MINISTRY OF EDUCATION AND SCIENCE OF UKRAINE
SUMY STATE UNIVERSITY
MEDICAL INSTITUTE
Physiology and Pathophysiology Department with course of Medical Biology
PRACTICALBOOK
FOR PROTOCOLS OF PHYSIOLOGICAL PRACTICAL WORKS
For students specializing 7.110101 «Medicine»
daily learning
STUDENT’S FULL NAME
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GROUP №_____________________
Sumy
2015 – 2016
2
3
І semester
PRACTICAL CLASS #1
Date: ______________
THEME: “INTRODUCTION TO PHYSIOLOGY. OBJECT AND TASKS THE COURSE
OF PHYSIOLOGY. METHODS OF PHYSIOLOGICAL RESEARCHES”
Questions for discussion:
1. Physiology as a science. Connect with other disciplines of physiology.
2. Basic concepts of physiology: the function, functional unit, the physiological system, the
functional state of the organism.
3. Structural and functional organization of the human body. The concept of functions at different
levels of living objects.
4. Elementary functions of cells.
5. Basic functional properties of the body as a whole. The structure features of cellular
membrane, functions of it, basic components.
6. Intercommunication of organism with an environment. A concept is about irritants,
irritations, biological reaction, excitation, excitability, excitative structures.
7. Methods of physiological investigations.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Сh.2,4.
INDIVIDUAL WORK “Basic stages of development of physiology”
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5
PRACTICAL CLASS #2
Date:________________
THEME: “RESTING POTENTIAL AND ACTION POTENTIAL OF NERVOUS AND
MUSCULAR FIBRES”
Questions for discussion:
1. Differences of chemical composition of extracellular liquid and intracellular environment.
2. The passive transport of components, its types and mechanisms (diffusion, osmosis).
3. The active transport of components, its types and mechanisms. Co- transport, countetransport.
4. A concept of the membrane potential and resting potential. Methods of registration of
resting potential, and its physical characteristics.
5. The ionic mechanisms of origin of the normal resting membrane potential (diffusion
potential, Nernst potential).
6. Resting membrane potential of nerves and skeletal muscles fibers. Main and
complimentary factors which influence on a value of the resting membrane potential.
7. Action potential: the structure, physical and physiological characteristics.
8. Structure and basic properties of ionic protein channels, which take part in development of
active potential. Voltage-gated sodium and potassium channels.
9. Ionic mechanisms of development of basic phases of action potential.
10. Initiation of the action potential: a positive-feedback mechanism, threshold for initiation
of the AP.
11. Excitability, its changes during development of active potential, refractory period.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch.4, 5.
Work for the independent exercise:
1. Draw the model of cellular membrane by Singer-Nicholson, mark its main components.
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2. Fill a table:
Basic
extracellular
cations
Basic
extracellular
anions
Basic
intracellular
cations
Basic
intracellular
anions
3. Draw graphically resting potential, depolarization and hyperpolarization.
4. Calculate the value of equilibrium potential for potassium ions (up to hundredths).
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5. Draw graphically action potential, mark the phases.
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6. Calculate the value of membrane potential of nerve fibers with increasing concentration of
potassium ions in extracellular fluid of 10 mEq/liter. Identify potential deviation from the
normal value of resting potential nerve fibers. What's name this deviation?
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7. How to affect the action potential of blocking potential of Na-dependent channels with
specific blockers - tetrodotoxin? Explain why?
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8.
How to change the excitability of cells in prolonged increase in extracellular
potassium ion concentration to 20 mEq / L? Explain why?
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PRACTICAL CLASS #3
Date: ____________
THEME: “MECHANISMS OF ELECTRICAL STIMULATION OF EXCITABLE
STRUCTURES AND MECHANISMS OF EXCITATION IN NERVE AND
MUSCLE FIBERS.”
Questions for discussion:
1. Propagation of the action potential. Mechanism of distribution of action potential for
nervous and muscles fibres.
2. Laws of conducting of excitation for nervous and muscles fibres. The safety factor for
propagation.
3. Special characteristics of signal transmission in nerve trunks.
4. Excitation of a nerve fiber by a negatively charded metal electrode.
5. Threshold for excitation and ―acute local potentials‖.
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6. Factors which determine speed of conducting of action potential for nervous and muscles
fibres.
7. Physiological anatomy of the neuromuscular junction.
8. Secretion of acetylcholine by nerve terminals. Effect of Ach on the postsynaptic muscle
membrane. Destruction of the released Ach.
9. Molecular biology of the acetylcholine formation and release.
10. End plate potential and excitation of the skeletal muscle fiber.
11. The structural and functional organization of nerve-muscle synapses (chemical and
electric synapses). Axonal transport.
12. Characteristics of the basic stages of nerve-muscles transmission
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch. 5,7.
Work for the independent exercise:
1. Draw graphically law of force-time. Mark needed points.
2. Calculate the safety factor for propagations when the resting potential nerve fiber is-80mV,
the critical level of depolarization is - 60 mV, overshoot is +20 mV. What this demonstrates
the value of reliability factor? Draw Active Potential that applies.
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3. Draw neuromuscular synapse, sign its parts.
4. Draw the acetylcholine channel. Release of Ach from synaptic vesicles.
5. Draw the acute local potentials.
6.
Two people accidentally hit by a uniform alternating current high voltage, but different
frequencies. In the first case the frequency is 50 Hz, and second - 500 000 Hz. One man was
injured and another suffered electrical injury. Which? Why?
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7.
Irritate the nerve fiber impulses constant electric current through microelectrodes. Anode
is on the outer surface of the membrane, cathode - inside. Voltage and pulse duration threshold. What is the process occur at the membrane? Why?
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PRACTICAL CLASS #4
Date:____________
THEME: “MECHANISMS OF CONTRACTION OF SKELETAL AND SMOOTH
MUSCLE.”
Questions for discussion:
1. Structural organization of the skeletal muscle.
2. The theory ―sliding myofilaments‖ of the muscle contraction.
3. The structure of actin and myosin filaments.
4. The ―walk-along‖ theory ―of the muscle contraction. Fenn effect (ATP)
5. Stages of muscle contraction.
6. The concept of the motor unit. Classification of motor units. Fast fibers, slow fibers.
7. Physiological characteristics of muscle contraction: length of the sarcomer, isometric –
isotonic, multiple fiber, summation – frequency summation (tetanization), muscle
hypertrophy - muscle atrophy, muscle tone – muscle fatigue.
8. Types of the smooth muscle. Physical basis for smooth muscle contraction.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch. 6, 7.
Practical work #1: The determination of the absolute muscular strength of a hand.
Materials and equipments: dynamometers.
Procedure:
1. To demonstrate the method of determination of absolute force of muscles of hand;
2. To demonstrate the method of determination of level of capacity of muscles of hand;
3. To demonstrate the method of determination of index of decline of capacity of muscles of
hand.
A tester in the standing position takes his hand with a dynamometer aside on the right
angle of 90° in relationship to the body. Another hand is let down and relaxed. On a signal the
tester makes the maximum efforts on the dynamometer 5 times with an interval in 5 seconds.
One should hold the dynamometer by fingers without jerks but with all his strength. Every
result should be fixed down. The muscular strength is estimated on the best result.
Results:
f1=________
f2=________
f3=________
f4=________
f5=________
Conclusion: The absolute muscular strength of the hand is _______________ H/cm2
Practical work #2: The determination of the level of the ability to work of a hand.
Materials and equipments: dynamometers.
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Procedure:
1. A tester measures an absolute muscular strength of the hand 10 times with an interval in 5
seconds.
2. The results should be fixed down.
3. The levels of the muscular ability to work are set with the help of the formula:
P = (f1 + f2 + f3 + f4 + f5 + f6 + f7 + f8 + f9 + f10):10
P- is the ability to work level,
f – the dynamometer index.
Results: f1 =______
f2 =______
f3 =______
f4 =______
f5 =______
f6 =_______
f7 =_______
f8 =_______
f9 =_______
f10 =_______
P = (_____+ _____+ ______+ ____ + _____ + _____ + _____+ _____ + ____ + ____) : 10 =
P = _________
Conclusion: The levels of the muscular ability to work is ___________________ H/cm2
Practical work #3: “The determination of the reduction of the muscular ability to work
level of the hand.”
Materials and equipments: dynamometers.
Procedure:
Using the results that had been received in the experiment 2, one should calculate the reduction
of the ability to work index with the help of the formula:
S = ((f1 - fmin) : fmax) x 100%
S – is the reduction of the ability to work index;
f1 - the rate of the primary dynamometry =_________________________
fmax - the maximum rate of efforts =______________________________
fmin - the minimum rate of efforts=________________________________
Results: 1. S = ((______ - ______) : ______ ) x 100%
S = ____________%
2. Draw the graph that will make clear the character of ability to work reduction:
On the abscissa axis you should put down the numbers of efforts, on the coordinate axis you
should put down of the dynamometer on every effort.
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Score
dynamometer
Number efforts
1
2
3
4
5
6
7
8
9
10
Conclusion: the reduction of the ability to work index is ___________________ %
Teacher’s signature ___________________
Work for the independent exercise:
1. Draw the sarcomere. Designate its component parts.
2. Draw the molecule of myosin. Mark its components.
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3. Draw the molecule of actin. Mark its components.
4. Draw the scheme of the excitation-contraction coupling.
5. Draw physical structure of smooth muscle.
6.
What length sarcomere force reductions greatest? Why?
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7.
On muscle inflict frequent rhythmic irritations. On myogram register smooth tetanus.
how to find out, does a muscle answer to every irritation?
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8.
The period reduction in single muscle irritation is 0.04 sec., relaxation time - 0.05 sec.
Find the type of contraction in frequency of muscle irritation 5 imp / sec.
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6. Calculate, which must irritate the minimum frequency of muscle to get: a) incomplete tetanus,
b) complete tetanus. If irritation single length of the muscle contraction - 0.02 sec, relaxation
time - 0.03 sec (latent period lasts 0.002 sec, it can be neglected).
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PRACTICAL CLASS #5
Data:_______________
THEME: "PRACTICAL SKILLS IN PHYSIOLOGY EXCITABLE STRUCTURES".
Practical work #1: “The preparations for close frog’s organs”
Materials and equipments: small and large scissors, anatomic pincers, scalpel, probe, stand,
cotton wool, physiological solution, preparing small planks, serviettes, tray, electrostimulator
with electrodes, a research object is a frog.
To study the physiology of frog muscle and nerve, the frog must be killed but its tissues kept alive. This can
be accomplished by destroying or pithing the frog’s central nervous system. The frog is clinically dead (clinical
death is defined as the irreversible loss of higher brain function), but its muscles and peripheral nerves will continue
to function as long as their cells remain alive. Under the proper conditions, this state can be prolonged for several
hours.
The technique involves grasping the frog securely with one hand and flexing its head forward so that the
base of the skull can be felt with the fingers of the other hand. Then perform these steps:
Procedure:
1. Force one blade of a pair of sharp scissors into the frog’s mouth as shown in figure 1.
2. Quickly decapitate the frog by cutting behind its eyes. It should be understood that the
frog is dead as soon as its brain has been severed from its spinal cord (fig 2.).
3. Insert a probe down into the exposed spinal cord as described above to destroy the frog’s
spinal reflexes (fig. 3).
Fig 1.
Fig 2.
Fig 3.
Results: 1) What was observed after causing a mechanical irritation of the decapitated frog?
2) What was observed after causing a repeated mechanical irritation of the frog, after
destruction of spinal cord?
3) Draw the scheme of experiment.
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3) The scheme of experiment:
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Conclusions: 1. Where are motive centers for a frog?
2. What does disappearance of reaction testify to after destruction of spinal cord?
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Practical work #2 “Preparation of the rheoscopic foot”
Procedure:
1.
2.
3.
4.
5.
6.
Prepare the spinal frog (fig.1).
Cut the spinal column in the middle of the body (fig.2).
Remove the insides of the upper part of the frog (fig.3).
Remove the skin from the preparation (fig.4).
Cut the sacral bone – urostile.
Slit the preparation along the middle line of the spinal column at the front (fig.5). Get
two separate extremities (fig 6).
7. Put them so that the back sides of the extremities would face up; find the sciatic nerve
(nervus ischiadicus).
8. Free the nerve from the other tissues (remove muscles) from pelvis to knee-joint. So
we get the rheoscopic foot (fig.7).
9. Check the functional state of the rheoscopic foot by irritating the sciatic nerve by the
electrostimulator (fig.8).
Fig.1
Fig.2
Fig.3
Fig.4
Fig.5
Fig.6
Fig.7
Fig.8
Results: 1) What was observed after causing an electric irritation on a sciatic nerve?
2) Draw the structure of rheoscopic paw, label its component parts.
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2) Structure of the rheoscopic paw:
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Practical work #3: “Preparation of Gastrocnemius muscle”.
Procedure:
1 Cut the Achilles’ tendon from the rheoscopic foot in the lower 1/3 of it (fig 9).
2 With the help of pincers, to separate the muscles from other tissues, leave the
gastrocnemius muscle, knee-joint and sciatic nerve with the adjacent spinal
column(fig.10-11).
3 A preparation of Gastrocnemius muscle consists of an Achilles’ tendon, knee-joint with
the fragment of thigh-bone, a sciatic nerve and a gastrocnemius muscle (fig.12).
4 Check the functional state of the preparation by:
a) irritating the sciatic nerve (indirect irritation) (fig. 13);
b) irritating the gastrocnemius muscle (direct irritation) (fig. 14).
