cognitive – cortex  Evaluation of information on emotional basis – using of memory – to
 emotive – affective - subcortical + cortical positive/negative stimuli
 conations – cortical + subcortical - motion  Key role in behaviour control (autonomic and motor reactions) – as response to
emotions
 Role in development of memory traces – engrams – with emotional component - load,
Components of emotions learning on the basis awarding/punishment
 psychic (fear, anger, sadness)
 autonomic (sweating, CVS, pale/reddish face) Role of amygdala in conditioned fear reactions:
 somatic (increase/decrease in muscle tone, body position, movements,...) Rats – dominant reaction - „freezing“ (passive avoidance).
Humans – sudden threat - „freezing“ – latter motoric activity (fight/flight) or continuation in
Regulation of emotions immobility („freezing)

 Limbic system ([Link]) Stimulation of amygdala

amygdala In humans during operations of temporal lobe
hippocampus  Fear with relevant ANS reactions
gyrus cinguli (limbic cortex)  Hallucination of the type „déja vue“

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Destruction of amygdala Physiological consequences: ↑ BP and splanchnic circulation, stronger peristaltics, decrease
(experimental or by cancer process) in skeletal muscles blood flow
 Loss of the fear
 Loss of agressivity [Link] related to reproductive activities
 Reduction of emotional expressions
 Loss of facilitation of engrams production with emotional load Determinants of:
 Loss of effort for social communication (self – isolation)  sexual behaviour
 Hypersexuality  parental behaviour (maternal and paternal)

Limbic system Regulation of sexual behaviour

- neural: neocortex, amygdala, hypothalamus, limbic cortex
1) Weak influence of cortex on emotions (affective component and autonomic changes). - hormonal: testosterone, estrogens
Only few connections to cerebral cortex
Emotional inteligency (EQ)
„It is easier to play than to mask emotions“ - ability to control individual´s own emotional status (and of other peole) and to use this
information in relationships
2) Inertia of emotions: firing from the neurons of the limbic system are present longer after
stimulus (emotions „live“ longer than stimuli)  5 components
1. self-consciousness (to understant internal feelings)
Role of the emotions 2. to control emotions
3. motivation (aimed to the target)
Physiological view: they help to survive to individuum / human (animal) kind 4. empathy
5. management of the social relationsips
Personality view: they make life rich to positive/negative experiences – life fullness

Types of emotions – related to: HYPOTHALAMUS

- Self-defense
- Nutrition Connections:
- Reproduction... - with the pituitary gland , with the posterior lobe (neurohypophysis) by neural fibres – tr.
hypothalamo – hypophyseus.
1. Emotions related to self-defence - with anterior lobe (adenohypophysis) by blood vessels (hypothalamic - hypophyseal portal
system).
 fear (passive defence - avoidance) – stimulation of hypothalamus and amygdala; - many afferent and efferent connections between hypothalamus and other parts of CNS –
mydriasis, sweating, postural changes, ... mainly by limbic system, thalamus, midbrain, hippocampus and others.
 agressivity (active defence - avoidance);
 placidity (peacefullness) – contrary to agressivity Functions of hypothalamus
Regulation of the autonomic functions – control of organs through ANS. Integration of the
Regulation of the emotions related to the fear: somatic with autonomic nervous system „centers“
 amygdala responsible for balance between extreme emotions (agressivity/placidity)
 hypothalamus integration center for autonomic and somatic responses during Regulations of the autonomic functions:
defecnsive behaviour
 hormonal – testosterone increases agressivity (castration), estrogens - placidity - Spinal cord (e.g. sacral) – regulation of defecation, micturition

[Link] related to nutrition - Medulla oblongata – more complex functions: cardiovascular, respiratory, salivation,
vomiting, secretion of GIT juices…
Stimuli: hunger, thirst regulated by hypothalamus (hunger and satiety centers) as
 affective component – emotions - controlled by limbic system (and hypothalamus) - Middle brain – acomodation, pupillary reflexes (eye)
 ⇒ nutritional behaviour (food search) – conation component
Other stimulus: apetite (strong cortical influence) - Hypotalamus = organ for integrative regulation

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 4. Endocrine control
1) Control of the cardiovascular system:
So-called neurogenic effects on heart rate and blood pressure Production of:
Stimulation: • ADH(AVP)
- posterior and lateral region: sympathetic responses – tachycardia, hypertensive reaction, • Oxytocine
mydriasis... • Hypothalamic neurohormons – regulation of adenohypophysis
- anterior – area preoptica: parasympathetic responses Reactions are modulated
and transmitted through pons and medulla. 5. Sexual functions

2) Thermoregulation - Regulation of gonads development, sexual cycles through adenohypophysis.

Hypothalamus anterior – monitoring of body temperature: Control of sexual behavior: Activity of lateral regions of hypothalamus – stimulation of
Central thermoreceptors – in area preoptica (2/3 for higher temperature, 1/3 for a decrease sexual behavior
of BT – „cold“) Coordination of autonomic functions in erection, ejaculations in males.