Fig.9
Fig.10
Fig. 11
Fig. 12
Fig.13
Fig.14
Results: 1 What was observed after causing an electric irritation on a sciatic nerve?
2 What was observed after causing an electric irritation on a gastrocnemius muscle?
3 Draw the structure of Preparation of Gastrocnemius muscle, label its components
parts.
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3 The structure of Preparation of Gastrocnemius muscle:
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Conclusion: 1) Nervous and muscular fabrics belong to which physiological structures?
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2) What are the properties of nervous and muscular fabrics?
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Practical work #4 “A study of the bioelectric phenomena in living tissues. The 1st Galvani’s
experiment.”
In excitable tissues, the bioelectric phenomena can be observed by both biological and physical methods.
Although the biological method in our time lost the value as a research method, for a physiologist it will always be
interesting due to a prominent role which it played in history of opening of the bioelectric phenomena. At the
biological method by Galvani was the first to lead to the existence of «animal electricity» and the same time begin a
new direction in physiology – studies about electric processes in an organism. Essence of the first experience of
Galvani shows that when touched with bimetallic pincers a preparation of gastrocnemius muscle, there is reduction
of muscles. The current which arises between two heterogeneous metals, copper and iron, is the reason of irritation
of the muscle.
Materials and equipments: set of preparing tools (anatomic pincers, small scissors, large
scissors, scalpel, probe), physiological solution, preparing small planks, serviettes, cotton wool,
tray, electrostimulator, with electrodes, bimetal pincers with copper and zinc ends, a research
object is a frog.
Procedure:
1. Prepare the spinal frog.
2. Cut the column in the middle of the body
3. Remove the skin from preparation
4. Place the preparation on the gum carpet
5. Place one tip of the bimetallic pincers under the root of the sacrum’s part of the
frog’s spinal cord (fig.1)
6. During the experiment one should wet the nerve-muscular preparation using a
physiological solution.
7. Observe the contraction of the muscles when we touch the nerve-muscular
preparation with the bimetallic pincers and write your observations and conclusions.
Fig.1
Results: 1 What’s observed when you touch the nerve-muscular preparation with metallic pincers?
2 To draw the scheme of the experiment.
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2 The scheme of experiment:
Conclusion: 1 How was the proved existence of the bioelectric phenomena proved in excitable
structures?
2 What is the reason of irritation of a muscle?
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Practical work #5: The 2nd Galvani’s experiment
This experiment of Galvani consisted of the reduction of muscles of frogs foot was reproduced without
participation of a metal, by throwing of preparation of sciatic nerve on the damaged area of thigh. Difference of
potentials between an external surface of a muscle and the inside surface, which exists at rest, expressly shows up
when a muscle is damaged. Potential which arises up between unharmed and damaged areas is called «potential of
damage». When a nerve gets on the damaged electronegative area of muscle, there is shorting of chain, in which
positive pole (the unharmed surface of muscle) and the area of nerve which compresses with it take part. Thus in the
second experiment of Galvani reason of excitation of nerve is an irritating action of current which arises directly in
tissues.
Between an external surface of a muscle and the inside surface in a state of rest, is a difference potential,
which brightly shows up at a damage. Potential which arises between the damaged and unharmed areas of a muscle,
«potential of damage» can be reason of excitation a nerve.
Procedure:
1. Cut the frog along on the middle line of spine (fig. 2).
2. Prepare the rheoscopical paw (pad) on one leg of the frog.
3. Cut across the hip muscle of the other leg of the frog (fig. 3).
4. Place the buttock’s nerve of the rheoscopical paw in the cross-section on the leg
muscle and observe the reaction (fig. 4).
5. During experiment it is necessary to moisten nerve-muscular preparation by
physiological solution.
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Fig. 2
Fig. 3
Fig. 4
Results: 1 What was observed after the contact of the sciatic nerve of rheoscopic
paw with the damaged area of muscle of the second half of frog?
2 To draw the scheme of experiment.
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2 The scheme of experiment:
Conclusion: What arises up between the damaged and unharmed areas of a muscle, how does it
influence on a rheoscopic paw experiment?
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Practical work #6: “An exposure of electric current in experiment with the second
reduction (Experiment of Matteuchi).”
Matteuchi showed that it is possible to cause reduction of muscles of nerve-muscular preparation, by
putting a nerve to the muscles of the second preparation, which grow short. This experiment demonstrates that in a
muscle which grows short there are considerable currents, which can be utilized in the quality of an irritant for the
nerve of the second preparation. These currents are called «currents of action».
Procedure:
1. To prepare a rheoscopic paw from the second half of frog.
2. Place the buttock’s nerve of the 1st part on the electrodes.
3. Place the buttock’s nerve of the 2nd part along the shin muscle of the 1st part.
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4. Give the electric current of 2V for 0,5 ms (fig. 5). Observe the twitching of the two legs.
5. During the experiment it is necessary to moisten nerve-muscular preparation by
physiological solution.
Fig. 5
Results: 1) How does excitation of muscle of the first preparation affect the state of the second
preparation?
2) Draw the location of rheoscopic quotation marks in experience of Matteuchi.
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2 The scheme of experiment:
Conclusion: Why is there reduction of muscles of the second preparation at reduction of
muscles of the first preparation?
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Teacher’s signature ___________________
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PRACTICAL CLASS #6
Data:_______________
THEME: "MODULE ON THE PHYSIOLOGY OF EXCITABLE STRUCTURES".
Questions for discussion:
1. The structure features of cellular membrane, functions of it, basic components.
2. Differences of chemical composition of extracellular liquid and intracellular environment.
3. The passive transport of components, its types and mechanisms (diffusion, osmosis).
4. Protein channels: selective permeability, gating.
5. Factors that affect net rate of diffusion.
6. The active transport of components, its types and mechanisms. Co- transport, counte- transport.
7. Pinocytosis, phagocytosis.
8. Intercommunication of organism with an environment. A concept is about irritants,
irritations, biological reaction, excitation, excitability, excitative structures.
9. Methods of physiological investigations.
12. A concept of the membrane potential and resting potential. Methods of registration of
resting potential, and its physical characteristics.
13. The ionic mechanisms of origin of the normal resting membrane potential (diffusion
potential, Nernst potential).
14. Resting membrane potential of nerves and skeletal muscles fibers. Main and
complimentary factors which influence on a value of the resting membrane potential.
15. Action potential: the structure, physical and physiological characteristics.
16. Structure and basic properties of ionic protein channels, which take part in development of
active potential. Voltage-gated sodium and potassium channels.
17. Ionic mechanisms of development of basic phases of active potential.
18. Initiation of the action potential: a positive-feedback mechanism, threshold for initiation of the AP.
10. Excitability, its changes during development of active potential, refractory period.
11. Propagation of the action potential. Mechanism of distribution of action potential for
nervous and muscles fibres.
12. Laws of conducting of excitation for nervous and muscles fibres. The safety factor for propagation.
13. Special characteristics of signal transmission in nerve trunks.
14. Excitation of a nerve fiber by a negatively charded metal electrode.
15. Threshold for excitation and ―acute local potentials‖.
16. Factors which determine speed of conducting of action potential for nervous and muscles fibres.
17. Physiological anatomy of the neuromuscular junction.
18. Secretion of acetylcholine by nerve terminals. Effect of Ach on the postsynaptic muscle
membrane. Destruction of the released Ach.
19. Molecular biology of the acetylcholine formation and release.
20. End plate potential and excitation of the skeletal muscle fiber.
21. The structural and functional organization of nerve-muscle synapses (chemical and
electric synapses). Axonal transport.
22. Characteristics of the basic stages of nerve-muscles transmission
23. Structural organization of the skeletal muscle
24. The theory ―sliding myofilaments‖ of the muscle contraction.
25. The structure of actin and myosin filaments.
26. The ―walk-along‖ theory ―of the muscle contraction. Fenn effect (ATP). Stages of muscle
contraction.
27. The concept of the motor unit. Classification of motor units. Fast fibers, slow fibers.
28. Physiological characteristics of muscle contraction: length of the sarcomer, isometric –
isotonic, multiple fiber, summation – frequency summation (tetanization), muscle
hypertrophy - muscle atrophy, muscle tone – muscle fatigue.
29. Types of the smooth muscle. Physical basis for smooth muscle contraction.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch. 2, 4, 5, 6, 7.
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PRACTICAL CLASS #7
Date:____________
THEME: “GENERAL PATTERNS OF NEURAL REGULATION FUNCTIONS.
ANALYSIS OF THE REFLEX ARC. THE PROCESSES OF EXCITATION
AND INHIBITION IN THE CNS.”
Questions for discussion:
1. Structure and functions a neuron. Classification of Neurons. Functions of neuroglia.
2. Reflexes Classification. Reflex arc. Structural and functional component of the reflex arc.
3. Classification of receptors. General mechanisms actions of receptors.
4. Physiologic Anatomy of the Synapse.
5. Types of Synapses—Chemical and Electrical
6. Excitatory or Inhibitory Receptors in the Postsynaptic Membrane.
7. Chemical Substances That Function as Synaptic Transmitters Basic lines of the nervous
adjusting of functions.
8. Neurochemical mechanisms of the integrative function of the CNS.
9. Classification of mediators, their general characteristics.
10. Electrical Events During Neuronal Excitation and Inhibition.
11. Central inhibition and its views and values. Pre- and postsynaptic inhibitions, its
characteristics and mechanisms.
12. The role of brake neuron chains is in the origin of central inhibition.
13. CNS synapses, their structure, mechanisms of information transfer. Features of transfer
excitation in the central synapses
14 ―Spatial Summation‖ in Neurons—Threshold for Firing. ―Temporal Summation‖
15. Divergence of Signals Passing Through Neuronal Pools
16. Convergence of Signals. Prolongation of a Signal by a Neuronal Pool—―Afterdischarge‖,
Reverberatory (Oscillatory) Circuit
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch.45-48.
Work for the independent exercise:
1. Provide examples of positive and negative feedback of the CNS?
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2. Draw neuron, mark its parts.
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3. Characterized of knee-jerk reflex by known to you classifications reflexes.
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4. Characterized of salivary secretary reflex by known to you classifications reflexes.
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5. Characterized of papillary reflex by known to you classifications reflexes.
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6. Draw reflex arc of somatic reflex, mark its functional components.
7. Motoneuron to simultaneously receive 8 stimulant presynaptic nerve impulses. Will this
generate motoneuron efferent nerve impulses, if the amplitude of single ZPSP is 2 mV?
_____________________________________________________________________________________
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_____________________________________________________________________________________
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24
8. Draw schemes of feedback, lateral and reciprocal inhibition.
9. What is the difference in the operation of ionotropic and metabolotropic synapses?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Латеральне
Реципрокне
гальмування
10. What is equal the time of theгальмування
excitation through a central synapse?
Is it different from the
Зворотне гальмування
time of the excitation through neuromuscular synapse? Explain why.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
11. What kind of central inhibition provides inhibition in CNS were biologically significant
afferent signals?
_____________________________________________________________________________
_____________________________________________________________________________
PRACTICAL CLASS #8
Data_______________
THEME:"ROLES OF SPINAL AND BRAIN STEM IN ADJUSTING OF MOTIVE
FUNCTIONS OF ORGANISM"
Questions for discussion:
1. Organization of the Spinal Cord. Alpha Motor Neurons. Gamma Motor Neurons.
Neurochemical integrative mechanisms of CNS function.
2. Functions of the Spinal Cord. Ascending tracts and Functions. Descending Tracts.
3. Autonomic Reflexes in the Spinal Cord
4. Functions of the Muscle Spindle it Roles in Muscle Control.
5. Golgi Tendon Organs it Roles in Muscle Control
6. Gamma Motor System (gamma efferent loop).
25
7. Muscle Stretch Reflex. Flexor Reflex and the Withdrawal Reflexes. Reflexes of Posture and
Locomotion
8. Clinical Applications of the Stretch Reflex
9. Spinal Cord Transection and Spinal Shock. The Brown-Sequard Syndrome.
10. Function of the Brain Stem. Excitatory-Inhibitory Antagonism Between Pontine and
Medullary Reticular Nuclei.
11. Vestibular sensation and maintenance of equilibrium, mechanism for stabilizing the eyes.
12. Vegetative function of the Brain Stem.
13. Cerebellum and Its Functions.
14. The decerebrate rigidity.
15. Clinical Abnormalities of the Cerebellum
16. Midbrain. and Its Functions.
17. Vegetative Control Functions of the Thalamus
18. Vegetative Control Functions of the Hypothalamus
19. Basal Ganglia—Their Motor Functions. Functions of Specific Neurotransmitter Substances
in the Basal Ganglial System. Clinical Syndromes Resulting from Damage to the Basal
Ganglia
20. Physiologic Anatomy of the Cerebral Cortex. Functions of Specific Cortical Areas
21. Electroencephalography.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch. 54 – 58.
Work for the independent exercise:
1. What changes characterized syndrome Brown-Sekar? What linked these changes?
_____________________________________________________________________________________
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_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
2. Draw the diagram of gamma-efferent loop. Explain the mechanism of its
function_____________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
26
3. What is the deferens between of spinal shock in frogs and monkeys? What is the evidence?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
4. The man wounded in the spinal cord segment II-IV lumbar segments. Which of spinal motor
reflexes may disappear as a result of this defeat?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
5. In humans afflicted spinal cord in the area of I-II sacral segments. Which of spinal motor
reflexes may disappear as a result of this defeat?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
6. A person experiencing asthenia, muscle dystonia and imbalance. Which department CNS is
infected? How else can identify the symptoms of the patient, if this assumption is correct?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
7. In humans, there hypokinesia and tremor alone. On the destruction of which is evidenced by
the CNS? What other symptoms can be detected in the patient, if this assumption is correct?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
8. Where localized pathological process if the patient in the presence of vision and hearing no
turning head and eyes toward the source of sound and light?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
9. At what level of CNS located centers that provide support to anti gravitational body posture in
mammals? Which thing you can confirm?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
27
10. Patients with cerebral blood flow violated the act of swallowing. Which department of the
brain is infected?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
11. What is nistahm? Where is the nerve center of this reflex?
_____________________________________________________________________________________
_____________________________________________________________________________________
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_____________________________________________________________________________________
_____________________________________________________________________________________
PRACTICAL CLASS #9
THEME:
"MECHANISMS
FUNCTIONS.”
Data:_______________
OF
REGULATION
OF
AUTONOMIC
NERVOUS
Questions for discussion:
1. Features of the autonomic nervous system.
2. Reflex arc of vegetative reflex.
3. Physiologic Anatomy of the Metasympathetic Nervous System.
4. Physiologic Anatomy of the Parasympathetic Nervous System.
5. Physiologic Anatomy of the Sympathetic Nervous System.
6. Neurotransmitters and Receptors of the Autonomic Nervous System
7. Basic Characteristics of Sympathetic Function
8. Basic Characteristics of Parasympathetic Function
9. Function of the Adrenal Medullae. Sympatho-adrenal system.
10. Dual Innervation.
11. Autonomic Reflexes. ―Alarm‖ or ―Stress‖ Response of the Sympathetic Nervous System
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch. 60.
Practical work #1 : "Investigation of vegetative tone and autonomic reactivity in humans.”
Materials and equipment: plastic sticks, stopwatches, sphygmomanometer, stethoscope.
Procedure:
I.
Determination Kerdu index.
1. In the experimental determine pulse frequency and magnitude of arterial pressure (AP).
II.
2. Calculate Kerdu index by the formula:

ÀP diastolic 
 100%
Kerdu index  1 pulse frequence

28
3. Estimate the value received. If Kerdu index is 0 - a state of autonomic balance
(eutonia). If the index is positive, then dominated by the SNS, if negative - PSNS.
III.
Determination of dermographism.
1. Blunt end of the dashed line sticks to the skin anterior chest wall.
2. Rate received stripes. Long white bar shows the predominance of tonus SNS, pink
strip - the prevailing tone of PSNS.
IV.
Research of Danini-Ashner reflex.
1. To determine the pulse frequency on the patient.
2. Within 30 sec. press on the eye balls by the increasing efforts.
3. Determine pulse rate after pressing.
4. Compare the received values. Slowdown or increased heart rate at 6-12 strokes
shows normal vegetative reactivity. Increased heart rate more than 12 attacks show the
excess reactivity. If the pulse rate does not change, then autonomic reactivity is reduced.
V.
Research of Chermak reflex
1 To determine the pulse frequency and magnitude of arterial pressure on the patient
2. Within 30 sec. press on the carotid artery.
3. Determine the pulse frequency and magnitude of arterial pressure after pressing.
4. Compare the received values. Reducing the pulse rate of 12 strokes or more, AP 10
mm or more indicates a normal autonomic reactivity.
Results:
1) Kerdu index in patient is _______, indicating ________________________.
2) ____________ color bar that shows ___________________________________.
3) Pulse rate before pressing __________________, after pressing _______________________,
indicating ______________________________________________________________.
4) Pulse rate before pressing________________, AP before pressing ___________________,
pulse rate after pressing________________, AP after pressing ________________,
indicating _____________________________________________________________ .
5) Draw reflex arc of Danini-Ashner reflex.
29
Conclusion: Specify the type of autonomic nervous system predominates in the patient's level of
its autonomic reactivity.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #2: "Investigation of work of the internal organs of a man."
Materials and equipment: stopwatches, sphygmomanometer, stethoscope.
Procedure:
I. Determination Hildebrandt coefficient (HC)
1. In a patient to determine the pulse frequency and breathing rate.
2. The patient performs 20 sits per 30 seconds.
3. Determine the pulse frequency and breathing rate.
4. Calculate the Hildebrandt coefficient before exercises and after exercises by the
formula:
HC = pulse rate / respiratory rate
5. Rate obtained values. At normal HC = 2,8-4,9.
Other figures show agreement in violation of the autonomic nervous system.
II.
Conducting of Letunov test.
1. In a patient to determine the pulse frequency and magnitude of arterial pressure.
2. The patient performs 20 sits per 30 seconds.
3. Determine the pulse frequency and magnitude of arterial pressure after exercises.
4. Compare the received values. In normal pulse rate increases by 30%, and systolic
pressure increased by 20-40 mm Hg. Update indicators should be within 3 minutes.
Results:
1) Pulse frequency before exercises ______________, breathing rate before
exercises___________,
Hildebrandt coefficient before exercises _________________________________________.
Pulse frequency after exercises _______________, breathing rate after exercises _________,
Hildebrandt coefficient after exercises ___________________________________________,
indicating _________________________________________________________________.
2) Pulse frequency before exercises _____________, AP before
exercises____________________,
Pulse frequency after exercises ______, AP after exercises ________________,
30
indicating ________________________________________________________________.
Recovery performance was due to ________.
Conclusion: The conclusion of consistency in the autonomic nervous system.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Teacher’s signature ___________________
Work for the independent exercise:
1. Draw reflex arc of vegetative reflex, mark its components.
2. What has been called ganglioblockers? Provide examples of ganglioblockers, noting their
effects.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
3. What are parasympatholytic substances? Provide examples of parasympatholytic substances,
noting their effects.
31
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
4. What are parasympathomimetic substances? Provide examples of parasympathomimetic
substances, noting their effects.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
5. What are sympatholytic substances? Provide examples of sympatholytic substances, noting
their effects.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
6. What are sympathomimetic substances? Provide examples of sympathomimetic substances,
noting their effects.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
7. Explain the mechanism of expansion in the human pupil, which occurs when strong pain.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
8. Patients increased red dermographism. Kerdu index is negative (-8). After pressing on the eyes
pulse frequency decreased by 15 strokes. Man complains of apathy, frequent depression,
indecision. What is the conclusion of the functional activity of the autonomic system you do?
Explain it.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
32
PRACTICAL CLASS #10
Data:_______________
Theme:"PRACTICAL SKILLS ON THE PHYSIOLOGY OF THE NERVOUS
REGULATION OF BODY FUNCTIONS.”
Practical work #1 Research of reflex time (by Turk)
General time of reflex (latent period) is determined from the beginning of action of irritant to beginning
of reflex reaction. It consists of: a) to time, necessary for an origin excitation in receptors; b) to time of
conducting of excitation from receptors to the nerve-centre; c) to time of conducting of excitation through a
nerve-centre (reflex time); d) to time, necessary for a transmission excitation from eff erent of nervous fiber on
the organ of effectors and for the display of his function.
Materials and equipments: set of preparing tools (anatomic pincers, small scissors, large scissors,
scalpel, probe), physiological solution, preparing small planks, serviettes, cotton wool, tray, stand,
solution 0,5%, 1% H2SO4, glass with water, stop watch, object for investigation is a frog.
Procedure:
1. Prepare a spinal frog.
2. Fix a spinal toad for the bottom jar on a hook of a support.
3. To moisten one piece of a filtration paper with 0,1% solution, to place on un internal
surface of a hip and on stop watch.
4. Deduct the time from the moment of immersion of limbs in the acid to the bending reflex.
5. After measuring the drug wash water.
6. Repeat 2-3 times in research, with a minimum of 2-3 minutes and calculate the average
reflex time for the force stimulus.
7. Repeat experiments with 0.3% and 0.5% solution of H2SO4. Calculate the average time
reflexes.
Results:
1. Calculate the average time for each Turk’s reflex force stimuli.
2. Graphically depict the time dependence of strength reflex stimulus (low of fourse of
time).
3. Drawn circuit experiment.
4. Drawn diagram reflex arc of Turk reflex.
1)____________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2)
Power
Time
33
3) Scheme of experiment:
4) Reflex arc of Turk reflex.
Conclusion:
1) What is time of reflex, what are periods consist of?_______________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
2) What does the number of stimuli to time reflexes? _______________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
3) What is the value of reflex time?_____________________________________________
__________________________________________________________________________
__________________________________________________________________________
34
Practical work #2: “Research of the phenomenon of summation.”
Materials and equipments: set of preparing tools (anatomic pincers, small scissors, large
scissors, scalpel, probe), physiological solution, preparing small planks, serviettes, cotton wool,
tray, stand, solution 0,5%, 1% H2SO4, glass with water, stop watch, object for investigation is a
frog.
Procedure:
A. Investigation of successive summation.
1. Prepare a spinal frog.
2. Fix a spinal toad for the bottom jar on a hook of a support.
3. Electrical electrodes attached to the back foot quotes frogs (one clear of insulation
postings attached to your finger wrapped second legs).
4. Causing irritation rare to find threshold stimulus strength (frequency of 1 Hz, duration
1 msec).
5. Slush single irritation subthreshold force. Watch as the drug.
6. Slush series irritation subthreshold force. Watch as the drug.
B. Investigation of simultaneous summation.
1. Prepare spinal frog.
2. Lock the spinal frog in the lower jaw to the tripod hook.
3. A small piece of filter paper wet in 0.1% solution of H2SO4, put the forceps on the skin
of his belly toads. Watch the reaction. Wash off paper
4. Put 3, 5, 7 papers, wetted with acid. Watch the reaction.
5. If the reaction does not occur, repeat the experiments with 0.3% solution of H2SO4.
Results:
1. What observed in A and B in experiments?
2. Drawn diagram of the spatial and simultaneous summation explain their mechanism.
1)__________________________________________________________________________________
_____________________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2)
Temporal summation
______________________________________
______________________________________
______________________________________
______________________________________
Spatial summation
_____________________________________
_____________________________________
_____________________________________
_____________________________________
35
Conclusion: What does summation activity in the CNS?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #3: “Analysis of the reflex arc.”
Materials and equipments: set of preparing tools (anatomic pincers, small scissors, large
scissors, scalpel, probe), physiological solution, preparing small planks, serviettes, cotton wool,
tray, stand, solution 0,5%, 1% H2SO4, glass with water, stop watch, object for investigation is a
frog.
Procedure:
1. Prepare spinal frog.
2. Lock the spinal frog in the lower jaw to the tripod hook.
3. Play Turk reflex for the right limbs.
4. Drug washout.
5. At the bottom ending in a hip area to make a circular incision of the skin and remove it
from the leg.
6. Repeat Turk reflex. Watch as the drug.
7. Play Turk reflex for the left limb.
8. At the bottom left thigh ending cut the skin, find sciatic nerve and cut it.
9. Repeat Turk reflex. Watch as the drug.
10. Prepare second spinal frog.
11. Lock the spinal frog in the lower jaw to the tripod hook.
12. Play Turk reflex.
13. Destroyed spinal cord.
14. Repeat Turk reflex. Watch as the drug.
Results:
1. Describe reflex reaction after
- destruction of receptor field;
- crossing sciatic nerve;
- destruction of the spinal cord.
2. Reflex arc diagram drawn, noting that the functional components were destroyed.
3. What are the laws of the excitation of reflex arc?
1)____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
2)
36
3)
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________
6.__________________________________________________________________________
Conclusion:
12. What are the material substrate reflexes?
13. What are the functional components of reflex arc?
14. What are the conditions necessary for the occurrence of reflex response?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Practical work #4 : "Central inhibition of spinal reflexes (Sechenov’s experiment)
Inhibition like a process in the CNS was discovered by Sechenov in 1862. The scientist has proved that the
irritation can cause brain intermediate braking reflexes that are spinal cord. This reaction is a manifestation of topdown influence in stopping the nervous system. Later it was found that highest departments CNS may hinder or
facilitate spinal reflex activity.
Materials and equipments: set of preparing tools (anatomic pincers, small scissors, large
scissors, scalpel, probe), physiological solution, preparing small planks, serviettes, cotton wool,
filter paper tray, a glass of water, crystals of NaCl, stopwatch; object for investigation is a frog.
Procedure:
1. Prepare thalamic frog for this:
• get a frog in left hand.
• Scissors to make a T-shaped incision of the skin on the head, cut a piece of bare skin and
cranium.
• Acute bransh of small scissors to enter into the cavity of the skull: to make cross roses
braincase trying not to damage the cord, remove the braincase.
• scalpel make an incision over the visual brain bumps and above the cut to remove brain
tissue. The resulting product is called thalamic frog.
2. Lock the frog for the lower jaw in a stand and define a Turk reflex.
3. After 2-3 minutes to dry the surface thoroughly brain filter paper to sodium chloride is not as
fast dissolve and not flowed in brain, with its flowed in the spinal canal is observed excitation
spinal motor centers and convulsions appear.
4. In visual bumps impose some crystals of NaCl.
5. After 3 minutes to determine a Turk reflex. If the index has not changed, repeat the definition
of a few minutes.
6. Remove NaCl; carefully wash brain by physiological solution.
7. After 5 minutes to determine a Turk reflex.
37
Sechenov’s inhibition
Results:
1) Time of bending reflex by Turk method in thalamic frog before imposing crystal of NaCl
___________________.
2) Time of bending reflex by Turk method in thalamic frog before imposing crystal of NaCl
___________________.
3) Time of bending reflex by Turk method in thalamic frog after removing crystal of NaCl
____________________.
Conclusion: 1. How does visual irritation bumps on spinal neurons of center bending reflex?