Peripheral thermoreceptors – spinothalamic tracts, thalamus, collaterals to hypothalamus. In 6. Behavioral responses associated with emotions
skin - periphery 10x more of the cold receptors than for hot environment.
Humoral signals – mediators (pyrogens) – transport through organum vasculosum laminae Lateral hypothalamus – stimulation - hunger, thirst,activity and agressivity
terminalis (OVLT) – the region non-protected by blood - brain barrier.
Changes of hypothalamic perfusion by vasoconstriction/ vasodilation of OVLT – influence on Ventromedial hypothalamus – stimulation - subjective feeling of satiety, complacence,
basal hypothalamic temperature – set of the set point for central BT. calmness, inactivity

Hypothalamus posterior – thermoregulatory center (area hypoth. posterior) – processing of Periventricular zone – near of the 3rd ventricle – stimulation – fear, aversion
information from area anterior and the periphery. Activation of effectors for
thermoregulation. 7. Sleep-wake patterns

3) Regulation of hydratation and food intake „Sleep centres“, „wakefullness centre“ – recently –only non-specific effects

Regulation of hydratation: Efects of hypothalamic lesions

Regulation of water intake: Bilateral lesion of the lateral hypothalamus:

Centre for thirst in lateral hypothalamus - a decrease of the food intake (anorexia)
Information from: - a decrease of the water intake
Hypothalamus itself - osmoreceptors - passivity
Periphery – volumoreceptors, mouth, pharynx..
Bilateral lesions of the ventromedial hypothalamic region:
Regulation of fluid output (through kidneys): - excessive food intake (hyperfagia)
Ncl. supraopticus - ADH (arginín – vazopresín = AVP) - excessive fluid intake
- hyperactivity
Regulation of apetite: - brutality
- expressions of anger - passion
lateral centre = apetite – dominant active
Ventromedial centre = satiety – after food intake – temporary inhibis the „feeding centre“
Corpus mamillare = coordinatio of the reflexes – movements of a tongue, chewing,
deglutition, swalowing…

Information from:
Glucoreceptors – glucostats in the centre of satiety
Periphery

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 Table I-Ethnoveterinary plants used by housewife or animal owner

Plant name! English name! Parts used Uses

Vernacular name

Allium cepa L. Bulb Food poisoning, skin diseases, hoof diseases, internal
Onion parasites, diarrhoea, FMD, dysentery and loss of
Pya) appetite
Allium sativum L. Clove Food poisoning, tympany, sterility, FMD, skin infection,
Garlic stomach-ache, arthritis, internal parasites and
Lahsan rheumatism
Brassica campestris L. Seed, Oil Constipation, dog bite, food poisoning, eczema,
Mustard stomachache, skin disease, hoof diseases, fever,
Sarson indigestion, dysentery, external parasites, mastitis,
mouth blisters and bum,
Capsicum annuum L. Fruit, Stem Hoof infection, skin disease, dog bite, eczema,
Chili haemorrhagic septicaemia, mouth blisters, wounds,
Mircha FMD and bums Tablel-Ethnoveterinary plants used by housewife or animal owner
Coriandrum sativum L. Seed, Leaf Tympany, diarrhoea, food poisoning, constipation,
Coriander haematuria, fever, indigestion, FMD and loss of appetite Plant narne/ English name! Parts used Uses
Dhanyiya Vernacular name
Curcuma domestica Vallars Rhizome Mouth blisters, sprains, internal parasites, skin disease,
Piper nigrum L. Seed Hoof diseases, pimples, constipation, internal parasites,
Turmeric constipation, internal injury, eye diseases, wounds,
Black pepper snake bite, eye disease, food poisoning, indigestion,
Haldi galactagogue, external parasites, sprains, mastitis,
Kalimircha haematuria, tympany, stomach-ache, loss of appetite,
cough, cold, bone fracture, heatstroke, wounds, FMD,
wounds and skin diseases
haematuria, broken hom and stomach-ache
Saccharum o./ficinarum L. Leaf, jaggery Fever, pimple, haemorrhagic septicaemia, constipation,
Dioscorea bulbifera L. Tuber Disease of skin and ear
Sugarcane blisters on tongue and chicken pox
The air potato
Canna
Ganthi
Solanum tuberosum L. Tuber Bums
Eleusine coracana (L.) Gaertn. Seed Sterility, bone fracture, dysentery and skin diseases
Potato
Finger millet Aalu
Mandua
Syzygium aromaticum (L.) Merr. Dried flower Skin disease and neck sore
Ferula asafetida L. Resin Neck sore, paralysis, tympany, internal parasites, Cloves
Asafoetida stomach-ache and indigestion Laung
Heeng
Vigna mungo (L.) Hepper. Seed Bone fracture, constipation, wounds, bone fracture,
Foeniculum vulgare Mill. Seed Diarrhoea, stomach-ache, dysentery, FMD and Black gram galactagogue, skin diseases, brokcn hom and food
Fennel paraplegia Mash poisoning
Sanuf
Vigna radiata (L.) R. Wilczek Seed Post-partum complaints and internal injury
Glycine max (L.) Merr. Seed Skin disease, diarrhoea, galactagogue, post partum Mungbean
Soybean complaints and stomach disorders Moong, Mung
Bhall
Zea mays L. Flour, cob Food poisoning and external parasites
Lens culinaris Medik. Seed Bone fracture, broken hom and haematuria Maize
Lentil Makka, Maize
Masoor Constipation, food poisoning, diarrhoea, eye diseases,
Zingiber officinale Rosc. Rhizome
Musa paradisiaca L. Plant juice, Glactagogue, tympany, diarrhea, haematuria, prolapse Ginger haematuria, improve stamina, indigestion, tympany,
Banana Fruit, Leaf of uterus, heat-stroke, sterility, dysentery, loss of Ginger dysentery, stomach-ache and skin diseases
Kela appetite, indigestion, mastitis, food poisoning and post
partum complaints
Ocimum tenuiflorum L. Leaf Constipation and wounds
Basil
Tulasi
Oryza sativa L. Husk, Grain Retention of placenta, skin disease, strength, wounds,
Rice neck sore, post- partum complaints and cough,
Dhan
(Con/d)