2. Which type (pre-or postsynaptic) is Sechenov’s inhibition?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
38
Practical work #5 “Research of clinically important reflexes."
Materials and equipments: neurological hammers.
Procedure:
In this exercise, a number of reflex arcs will be tested that are initiated by distinctive stretch receptors within
muscles. These receptors, called muscle spindles, are embedded within the connective tissue of the muscle and
consist of specialized thin muscle fibers (intrafusal fibers) that are innervated by sensory neurons. The intrafusal
fibers are arranged in parallel with the normal muscle cells (extrafusal fibers), so that stretch of the muscle also
places tension on the intrafusal fibers. Located within the spindles, the intrafusal fibers respond to the tension by
causing the stimulation (depolarization) of the sensory neuron. The sensory neuron arising from the intrafusal fiber
synapses with the motor neuron in the spinal cord that, in turn, innervates the extrafusal fibers. The resultant
contraction of the extrafusal fibers of the muscle releases tension on the intrafusal fibers and decreases stimulation
of the stretch receptors. In a typical clinical examination, this reflex is elicited by striking the muscle tendon with a
rubber mallet, creating a momentary stretch. When the extrafusal muscle fibers contract during the stretch reflex,
they produce a short, rapid movement of the limb (the jerk). This is very obvious for the kneejerk reflex, but can be
quite subtle for the biceps- and triceps-jerk reflexes. Use of the flexicomp allows the limb movement to be seen as a
tracing on the computer screen.
1. Procedure for knee-jerk reflex – tests femoral nerve
1. Allow the subject to sit comfortably with his or her legs
free.
2. Strike the ligament portion of the patellar tendon just below
the patella (kneecap), and observe the resulting contraction
of the quadriceps muscles and extension of the lower leg.
2. Procedure for ankle-jerk reflex – tests medial popliteal nerve
4. Have the subject kneel on a chair with his or her back to
you, and with feet (shoes and socks off) projecting over
the edge.
2. Strike the Achilles (calcaneal) tendon at the level of the
ankle and observe the resulting plantar extension of the
foot.
3. Procedure for biceps-jerk reflex – tests musculocutaneous nerve
1. With the subject’s arm relaxed but fully extended on
the
desk, gently press his or her biceps tendon in the
antecubital fossa with your thumb or forefinger and
strike
this finger with the mallet.
2. If this procedure is performed correctly, the biceps
muscle will twitch but usually will not contract
strongly enough to produce arm movement.
39
4. Procedure for triceps-jerk reflex – tests radial nerve
1. Have the subject lie on his or her back with the elbow
bent, so that the arm lies loosely across the abdomen.
2. Strike the triceps tendon about 2 inches above the
elbow. If there is no response, repeat this procedure,
striking to either side of the original point.
3. If this procedure is correctly performed, the triceps
muscle will twitch but usually will not contract strongly enough to produce arm movement.
5. A cutaneous reflex: the plantar reflex and Babinski’s sign
The plantar reflex is elicited by cutaneous (skin) receptors of the foot and is one of the most
important neurological tests. In normal individuals, proper stimulation of these receptors located
in the sole of the foot results in the flexion (downward movement) of the great toe, while the
other toes flex and come together. The normal plantar reflex requires the uninterrupted
conduction of nerve impulses along the pyramidal motor tracts, which descend directly from the
cerebral cortex to motor neurons lower in the spinal cord. Damage anywhere along the pyramidal
motor tracts produces a Babinski reflex, or Babinski’s sign, to this stimulation, in which the great
toe extends (moves upward) and the other toes fan laterally. Infants exhibit Babinski’s sign
normally because neural control is not yet fully developed. Abdominal reflex is a superficial
neurologic reflex obtained by firmly stroking the skin of the abdomen around the umbilicus. It
normally results in a briskcontraction of abdominal muscles in which the umbilicus moves
toward the site of the stimulus. This reflex is often lost in diseases of thepyramidal tract and can
also be lost with age or abdominal surgery.
tip
starting
1. Have the subject lie on his or her back with knees
slightly bent, and with the thigh rotated so that
the lateral (outer) side of the foot is resting on the floor
2. Applying firm (but not painful) pressure, draw the
blunt probe along the lateral border of the sole,
the heel and ending at the base of the big toe.
Observe the response of the toes to this procedure.
40
Results: drawn the reflex arcs investigated reflexes, sign of their components.
Knee-jerk reflex
Biceps-jerk reflex
Ankle-jerk reflex
Triceps-jerk reflex
41
Plantar reflex
Abdominal reflex
Conclusion: What are the receptors, and why arises tendinous reflexes?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Practical work #6 : "Study of functional asymmetry of bark large hemispheres."
Materials and equipment: centimetric tape, ruler, dynamometer.
Procedure:
1. Evaluation of leading hand.
1. Detection of morphological asymmetry:
- measure the length of each omitted from hand shovels acromial appendix to the end of
third phalanxes. Presenter is a hand that is longer from the other by more than 0.2 cm;
- measure the height of the nail bed thumbs (using a ruler). Leading hand is higher nail
bed.
Length of the right hand____________,
length of the left hand _____________.
The height of the thumb nail bed of the right hand, ___________________,
The height of the thumb nail bed of the left hand ___________________.
2. Detecting functional asymmetries:
- plexus fingers brush. Considered a leading hand, the thumb which was on top;
- crossing hands (outside of Napoleon). Considered a leading hand, wrist which will be
on the other hand forearm above ;
42
-
applause. The leading hand makes drums movements (test has a high information
value);
- dynamometry. Leading arm measured muscle strength in the first place. In the
leading arm strength more. Indicators of power in the hands of three-time
measurement is more resistant to leading hand. The hand is leading if its strength
exceeds 2 kg.;
- test the accuracy of hand movement. Draw a circle on paper. Right handed man make
movements by pencil anti-clockwise, left-handed - clockwise;
- raising test subjects lying on the floor. Items are usually lifted from the floor leading
hand;
When plexus fingers above the thumb was _______________ hands.
When crossing the hands on the forearm ___________ ___________ hands revealed brush
hands.
During the applause of drums carries __________ hand movements.
The Power of muscles of the right hand __________,
The Power of muscles of the left hand __________.
Circle drawn for (against) clockwise.
Subjects lifted ___________ hand
2. Evaluation of leading legs:
- filling up foot to the other. Often the top is the leading foot;
- step forward, step back. These actions leading leg performs first;
- length measurement step. Measure the length 5 - 10 steps. Steps leading legs have
more length.
When filling up foot to the other, top is ___________ leg.
The first step performs
___________ leg.
Average length of the right steps ___________,
Average length of the left steps ___________
3. Evaluation of leading the eye:
- test "nictation" eye. Proposed blink one eye. Of course, close non-leading eye;
- Rozenbah test. Target set in the fixing eye pencil hand drawn and then alternately
close one, the second eye. Leading the eye is that, when you close the pencil is
"shifted" in his direction. If the pencil "moves" when you close both eyes, the
presenter is that when you close the pencil which moves to larger distances;
- consideration in telescopes. Used as a rule, driving the eye;
When nictation __________ closed eye.
When you close the right eye pencil moves on ________ cm
When closing the left eye pencil moves on ________ cm
In consideration of items used in telescopes
_________eye
4. Evaluation of leading ear:
- test "whisper". Experimenter reads the words in a whisper. Target returns driving ear
toward speaking;
- test "phone conversation‖. Often this is used for driving the ear;
- test "ticking clock". Examiner offered to assess the volume ticking clock. Clock is
applied primarily to lead the ear.
As a side conversation returns __________ ear.
For telephone calls using ___________ ear.
43
Clock ticking estimated
___________ ear.
5. Rating touch:
- Recognition test numbers painted on the back surface of the wrist (from 0 to 9 - Foster
Test). Rather, perfect recognize the numbers drawn at the leading hand;
- test guessing coins (1, 2, 5, 10 cents). Shorter response time and perfect in the leading
hand;
- test of ability to carry tactile information in the visual field. Examiner offered to draw
figures from memory, which enjoyed without visual control, right and left hands (no
instructions). A perfect and shorter time to leading the side.
Faster and perfect recognized figures drawn on __________ hand.
Specifically guessed
coins by
__________ hand.
More precisely drawn figures by
__________ hand .
Results: The majority of samples to determine a leading hand, leading foot, driving the eye, ear,
driving, leading the side.
1. Evaluation of leading hand:
Leading hand is __________________.
2. Evaluation of leading legs.
Leading leg is ____________________
3. Evaluation of the leading eye.
Leading eye is ____________________
4. Evaluation of the leading ear.
Leading ear is ____________________
5. Rating touch.
Leading hand is ____________________
Conclusion: To conclude the existence of distinct functional asymmetry (all samples or right or
left), the absence of functional asymmetry - ambidexterity (equality tests left and right), the
existence of functional asymmetry of the elements ambidexterity (most of the samples for one
side, but not all ). Make a general conclusion about the leading hemisphere.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Teacher’s signature ___________________
44
PRACTICAL CLASS #11
Data:_______________
Theme:"MODULE ON THE PHYSIOLOGY OF THE NERVOUS REGULATION OF
BODY FUNCTIONS."
1.
2.
3.
4.
5.
6.
7.
8.
9.
Basic lines of the nervous adjusting of functions.
Functions of neuroglia.
Reflex. Reflexes Classification.
Reflex arc. Features of conducting of excitation are on a reflex arc.
Classification of receptors. General mechanisms of functioning receptors.
A concept is about a nerve-centre. Properties of nerve-centers.
Classification of mediators, their general characteristics.
Description exciting and brake postsynaptic potentials.
CNS synapse, their structure, mechanisms of information transfer. Features transfer
excitation in the central synapses.
10. Central inhibition and its views and values.
11. Characteristics and mechanisms of pre-and postsynaptic inhibitions.
12. Functions of spinal cord.
13. Mechanisms of muscular and joint reception (proprioreceptions).
14. Description of tonic reflexes (miotatichnogo and neck tonic), those reflex arcs.
15. Description of phase reflexes (tendon, leather, rhythmic, bend, cross-reflex), them reflex
arcs.
16. Neuron organization of back brain.
17. Neuron organization of middle brain.
18. The role of reticular formation in the implementation of motor functions. Influence of
medial and lateral paths of reticulospinal motoneuron spinal cord.
19. Functional organization and functions of basal nuclei.
20. The functions of the cerebellum. Effects of removal or destruction of the cerebellum that
occur in humans, their physiological mechanisms.
21. Functional characteristic nuclei thalamus.
22. Functions of hypothalamus.
23. Features articulate the structure of the crust of large hemispheres. Areas of large
hemisphere cortex. Electroencephalography.
24. Structural features of PSNS and SNS.
25. PSNS and SNS influence on the internal organs: heart, blood vessels, gastrointestinal
tract, bronchi, secretory organs, pupil, lacrimal glands.
26. Vegetative reflexes.
Guyton, Arthur C. Textbook of medical physiology – Ch.. 45, 46, 54, 55, 56, 57, 60,
45
PRACTICAL CLASS #12
Data:_______________
THEME:"HUMORAL REGULATION OF AUTONOMIC FUNCTIONS”
Questions for discussion:
1. Basic features of humoral regulation of functions.
2. Regulation of humoral factors, their characterization and classification.
3. The concept of hormones. Properties hormones.
4. Classification of hormones.
5. The concept of endocrine function of components.
6. Regulation of the endocrine glands.
7. The mechanism of secretion of hormones and forms of transport.
8. Characterization of mechanisms cytoreception. The value of secondary mediators.
9. The concept of the hypothalamic-hypophysial system.
10. Neurohypophysis Hormones: chemical nature, the regulation of the selection mechanism
of action and functional effects.
11. Adenohypophysis Hormones: chemical nature, the regulation of the selection mechanism
of action, functional, metabolic and structural effects.
12. Role of somatotropin in ensuring the growth and development. Value somatomedine.
Effects of hypo-and hypersecretion somatotropin. The role of other hormones that affect
the processes of growth (insulin, sex hormones, cortisol).
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch. 74,75.
Work for the independent exercise:
Hormone
1
Vasopressin
Oxytocin
TSH
Place of
creation
Chemical
nature
2
3
Mechanism
Regulation
Biological
of
of the
effects
сytoreception secretion
4
5
6
Note
7
46
1
ACTH
FSH
LH
Somatotropin
Prolactin
Thyroxine
Triiodthyronine
Calcitonin
Parathyroid
hormone
1,25(ОН)2D3
2
3
4
5
6
7
47
1
Aldosterone
Cortisone
Insulin
Glucagon
Epinerphine
Progesteron
2
3
4
5
6
7
48
1
Estrogen
Androgens
MSH
Tymosin
Relaxin
Chorionic
gonadotropin
2
3
4
5
6
7
49
Practical class #13
Data:_______________
Theme:"ROLE OF ENDOCRINE GLANDS IN REGULATION OF BODY
FUNCTIONS."
Questions for discussion:
1.
Hormones of the pancreas: insulin, glucagon, somatostatin and their impact on
metabolism and the concentration of glucose in the blood.
2. Functional System, which provides support for the sustainability of the concentration of
glucose in the blood.
3. Hormones that regulate calcium and phosphate homeostasis: parathyroid hormone,
calcitonin, 1,25 (ОН)2D3. The influence of other hormones in calcium metabolism
(glucocorticoids, somatotropin. Thyroid hormones, estrogens, insulin).
4. Thyroid hormones: chemical nature, synthesis and secretion, regulation of the selection
mechanism of action. Functional and metabolic effects. Effects of hypo-and
hypersecretion.
5. Adrenal cortex hormones: chemical nature, the regulation of the selection mechanism of
action, functional and metabolic effects.
6. Adrenal hormones in brain matter: chemical nature, the regulation of the selection
mechanism of action, functional and metabolic effects.
7. The concept of stress. Types of adaptation to stressors. Adaptation syndrome (G. Selye).
The role of sympatho-adrenal system in adaptation.
8. Male sex hormones: chemical nature, the regulation of the selection mechanism of action,
functional, metabolic and structural effects.
9. Female sex hormones: chemical nature, the regulation of the selection mechanism of
action, functional, metabolic and structural effects.
10. Monthly ovarian cycle. Pregnancy. Hormones of the placenta.
11. Thymus hormones. Thymic-lymphatic status.
12. Hormones epiphysis.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Сh. 76-80.
50
Practical class #14
Data: _______________
Theme:"Module on the physiology of humoral regulation of body functions."
Questions for discussion:
1. Basic features of humoral regulation of functions.
1 Regulation of humoral factors, their characterization and classification.
2 The concept of hormones. Properties hormones. Classification of hormones.
3 The concept of endocrine function of components. The mechanism of secretion of
hormones and forms of transport. Characterization of mechanisms cytoreception. The
value of secondary mediators.
4 The concept of the hypothalamic-Hypophysial system.
5 Neurohypophysis Hormones: chemical nature, the regulation of the selection mechanism
of action and functional effects.
6 Adenohypophysis Hormones: chemical nature, the regulation of the selection mechanism
of action, functional, metabolic and structural effects.
7 Role of somatotropin in ensuring the growth and development. Value somatomedine.
Effects of hypo-and hypersecretion somatotropin. The role of other hormones that affect
the processes of growth (insulin, sex hormones, cortisol).
8 Hormones of the pancreas: insulin, glucagon, somatostatin and their impact on
metabolism and the concentration of glucose in the blood.
9 Functional System, which provides support for the sustainability of the concentration of
glucose in the blood.
10 Hormones that regulate calcium and phosphate homeostasis: parathyroid hormone,
calcitonin, 1,25 (ОН)2D3. The influence of other hormones in calcium metabolism
(glucocorticoids, somatotropin. Thyroid hormones, estrogens, insulin).
11 Thyroid hormones: chemical nature, synthesis and secretion, regulation of the selection
mechanism of action. Functional and metabolic effects. Effects of hypo-and
hypersecretion.
12 Adrenal cortex hormones: chemical nature, the regulation of the selection mechanism of
action, functional and metabolic effects.
13 Adrenal hormones in brain matter: chemical nature, the regulation of the selection
mechanism of action, functional and metabolic effects.
14 The concept of stress. Types of adaptation to stressors. Adaptation syndrome (G. Selye).
The role of sympatho-adrenal system in adaptation.
15 Male sex hormones: chemical nature, the regulation of the selection mechanism of action,
functional, metabolic and structural effects.
16 Female sex hormones: chemical nature, the regulation of the selection mechanism of
action, functional, metabolic and structural effects. Monthly ovarian cycle. Pregnancy.
Hormones of the placenta.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch.. 74, 75, 76, 77
51
Practical class #15
Data:_______________
Theme: «Characteristics of sensory systems."
Questions for discussion:
1. The concept of sensory systems (analyzers).
2. General principles of structure and basic functions of analysis.
3. Properties analyzers.
4. The notion of absolute and differential threshold of feeling. Weber-Fechner Law.
5. Functional organization analysis.
6. Classification of receptors and their function.
7. The functions of conduction and central departments analyzers.
8. Structural-functional organization of somato-sensory system (cutaneous and proprioseptic
sensitivity).
9. Physiological bases of pain. Nociception, physiological characteristics and classification
nociceptors.
10. Nociassociation or pain system, its structural and functional organization, leading
ways and levels of processing. Physiological significance of pain.
11. Antinociassociation system, its structural and functional organization opiatic and nonopiatic
mechanisms, physiological role. Physiological bases of anesthesia.
12. Structural-functional organization of taste sensory systems. Types of tastes
mechanisms of their perception, physiological role.
13. Structural-functional organization of olfactory sensory system. Classification of smells,
theory of perception.
14. Structural-functional organization of the visual analyzer.
15. The optical system of the eye. Mechanism of refraction and accommodation. Refractive
errors eyes.
16. Pupillary reflex, its physiological significance.
17. Receptor apparatus visual analyzer. Structure and function of individual layers of the
retina.
18. Photochemical and electrical phenomena in the retina.
19. Light and Contrast Sensitivity of view. The notion of adaptation view.
20. Modern understanding of the mechanisms of perception of color. Major violations
perception of color.
21. Basic visual function and physiological basis of their research.
22. Overview of the hearing analyzer. Features external and middle ear.
23. Structural-functional organization of the inner ear. The mechanisms of perception of
sounds.
24. Analyze frequency and strength of sounds. Characteristics of sound sensations.
25. Structural-functional organization of the vestibular analyzer. Vestibular reactions.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch. 45-53.
Work for the independent exercise:
1. Draw a scheme of olfactory analyzer, designate its parts.
52
2. What would seem studied water temperature of 200, while lowering it in both hands, if he
kept one hand in the water temperature of 400, and another - a temperature of 100? How
to explain the feeling that when this occurs?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
3. During the application of weak shots to the back surface of the skin brush sample mostly
felt touch, less pain. With more intense injection of the same area, he felt only pain.
Please explain this phenomenon.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
4. A man, who entered the room, felt a sharp smell of lily of the valley. She soon ceased to
feel it. Why do people who were long in this room doing not feel this smell?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
5. Draw the scheme of the main ways of somatosensory system; specify its types of
receptors on which they transmit nerve signals.
53
6. Draw the scheme of visual analyzer, label the component parts.
7. Draw the scheme of hearing analyzer, label the component parts.
8. Draw the scheme of vestibular analyzer, label the component parts.
54
Practical class #16
Data:_______________
Theme: "PHYSIOLOGICAL BASES OF BEHAVIOR."
Questions for discussion:
1. General characteristics of congenital and acquired forms of behavior.
2. Comparison of conditional and unconditional reflexes.
3. Conditional reflexes: general characteristics, properties, conditions of formation and
preservation. Mechanism of closure of the temporary connection.
4. Braking conditional reflexes, brake types, their physiological significance.
5. Memory. Types and mechanisms of memory.
6. Structure holistic act behavior (by P.K. Anokhin).
7. The role of motivation in the implementation of behavioral reactions.
8. The mechanism of formation and biological significance of emotions.
9. Sleep, its phase, the development of mechanisms and biological significance for the
organism.
10. Concept about first and second signal system.
11. Functions of new part of the brain and higher nervous activity of man.
12. Functional asymmetry using a large hemispheres of the brain, the concept of dominant
hemisphere function non-dominant hemisphere interaction hemisphere.
13. Language. Functional language. Physiological bases of its formation. Age of higher nervous
activity in man.
14. Types of higher nervous activity, their classification, physiological bases, methods. The role
of education.
15. Types of nervous system in humans, methods of research.
16. Thinking. Role of brain structures in the process of thinking. Consciousness.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch.
TOPIC LIST FOR REPORTS:
1. Influence of social factors on the formation of higher mental functions.
2. Analytic-synthetic activity of the cerebral cortex.
3. Human circadian rhythm.
4. The role of the limbic system in the formation of emotions.
5. Neurochemical basis of memory.
6. Organization of primary and secondary memory.
7. Biological motivation and intelligence.
8. The mechanism of sleep.
9. Functional and structural prerequisites for the formation of consciousness.
10. Role prefrontalnoyi cortex in the development strategies of behavior.
11. Principles of behavioral reactions in humans.
12. Principles of formation of automatic movements in human behavior.
13. Nature neural processes that underlie thinking.
14. Principles of coding and transmission of sensory information.
15. Neural mechanisms of the cerebral cortex.
16. Perceptions of information and emotions.
17. The spatial organization of brain processes.
55
18. Principles of formation of abstract thinking.
19. Neurophysiological aspects of the systemic mechanisms of behavior.
20. The role of biological motivation in the formation of emotions.
21. Information processes of the brain.
22. Mechanisms for evaluation of signals from the environment in the cerebral cortex.
23. Fundamentals of human adaptation to new environmental conditions.
24. The principles of integrity in the brain.
25. Mechanisms of formation of food behavior.
26. The role of instincts in human life.
Practical class #17
Data:_______________
Theme: "PRACTICAL SKILLS ON THE PHYSIOLOGY OF ANALYZERS AND HIGH
NERVOUS ACTIVITY.
Practical work #1 : " Research of somato-sensory analyzer."
Materials and equipment: peas, esteziometer, ruler, object for investigation – human.
Procedure:
1. Aristotle’s experiment.
Index and middle fingers of the hand cross and ride them pea in the horizontal plane with your
closed eyes. In a normal feeling that fingers rolled 2 peas.
2. Ivanov’s experiment.
Cross index and middle fingers of the hand and slowly holding the tip of the nose. In a normal
feeling that fingers touched two nose tips.
3. Determination of the spatial threshold tactile sensitivity of human skin.
Target sits in a chair; he offered to close the eyes. Esteziometer (compasses Weber) with the
most elevated legs to affect different areas of the skin (ends of fingers, palms, nose tip, forehead,
forearm, shoulder, back). This followed the two legs esteziometer touched the skin
simultaneously with the same stamping. Continue to touch different areas of the skin in that
order, gradually increasing the distance between the arms, adding each time to 1 mm. Each
sample has a touch answer, one or two touch, he feels. Record in which the distance between the
arm and the skin area where he first felt the double touch.
Results:
1. When skating pea crossed fingers, we feel
_____________________________________________________________________________
because
__________________________________________________________________________
2. When you touch the tip of the nose crossed fingers felt
_____________________________________________________________________________
because
_____________________________________________________________________________
56
3. Spatial threshold tactile skin sensitivity:
Skin
Distance (mm)
Ends of fingers
Palms
Nose tip
Forehead
Forearm
Shoulder
Back
Conclusion: Mark where the body segment density location tactile receptors in? What body area
the patient is most sensitive?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #2: "Determination of sharpness vision."
Visual acuity - the ability to see these two points separately at their closest approach. Develop measures of
the image on the retina depends on the angle of view - the angle that is formed between the light rays that come to
the eyes of two light points. Minimum angle of view, which distinguishes between two people is illuminated point is
1o.
Visual acuity is determined in relative units (standard - 1.0) Definition for transmitting to help special-tables
(Sivtsev-Golovin’s tables). Tables are containing 12 rows of letters and symbols as rings. On the left side of the
table near each line represents the distance from which recognize letters in normal stars. On the right side indicated
visual acuity patient, which recognize the letters and characters of this line from a distance of 5 m.
Materials and equipment: Sivtsev-Golovin’s tables, object for investigation – human.
Procedure:
1. Hang on a wall Sivtsev’s table so that its bottom line was at eye level patient.
2. The patient sits down on a chair at a distance of 5 meters from the table.
3. Close one eye a corymb.
4. Experimenter showed him the letters and invites them to call. Investigations begin with
top line, gradually moving to lower.
5. Finds a row in which the patient cannot name all the letters. The last line in which the
patient correctly named all the letters is an indicator of visual acuity. On the right side of
the table specified visual acuity patient, which recognize the letters and characters at a
distance of 5 m.
6. If the study conducted at a distance, more or less than 5 m, the calculation of visual acuity
are Snellen’s formula: v = d / D, where v-visual acuity, d - the distance from which the
patient sees this line, D - the distance from which he should see this line for normal
visual acuity (1.0) - shown on the left side of the table.
7. Similarly, exploring the second eye.
Results:
Sharpness vision: right eye – ___________, left eye – ___________.
_____________________________________________________________________________
_____________________________________________________________________________
57
_____________________________________________________________________________
_____________________________________________________________________________
Conclusions: mark, whether certain indexes a norm answer
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #3: "Determination of the visual field."
Part of the space, which covered the fixed condition the eyeball is called the field of view. Size of the visual field is
limited to nose, superciliary arcs, cheeks. In normal field of view of an adult is: top - 48-50o, down - 65-70o, outside
- 90o inside - 50-60o. Determine the field of view by using perimeter or under the control of the visual field
experiment. The limits of the visual field size measured angle that formed the eye visual axis and the line held by the
last seen point to the periphery through the point of the eye to the retina.
Materials and equipment: board, chalk, marker, object for investigation – people.
Procedure:
1. A patient stays at a distance of 1 m from the board.
2. In the center of the board at eye level the patient to draw a circle with diameter 1 - 2 cm
and hold it through the 8 lines every 45o.
3. The patient covers one eye, and the second captures Token, which is located in the circle.
4. Experimenter moves the marker on each line from the center to the periphery and makes
on the icon at the place the line where the patient stops seeing token.
5. The marked points connecting straight lines.
Results: Draw received schematic view for each eye.
Right eye
Left eye
Conclusions: mark the visual field.
:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
58
Practical work #4: "Observation blind spots (Marriott’s experiment)"
Materials and equipment: cards, object for investigation – people.
Procedure:
1. Set at a distance of 20-25 cm at eye level the patient card, a painted cross (left) and circle
(right).
2. Close right eye. Left lock right image.
3. Estrange or bringing the card to the eye, find the distance at which the image disappears.
4. Repeat the study, closing the left eye.
Results: Describe the results of observations.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Conclusions: explain results.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #5: "Investigation of pupillary reflex."
Materials and equipment: object for investigation – people.
Procedure:
1. The patient sits down on a chair so that eyes light up a moderate light, and captures the eyes
and external remote high point so that the eyes were directed upwards.
2. Eyes close by hands on 20 sec.
3. Quickly take your hands and observe the change of the width of pupil.
4. Close one eye and hand to observe or change the width of pupil second eye.
Results: Describe the results of observations.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Draw the reflex arch of pupillary reflex
Conclusions: explain results.
:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
59
Practical work #6: "Determination of sharpness hearing."
Materials and equipment: object for investigation – people.
Procedure:
1. The patient sits down at a distance of 6 m from the experimenter, one hand covering the
ear.
2. Experimenter called whisper words with hard consonants (or numbers).
3. The patient repeats the words heard.
4. If the patient cannot hear the words, then reduce the distance to the experiment at 1 m and
closer.
5. Repeat the study for the second ear.
Results:
sharpness hearing for the right ear _________________________________,
sharpness hearing for the left ear _________________________________.
Conclusion: explain the results.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #7: "Investigation of air and bone conduction of sounds."
Air conducting sounds are normal physiological process, and bone-conducting (through the skull bone) - a related
process and to obtain sound information is of secondary importance. In the normal relations between duration of air
and bone conduction 2: 1. When you damage the sound device sound tuning fork to hear through bone. This study
has important diagnostic value.
Materials and equipment: Tuning forks, stopwatches, cotton tampons, object for investigation
– human.
Procedure:
1. Patient sits down on a chair.
2. Make stem tuning fork that sounds to mastoid process.
3. Fix the time during which the patient hears the sound of tuning fork. This duration of
bone conduction sounds.
4. Once the sound disappears, pitchfork to move the ears and placed at 0.5 cm from the
outer ear passage.
5. Fix the time during which the patient hears the sound of tuning fork. This duration of air
conduction sounds.
6. To avoid adaptation hearing analyzer during the study pitchfork is remote from the ear
(50 cm), then again bring to it. Fork must be held for the legs, not touching it bransh not
to extinguish it amplitude fluctuations.
7. Put the fork stem, which sounds at mid sinciput.
8. Fix any sound in both ears.
9. Close the external acoustic duct of right ear a wadding tampon.
10. Mark amplification in a closed ear.
60
Results:
The duration of bone conduction ______________________,
The duration of air conduction ________________________.
The relationship between the duration of bone conduction and air conduction _______________.
Conclusion: What kind of conduct sound better? What kind of conduct sound prevailing in the
patient? Why increasing bone conduction in the closed ear?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #8 : "Investigation of the vestibular analyzer."
Materials and equipment: object for investigation – human.
Procedure:
1. Patients with closed eyes set on a background of vertical lines (edge of the cabinet,
cheek) with heel upon and socks and hands extended forward. Mark, in which direction
and how many cm is a deviation from the vertical line.
2. On the floor to draw 3 circles with diameters 25, 50 and 100 cm Cola divided into 8
sectors of 45o each. The patient with closed eyes becomes the center of the circle back to
the light. Under its own arithmetic makes 50 steps in place raising feet high. When he
stops, evaluate degree of rotation around its own axis. In the normal rotation does not
exceed 45o. Linear displacement forward while allowed tagging 100 cm.
3. On the floor to hold 2 parallel lines at a distance of 20 cm length of 5 m race ends on both
sides start-finish rectangular 30x40 cm sites studied offer pass line first opened, and then
with eyes closed - forward and back. Deviation should not exceed 15 cm.
Results:
1. Deviation from the vertical line is _________ cm.
2. Deviation forward (back) is _______ cm axis _______ o.
3. Deviation from the site is _________ cm.
Conclusion: mark vestibular analyzer.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #9: "Evaluation of short-term memory capacity."
Materials and equipment: colored pictures, object for investigation – human.
Procedure:
1. Assessment of visual memory capacity.
61
2. During the 30 sec. study examines 15 cards with colored drawings. Then he called
drawings, which are remembered in an arbitrary sequence. The number of these cards is
the capacity of visual memory.
3. Evaluation of auditory memory capacity.
4. During 30 sec. studied read aloud 15 words. He calls the words, remember that in an
arbitrary sequence. The number of these cards is the capacity of auditory memory.
5. Rating capacity logical memory.
6. During 30 sec. studied reading set of 15 words that are interlinked content and form of
the specific event or phenomenon. He calls the words that remembered. Number of these
words is the capacity of logical memory.
Results:
1. The capacity of visual memory is __________
2. List of words to assess auditory memory
_________________________
________________________
________________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
______________________
________________________
________________________
________________________
________________________
________________________
________________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
Capacity auditory memory is __________
3. List of words to assess the logical memory
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
Capacity logical memory is __________
Conclusion: Mark, what kind of short-term memory prevails in the patient.
_____________________________________________________________________________
_____________________________________________________________________________
Teacher’s signature ___________________
62
IІ semester
Practical class #18
Data___________________
Theme: "PHYSICAL AND CHEMICAL PROPERTIES (CHARACTERISTICS) OF THE
BLOOD.”
Questions for discussion:
1. Functions of blood.
2. Volume of circulatory blood (VCB). Factors which are determine VCB.
3. Composition of peripheral blood.
4. Haematocrit. Factors which determine haematocrit. Methods of haematocrit determination.
5. Value of water.
6. Composition and value of proteins in blood plasma.
7. The role of oncotic pressure in the redistribution of water in an organism.
8. Value of electrolytes in blood plasma.
9. Osmotic pressure of blood plasma. Functional system which provides constancy of osmotic
pressure.
10. Physical and chemical properties of the blood.
11. Active reaction of blood. Mechanisms which provides of constancy of pH.
12. Principles of functioning of buffer systems.
13. Indexes of the acid-base state of blood.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch. 32
Work for the independent exercise:
1. Draw the reflex arc of the osmoregulative reflex.
2. Write down reactions, explaining the mechanism of the phosphate buffer system.
When acidosis:
___________________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________________________________
63
When alkalosis:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
3. What are the factors that affect the ESR?
Accelerating ESR
Practical class #19
Reduce ESR
Data:_______________
Theme: "PHYSIOLOGICAL CHARACTERISTICS OF BLOOD CELLS.".
Question for discussion:
1. 1. The concept of Erythron.
2. The functions of erythrocytes.
3. Amount of red blood cells. Understanding of erytrocytosis and erytropenia.
4. Methods of counting the number of red blood cells.
5. Forms of the red blood cells.
6. Diameter of erythrocytes. Curve of Price - Jones.
7. Plasticity of erythrocytes.
8. Osmotic resistance of erythrosytes.
9. Erythrocyte sedimentation rate (ESR). Factors that influence the ESR.
10. Functional properties of the components of erythrocytes.
11. Forms and compounds of hemoglobin.
12. Methods for determination of hemoglobin in peripheral blood.
13. Indicators used to assess erythropoiesis.
14. Formation of red blood cells in the body.
15. Mechanisms of regulation of erythropoiesis.
16. Causes and mechanisms of destruction of erythrocytes.
17. Types of hemolysis.
18. Distribution of leukocytes in the body.
19. Functional properties of leukocytes.
20. Leukopenia and leukocytosis. Types of leukocytosis.
21. Leukogram. Understanding the shift count to the right and left. Concept about turncoat
count.
22. Basic features of some forms of leukocytes.
23. Mechanism of phagocytosis.
64
24. Mononuclear phagocytic system.
25. Regulation of formation and activity of leukocytes.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch. 32.
Work for the independent exercise:
1. Call the enzyme systems of erythrocytes. What is their significance?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
2. Calculate the oxygen capacity of blood, if the amount of hemoglobin is 120 g / liter.
Evaluate the value received.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
3. Draw Price-Jones curve.
4. What is the amount of blood hemoglobin, which transports 1 liter 160 ml of oxygen?
Evaluate the value received.
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
5. In women weighing 70 kg is 5.0 liters of blood, hematocrit - 33% of erythrocyte-3,2 •
1012 /l, hemoglobin - 115 g / l, color index - 1.1, the minimum osmotic resistance (NaCl)
- 0.40%, maximum - 0.34%. Rate listed indicators. As evidenced by a blood test?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
65
6. Calculate the color index, if the amount of hemoglobin is 100 g / l of erythrocyte 3,0 ·
1012. Is the found size a norm answer?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
7. Draw and label stages of phagocytosis.
І stage-
ІІ stage-
ІІІ stage-
IVstage-__________
8. Write a clinical analysis of blood of a healthy three-year child.
Erythrocytes - __________, hemoglobin - ________, color indicator - ______, ESR - ________, leukocytes _________, leykogram: Basophils - ___________, eosinophils - ____________, band neutrophils - __________,
stab neutrophils - ___________, lymphocytes - _____________, monocytes - .______________.
_____________________________________________________________________________
9. Write a clinical blood test for hemophilia patients.
Erythrocytes - __________, hemoglobin - ________, color indicator - ______, ESR - ________, leukocytes ____________, leykogram: Basophils - ___________, eosinophils - ____________, band neutrophils - __________,
stab neutrophils - ___________, lymphocytes - _____________, monocytes____________.
_____________________________________________________________________________
10. Write a clinical analysis of blood of the patient who is being treated in Allergic department.
Erythrocytes - __________, hemoglobin - ________, color indicator - ______, ESR - ________, leukocytes ____________, leykogram: Basophils - ___________, eosinophils - ____________, band neutrophils - __________,
stab neutrophils - ___________, lymphocytes - _____________, monocytes____________.
_____________________________________________________________________________
11. Write a clinical blood test of pregnant women.
Erythrocytes - __________, hemoglobin - ________, color indicator - ______, ESR - ________,
leukocytes - ____________, leykogram: Basophils - ___________, eosinophils - ____________,
band neutrophils - __________, stab neutrophils - ___________, lymphocytes - _____________,
monocytes____________.
_____________________________________________________________________________
12. What are the main differences between physiological and pathological leukocytosis. Under
what conditions may cause a physiological leukocytosis?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Practical class #20
Data:_______________
66
Theme: "BLOOD TYPES. MECHANISMS OF HEMOSTASIS "
Questions for discussion:
1. Definition of the terms: agglutinogene, aglutinin, agglutination.
2. Characterization of blood group ABO system.
3. Current understanding of blood group ABO system.
4. Determination of blood groups in the ABO system.
5. Characterization of blood group system Rh.
6. The concept of Rh-conflict.
7. Other systems of blood.
8. Stages of blood transfusion.
9. Regulation of blood transfusion.
10. Functions of hemostasis.
11. Mechanisms of hemostasis.
12. Role of the vascular wall in hemostasis.
13. Platelet function.
14. Stages of vascular-platelet hemostasis.
15. Factors of clotting blood.
16. Clotting phases.
17. Role of calykrein-kinin system in hemostasis.
18. Fibrinolysis.
19. Anticoagulative system.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch. 33, 34, 35, 36.
Work for the independent exercise:
1. In determining the blood group agglutination was only with the standard serum O group. What
conclusion can be made to conduct research? What is the group of the examined blood?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
2. From experimental animals obtain blood and ensure its liquidity. What are the means and
ways to prevent clotting? Please specify which cases will be suitable for blood transfusion.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
67
3. State plasma coagulation factors indicate their importance.
Factor’s name
Functions
I
II
III
IV
V, VI
VII
VIII
IX
X
XI
XII
XII
4. What are components of anticoagulative system? Give their meaning.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
5. What are the components of fibrinolysis? Give their meaning. What are the ways of activating
this system?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Practical class #21
Data:_______________
Theme: "PRACTICAL SKILLS ON THE PHYSIOLOGY OF BLOOD."
Practical work#1: “Determination of erythrocyte sedimentation rate (ESR)”.
At standing of stabilized blood, erythrocytes under power of the gravity are precipitated. Blood is divided
in 2 layers: upper (colorless, transparent) – a plasma; lower (red, opaque) – an erythrocytes. The normal ESR of men
is 2-10 mm / hr., of women - 2-15 mm / hr.
Materials and equipments: Panchenkov’s apparatus, which consists of to the stand with rubber
basis, capillaries for determination of ESR, sentinel glass, 5% solution of sodium citrate, 96%
alcohol, 2% solution of alcoholic iodine, cotton wool, rubber pear.
Procedure:
1. Irrigate the capillary with 5% solution of sodium citrate.
2. Take the solution of sodium citrate before the mark P of the capillary and release it on the
glass.
68
3. Take the blood twice before the mark K on the capillary; release both portions on the
glass.
4. Stir mixture of blood and sodium citrate (4:1) thoroughly taking it in the capillary and
releasing it on the glass several times.
5. It is necessary to hold the capillary horizontally, having lowered its tip in the drop of
blood, law of capillarity, fills the capillary itself, or you can use a dropping pipette.
6. Fix the capillary in the Panchenkov’s apparatus.
7. Determine the height of the vertical column of the plasma in the capillary in 30 minutes
or 1 hour.
Results:
1. Draw Panchenkov’s apparatus and the capillary apart.
2. Write down the size of ESR in a norm.
3. Write down the height of the vertical column of the plasma in the capillary:
Panchenkov’s apparatus
Capillary for
determination of ESR
5. ERS for women = ___________ mm per hour;
ESR for men = ___________ mm per hour.
6. After 30 min. =
_________ mm,
After 60 min. (1 hour) = __________ mm.
Conclusions:
1.Was your ESR value normal in the study of the blood?
2.Was the ratio of albumin and globulin in blood plasma normal?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
69
Practical work #2: "Erythrocyte count."
Erythrocytes are counted with the help of Goryaev’s calculating camera under the microscope. This method
is complicated but regular enough (permissible variation is not up to 2,5%).
The net rate of calculating camera consists of 225 large quadrates, 25 out of them are divided into 16 small
ones.
The side of small quadrate is 1/20 mm, square is 1/400 mm2, the height of camera (the distance between the bottom
and the covering glass) is 1/10 mm. So, the size of the camera upon the small quadrate is 1/4000 mm3 (1/400•1/10).
Blood for the count of the erythrocytes is diluted in special mixing tube (melanger) – capillary pipettes with
the ampoule dilation. There are marks 0,5 and 101 on the mixing tubes. Mark 0,5 shows what part of the mixing
tube takes this column of capillary, filled with blood. This volume takes 1/200 of the all volume of the mixing tube.
So, blood is dissolved in 200 times. Blood can be diluted in 200 times by other methods. For example, put 4 ml of
5% solution of sodium citrate in the test-tube and add 20 ml of blood with micropipette. It is necessarily to wash out
the micropipette three times in this solution, so that all blood will get into the tube.
Normally the amount of erythrocytes of men is 4-5•1012, of women 3,9-4,7•1012.
Materials and equipments: microscope, Goryaev’s camera, covering glass, mixing tube for the
erythrocytes, 3% solution of sodium chloride, 96% alcohol, 2% alcohol solution of iodine, cotton
wool.
Procedure:
1. To prepare Goryaev’s camera for work:
- perform defatting with alcohol and dry the camera and the covering glass;
- lap the covering glass to the camera till the appearance of the Newton’s rings;
- find the net under the large enlargement.
2. Prepare blood for work:
- fill the capillary till the mark of 0,5; clean the opening from blood with the cotton
wool;
- don’t release the blood from the capillary and fill it with 3% solution of sodium
chloride till the mark of 101;
- mix the solution with blood in the ampule of mixing tube (there is a tiny red ball
to ease the mixing process). Blood will be diluted in 200 times.
3. To fill camera with blood:
- blow first two drops of solution out of the capillary on the cotton wool;
- next drops from the ampule solution put in the camera. Put the tip of the melager
on the edge of camera near the covering glass and blow it out accurately. Solution
will go under the covering glass into the camera and will fill it. Wait for 1-2
minutes for erythrocytes to sedimentate on the bottom of the camera.
4. Calculate the amount of the erythrocytes:
- count the amount of erythrocytes in 5 large quadrates of the net diagonally.
Remember Burker’s rule when counting erythrocytes: in small quadrates count
cells, which are inside the quadrate and on its superior and left sides. This will
predict counting erythrocytes twice;
- calculate the amount of erythrocytes in 1 mkl of blood by formula:
E  a * 4000 * 200  / 1 * 5 *16
Where E – is the quantity of erythrocytes in 1 mkl;
a – the amount of erythrocytes in 5 large quadrates of net;
5 – the amount of large quadrates;
16 – the amount of small quadrates;
200 – the degree of blood dilution;
1/4000 mm3 – the volume of 1 small quadrate
70
There is a simplified formula: E = a•104
- to find the amount of erythrocytes in 1 l of blood by formula E•106
Results:
1. Draw down the mixing tube for the erythrocytes.
2. Write down the process of the erythrocyte counting.
3. Define the amount of erythrocytes in 1 l of blood.
4. What is the normal number of erythrocytes for men?
1)
Mixing tube for the erythrocytes
2) The process of the erythrocyte counting:
3)____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
4) At norm the number of erythrocytes for men = ________________,
for women______________.
Conclusion: Is the amount of erythrocytes normal in the examined blood?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Practical work #3: “Method of definition of hemoglobin level in blood (Sali’s method).”
Sali method is used for the definition of the hemoglobin amount in blood.
Principle of this method is as follows: after adding hydrochloric acid hemoglobin transforms into
hydrochloric hematin that has brown color, intensity of which is directly proportional to the hemoglobin content.
The solution of hydrochloric hematin is diluted with water till it gets standard color.
This method of the definition of hemoglobin amount gives results with accuracy of 10%. Mistake is
associated with the technical problems during definition and possible subjective mistakes in the definition of color.
But this method is widely spread because it is easy and simple.
71
Hemometer Sali is used for this definition. It is a holder with 3 test-tubes. There is 1% solution of
hydrochloric hematin. Middle tube has marks from 0 to 23•10 g/l and it is for the definition of hemoglobin in the
examined blood.
Normally, the amount of hemoglobin of men is 140-160 g/l, of women – 120-140 g/l.
Materials and equipments: hemometer Sali, pipette, glass stick, 0,1N solution of hydrochloric
acid, distillated water, 96% ethanol, cotton wool.
Procedure:
1. With the help of pipette put 0,1N solution of hydrochloric acid into the middle tube of
hemometer till the lowest mark (0,2 ml);
2. For the definition of hemoglobin put blood into the capillary till the mark (0,02 ml);
3. Clean the opening of the capillary with cotton wool;
4. Put the capillary into the tube with acid and carefully eject the blood from the capillary to
the bottom of the tube;
5. Without taking out the capillary from the tube, clean it with acid from the upper layers;
6. Mix blood with acid by shaking the tube;
7. Put the tube into the hemometer;
8. Leave hemometer for 4-5 minutes. By this time acid will destroy erythrocyte membrane,
transform hemoglobin into hydrochloric hematin that has brown color;
9. Put distillated water into the middle tube, until the color of the solution in the middle tube
becomes the same color with the one in standard tubes;
10. Fix the level of solution in the middle tube by the lower meniscus;
11. Get the value in g/l, the value in g% should be multiplied by 10.
Results:
1. Draw hemometer of Sali.
2. Calculate the amount of hemoglobin in the examined blood. Write down the results in the
absolute units.
For example:
Hemometer has graduations in absolute units of hemoglobin.
Result – 15 g%
Calculation: 15 g% • 10 = 150 g/l.
3. Write down the number of hemoglobin at norm:
1)
hemometer Sali
2) _________________________________
_____________________________________
_____________________________________
_____________________________________
3) At norm Hb= __________________
( for men)
Hb= __________________
(for women)
72
Conclusion:
Is the amount of hemoglobin normal in the examined blood and what does it testify?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Practical work #4 ―Calculation of the color index.”
In clinics 5 indexes of the blood is calculated: color index, average hemoglobin content in the erythrocyte, average
concentration of hemoglobin in the erythrocyte, average erythrocyte volume, average diameter of erythrocyte. It is
necessary to define color index in clinical analysis.
The value of this index shows relative hemoglobin content in every erythrocyte. Normally color index is 0,85 – 1,15.
Increase or decrease of it testifies interruption of the erythrocytes saturation with hemoglobin.
Nomogram is used for the calculation of color index:
a – normal color index value;
b – hemoglobin content by Sali method (%);
c – number of erythrocytes (in 1 l of blood)
а
а
б
в
b
c
To calculate hemoglobin amount in % the following operations are performed. For example
there is 14 g% of hemoglobin in blood:
16,7 g% - 100%
14 g% - x
x = 14•100 / 16,7 = 84%
Procedure:
1. Find the amount of erythrocytes in 1 mkl of blood and amount of hemoglobin, calculate
color index (CI).
2. If the amount of hemoglobin is in g/l, then CI is calculated using a formula:
CI = (number of Hb (g/l)•3): (first 3 digits of the erythrocytes amount)
For example: if hemoglobin amount is 140 g/l, erythrocytes – 4,2 • 1012 (4 200 000 000 000),
then CI = (140 • 3) : 420 = 1
Results:
1. Calculate the color index using data from previous practical works.
2. Answer following questions in conclusion:
3. Write down the color index at norm.
1)____________________________________________________________________________
_____________________________________________________________________________
73
_____________________________________________________________________________
_____________________________________________________________________________
2)____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
3) CI at norm = _______________
Conclusions: What is the degree of erythrocyte saturation with hemoglobin and what does it
testify?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Practical work#5: “Definition of the blood group by ABO system with the help of
coliclones.”
For the definition of the blood group in any system the same principle is used: providing conditions for erythrocytes
agglutination in the medium of standard isohemagglutinating serums or coliclones, that have high titre of antibodies
to the examined antigens of erythrocytes.
Materials and equipments: white plate, pipettes, glass, pencil for glass, examined blood, closed
tubes with solutions of coliclones anti-A and anti-B, isotonic solution of sodium chloride.
Procedure:
1. Divide dry white plate on 4 sectors with glass-pencil.
2. Make notes ―anti-A‖, ‖anti-B‖.
3. With the help of pipettes put drops (0,1 ml) of coliclones anti-A and anti-B in the
accordant sector. Make a string using the same pipette (diameter of the string should not
be less than 1,5 – 2 cm).
4. Put one drop of the examined blood on the glass.
5. Using the angles of another glass put blood (0,01 ml) in the drops of coliclones. Angles
of glass should be different for different coliclones.
6. Mix blood with the drop of coliclone with the angle of glass. Correlation between blood
and coliclone should be 1:10 (mixed drop has pink color).
7. Observe the reaction on the plate during 2,5 minutes.
Results and control:
1. If agglutination does not occur with coliclone anti-A and with coliclone anti-B. So,
examined erythrocytes do not have antigens A and B, and blood belongs to group I (0,
αβ).
2. If agglutination occurred only with coliclone anti-A. So, examined erythrocytes have only
antigen A and blood belongs to group II (A, β).
3. If agglutination occurred only with colicone anti-B. So, examined erythrocytes have only
antigen B and blood belongs to group III (B, α).
4. If agglutination of erythrocytes is observed in both drops of coliclones. So, examined
erythrocytes have both antigens A and B and blood belongs to group IV (AB).
74
It should be mentioned that all processes that occur after 2,5 minutes after mixing will not be
connected with specific agglutination, which is examined and these can have other reasons. False
agglutination can occur when erythrocytes gathers in monetary column. This agglutination can
be easily discerned from the real one if added 1-2 drops of isotonic solution of sodium chloride
to 1 drop of blood. False agglutination will disappear in this case.
Results:
Write down the results of agglutination reaction with coliclones anti-A and anti-B in the
following chart:
coliclone
blood
І (0, αβ)
Anti-A
Anti-B
ІІ (А, β)
ІІІ (В, α)
ІV (АВ)
Conclusion:
1. Explain the presence/absence of agglutination of the examined blood with coliclone antiA?
2. Explain the presence/absence of agglutination of the examined blood with coliclone antiB?
3. What is the blood group studied?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practicalwork #6 “Definition of blood group by ABO system with the help of standard
serums.”
Materials and equipments: chart boards for the definition of blood group, pipettes, glass,
examined blood, standard serums, isotonic solution of sodium chloride.
Procedure:
1. Put one drop (0,1 ml) of standard serum of I, II, III group on the surface of the chart
board in the corresponding sector.
2. Put one drop of the examined blood on the glass with the help of a pipette.
3. Using another glass put part of blood (0,01 ml) in each drop of blood serum. Angles of
glass for every serum should be different.
4. Mix blood with serum using the same angle of glass. Correlation of blood and serum
should be 1:10 (mixed drop should have pink color).
5. Observe the reaction on the chart board after 5 minutes.
75
Results and control:
12. If agglutination is absent in all drops of serums, we can suggest that examined
erythrocytes do not have antigens A and B and blood belongs to group I (0, αβ).
13. If agglutination occurred with serums of I and III group, we can suggest that erythrocytes
have antigen A and blood belongs to group II (A, β).
14. If agglutination occurred with serums of I and II group, we can suggest that erythrocytes
have antigen B and blood belongs to group II (B, α).
15. If agglutination is observed in all serums, we can suggest that erythrocytes have both
antigens A and B and blood belongs to group IV (AB). In this case serum of group IV is
put on the plate and if agglutination does not occur, blood belongs to group IV.
Results:
Write down a chart with the results of agglutination reaction with serums of different groups:
serum
blood
І (0)
І (αβ)
ІІ (β)
ІІІ (α)
ІV(-)
ІІ (А)
ІІІ (В)
ІV (АВ)
Conclusion:
1. Explain the presence/absence of agglutination of the examined blood with serums of
different groups?
2. What is the blood group studied?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Practical work#7: “Definition of the total time of blood clotting.”
Duration of bleeding time is measured from the time of skin puncture to the end of
bleeding. This indicator gives an idea of the relative balance of functional components of blood
coagulation, but it gives more information - of the functional activity and platelet count. The
normal duration of bleeding is equal to 3 minutes.
Materials and equipments: glass, glass hook, clock, needle, 96% ethanol, 2% alcohol solution of
iodine, cotton wool.
Procedure:
1. Take blood from a rat’s tail, put it on the glass and check the time it clots.
2. Take out the content of drop with the interval 20-30 sec (hook should be held vertically),
wait, till fibrin fiber will drag after the hook.
3. Check the time again and consider it as the moment the clotting started.
4. Put the hook into the blood; drag the drop on the glass horizontally with the same
interval.
5. Check the time as a soon as clot is dragged after the hook, which corresponds to the end
of clotting.
76
Results:
1. Write down the time the clotting started and the time the clotting ended.
2. What is the duration of bleeding in normal state?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Conclusion:
Is the time of blood clotting normal? What does it testify?
_____________________________________________________________________________
_____________________________________________________________________________
Teacher’s signature ___________________
Practical class #22
Data_____________________
Theme: "MODULE ON THE PHYSIOLOGY OF BLOOD"
Questions for the training:
1. The functions and composition of blood. Physical and chemical properties of blood.
2. Plasma proteins: the number, classification, functions. Oncotic pressure of blood plasma. The
role of proteins in the redistribution of body water.
3. The role of water and electrolytes plasma of blood. Osmotic pressure of plasma, mechanisms
to support it. The concept of hypo-, iso- and hypertonic solution. Properties of blood substitutes.
4. Blood pH. Mechanisms of support. Characteristics of blood buffer systems. Indicators of acidalkaline balance.
5. Characteristics of ABO blood group system. Modern aspects of blood groups.
6. Characteristics of Rh blood group system. Rhesus-conflict.
7. Stages of blood transfusion. Properties of blood substitutes.
8. General characteristics and properties of red blood cells. The functions of red blood cells.
9. Causes and mechanisms of destruction of red blood cells in the body. The concept of
hemolysis of red blood cells, types of hemolysis. Erythropoiesis. Regulation of content of red
blood cells in the peripheral blood.
10. The main physiological and pathological hemoglobin compounds. Color index.
11. Distribution of leukocytes in the body. Types and causes leykotsytoziv. Main characteristics
and properties of leukocytes. Leukocyte formula, the concept of her shift. Functions of
granulocytes. Features agranulocytes.
12. Regulation leucopoiesis and activity of leukocytes.
13. Structure of hemostasis. Types of hemostasis.
14. Platelet function. The role of the vascular wall and platelets in hemostasis.
15. Vascular-platelet hemostasis.
16. Coagulation hemostasis.
17. Anticoagulant system.
18. Fibrinolysis system.
77
Practical class #23
Data_____________________
Theme: “GENERAL CHARACTERISTIC OF THE CIRCULATION SYSTEM. THE
PHASE ANALYSIS OF THE CARDIAC CYCLE.”
Questions for discussion:
1. General description of circulation system, its structure. Functional departments of the
circulation system.
2. Basic and additional functions of the circulation system.
3. Functional properties of cardiac muscle. Comparative description of not typical and typical
muscular fibers.
4. Electrical activity of the heart.
5. Pacemaker potential. Action potentials in cardiac muscle.
6. Velocity of signal conduction in cardiac muscle.
7. Refractory period of cardiac muscle.
8. Excitation-contraction coupling – function of calcium ions and the transverse tubules.
9. Automatic electrical rhythmicity of the sinus fibers.
10. Mechanism of sinus nodal rhythmicity. Self-excitation of sinus nodal fibers.
11. Internodal pathways and transmission of the cardiac impulse through the atria.
12. Atrioventricular node and delay of impulse conduction from the atria to the ventricles.
13. Rapid transmission in the ventricular Purkinje system.
14. Transmission of the cardiac impulse in the ventricular muscle.
15. Summary of the spread of the cardiac impulse through the heart.
17. Structural and functional elements of heart as a pump. Functions of atria and ventricles.
18. Heart valve device, its function.
19. The concept about cardiac cycle. Phase structure of cardiac cycle. Determination methods.
20. Description of atria systole.
21. Description of ventricles systole: periods of tension and banishment.
22. Description of ventricles diastole.
23. The modes of reductions of heart and types of loadings on it.
24. A concept about tones of heart and methods of their study. Phonocardiography.
25. Description of the first tone of heart. Description of the second tone of heart.
27. Cardiac shove, properties.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch.9, 10.
Work for the independent exercise
1. Draw the action potential of atypical cardiomyocytes, mark its phases.
78
2. Draw the action potential of typical cardiomyocytes, mark its phases.
3. Draw a scheme of the conductive systems of the human heart.
4. Isolated heart of rat transferred to perfusion solution that does not contains calcium ions.
Which changes in cardiac activity is observed?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
5. A man took a drug that blocked the slow calcium channels. What wear the changes observed
prior to the administration of the drug?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
6. Display in the table structure of cardiac cycle duration, check phases and periods.
79
7. If a healthy adult human cardiac output (HOS) is 4200 ml, the frequency of cardiac
contraction (FCC) - 70 per minute. Calculate systolic volume (SV) heart. How do obtain value
correspond to the normal value greatness on a consistent as the norm?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
8. During ventricular systole the pressure in them increases. Explain why the blood does not
flow back to atria? Indicate the amount of blood pressure in the ventricle and atrium.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
9. Phase of isometric reduction is the second in the period of tension during the ventricular
systole. Explain why it is called; characterize value of blood pressure in the cavities of
the right and left heart, aorta and pulmonary artery and the status of the heart valve
apparatus in this phases.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
10. In human minute volume of blood at rest is 6.3 L/min., body surface area - 1.8 m2.
Calculate cardiac index, estimate its value.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical class #24
Data_____________________
Theme: “REGISTRATION AND ANALYSIS OF ECG. REGULATION OF CARDIAC
ACTIVITY.”
Questions for discussion:
1. Elements of electrocardiogram (waves, segments, intervals) and their description.
2. Methods for recording of electrocardiograms (ECG).
3. Flow of current around the heart during the cardiac cycle.
a) Recording electrical potentials from a partially depolarized mass of syncytial cardiac
muscle.
b) Flow of electrical currents in the chest around the heart.
4. Electrocardiographic leads. Three bipolar limb leads.
5. Bases of vectorial analysis of ECG. A concept is about the total instantaneous vector of
heart. Axes of taking ECG.
6. Vectorial analysis of origin of indents of ECG.
80
7. Myogenic mechanism of the heart. Frank-Starling law.
8. Immediate adaptation mechanisms of the heart to volume load and resistance.
9. The character and mechanisms of the sympathetic nervous system effect on the heart.
10. The character and mechanisms of the parasympathetic nervous system effect on the heart.
11. Role of methasympathetic nervous system in regulating the activities of the heart.
Intracardiac reflexes.
12. Effect of humoral factors in the heart regulation.
Literature:
Guyton, Arthur C. Textbook of medical physiology – Ch. 11.
Practical work #1: “Registration and analysis of electrocardiogram”
The regular pattern of electrical impulse production and conduction in the heart results in the mechanical
contraction (systole) and relaxation (diastole) of the myocardium—the cardiac cycle. The recording of these
electrical events, or electrocardiogram (ECG), may reveal abnormal patterns associated with abnormal cardiac
rhythms.
Materials and equipments: electrocardiograph, cotton wool, alcohol, physiological solution;
object of researches is a man.
PROCEDURE
1. With the subject comfortably reclining (lying down), rub a silver dollar-sized amount of
electrolyte gel (physiological solution) on the medial surface, about 2 inches above the
wrists and ankles. Attach electrode plates to these four spots, using the rubber straps
provided (fig. 1).
2. Attach the four ECG leads to the appropriate plates.
3. The specific instructions for obtaining ECG tracings vary with the instrument being used.
Your instructor will demonstrate the use of the recording equipment in your lab. The
following instructions are valid only for a single-channel electrocardiograph.
(a) Turn on the power switch.
(b) Set the paper-speed selector switch to 25 mm (2.5 cm) per second.
(c) Set the sensitivity to 1 (most sensitive).
(d) Set the lead selector switch to the first dot to the left of the STD or CAL position.
(e) Turn the control or knob to the run or record position.
4. Turn the position knob until the stylus is centered on the ECG paper.
5. Turn the lead selector switch to the 1 (lead I) position to measure the voltage difference
between the right and left arms. As the paper is running, depress the mark button once—this
makes a single dash at the top of the chart to indicate that the record is from lead I. Continue
recording until an adequate sample of the tracing can be provided to each member of the
subject’s group; then stop the paper drive by turning the lead selector switch to the dot
above the 1 position. Each dot is a ―rest‖ position where the movement of the chart will stop
between recordings from each lead.
6. Turn the lead selector switch to the 2 (lead II) position to measure the voltage difference
between the right arm and left leg. As the chart is running, depress the mark button twice—
the two dashes produced at the top of the chart will indicate that this is the recording from
lead II. Stop the chart by turning the lead selector switch to the dot above the 2 position.
7. Repeat this procedure with lead III to measure the voltage difference between the left arm
and the left leg.
8. After recordings from leads I, II, and III have been obtained, turn the lead selector switch to
the STD or CAL position. Run the recording out of the machine, allowing members of the
group to cut sample tracings of each lead.
81
9. Remove the electrode plates from the subject’s skin and thoroughly wash the electrolyte gel
from both the plate and the skin.
10. Tape samples of the recordings in your laboratory report and label all the waves.
11. Determine the P-R interval of lead II. This can be done by counting the number of small
boxes between the beginning of the P and the Q and multiplying this number by 0.04 sec.
Results: 1. Write down information about patient (surname, name, age, sex).
2. Paste in the fragment of ECG.
3. Draw in a copybook ECG schematically, to designate indents, segments, intervals.
4. To analyze ECG on the offered chart (calculations to conduct after the standard lead).
Patient_________________________________________________________, age___________
_____________________________________________________________________________
_____________________________________________________________________________
Scheme of ЕCG :
Analysis of ECG
1. Description of waves of ECG.
Characteristics of waves are:
•
Direction (positive, negative)
•
Duration (sec)
•
Amplitude (mm)
Direction:
Waves _________________ have positive direction, because the projection of vector is directed
in the side of the positive electrode lead;
Waves __________________ are negative, because the projection of vector is directed in the
side of the negative electrode lead.
82
Duration:
Waves
Norm (sec.)
P
Q
R
S
T
0,08-0,1
0,02-0,03
0,03-0,05
0,02-0,03
0,16-0,24
Given patient
(sec.)
Conclusion
Amplitude:
Amplitude of waves are estimated in relation to the R. wave
In the standard taking of correlation between amplitudes of indents makes:
T = 1/2 R,
S = 1/3 R,
Q = 1/4 R,
P = 1/8 R.
Amplitude of wave of R in a norm makes 18-22 mm
The Proper values of amplitude of waves (a norm is for a patient) expect accordingly waves of
R, the height of which is determined for ECG.
Waves
Normal correlation
of indents
A norm is for a
patient (mm)
Given patient
(mm)
Conclusion
P
Q
R
S
T
2. Characteristics of segments of ECG:
Characteristics of segments are:
•
Attitude is toward isoline;
•
Duration (sec.).
Attitude is toward isoline:
In a norm in the standard and increased odnopolyusnikh lead segments are located on isoline,
their displacement up does not exceed downward ± 0,5 mm, in the pectoral lead –
(V1 – V3) – not more than 2 mm.
●
Duration:
Segments
Norm (sec.)
PQ
S-T(RT)
T-P
0,04-0,10
0,09-0,19
0,24-0,32
3. Description of intervals of ECG:
Description of intervals
Given patient
(sec.)
Conclusion
83
● Duration
Intervals
Norm (sec.)
PQ
QRS
QT (RT)
R-R
0,12-0,2
0,06-0,10
0,36-0,44
0,72-1,0
Given patient
(sec.)
Conclusion
4. Determination of duration of cardiac cycle.
Duration of cardiac cycle is the interval of R-R.
At norm duration of cardiac cycle is 0,72 - 1,0
5. Calculation of frequency of cardiac contractions.
FCC is determined by a formula:
60
FCC =
, where 60 – a number of seconds is in 1 minute;
RR
iR – R – duration of interval (sec.).
60
FCC =
= ________________________________________________________________
RR
In a norm FCC is 60 – 80 per a minute.
6. Calculation of duration of electric systole and systolic index.
The electric systole of ventricles is determined by the interval of Q – T.
Normal duration of iQ-T is determined by Bazett’s formula:
iQ  T  K  iR  R
where K – Coefficient which is even for men – 0,37, for women – 0,40.
iR-R – duration of cardiac cycle.
by Bazett’s formula – iQ-T = ______________________
by ECG – iQ-T =________________________________
Systolic index (SI) is characterized by attitude of electric systole toward duration of cardiac
cycle (iR – R).
iQ  T
In norm SI = 40% ± 5%.
SI =
*100%
SI =_____________________
iR  R
7. Determination by ECG of direction of electric axis of the heart.
The projection of middle resulting vector of QRS on a frontal plane is called the middle electric
axis of the heart.
Localization of electric axis of the heart is defined in 6-axis system of Bauley, by angle α, which
is formed by electric axis of the heart and positive half of axis of the 1 st standard limb lead.
There are two methods for determining the electrical axis of heart:
1. Visual definition of  angle
It’s most simple and available method that allows you to quickly evaluate the angle α with
accuracy ±10°. This method is based on 2 principles:
a) The maximal positive value of algebraic sum of waves of QRS complex is in lead, axis
of which is the same to electric axis of the heart or is parallel to it.
84
b) Complex of QRS type, algebraic sum of waves of which is 0 (R = S or R = Q+S), is
recorded in the lead, axis of which is perpendicular to electric axis of the heart.
2. Definition of  angle by graphical method
For building the electrical axis of heart used 1st and 3rd limb lead.
- draw a circle;
- draw Einthoven's triangle inside this circle;
- make a centre on the triangle;
- draw parallel line A to the first triplet, and the point it intersects outside the circle is zero
(0), being the positive (+) side of the limb lead;
- draw a line B passing through the centre which is parallel to the 3rd limb lead;
- calculate the algebraic sum (result) of the QRS waves of the lst and 3rd limb lead;
- make a scale of any choice of the algebraic sum of the 1st and 3rd limb lead from the
centre point; (Indicate if positive or negative on scale).
- draw other lines perpendicular to line A and line B respectively, passing through the last
points of the scale;
- draw the perpendicular lines to intersection and draw another line connecting this
intersection to the centre point;
- after this connection, an angle is obtained called "", measure  with a protractor.
QІ = _______
RІ = _______
SІ = _______
Σ (QRS)І =_______
QІІІ= _______
RІІІ= _______
SІІІ= _______
Σ (QRS)ІІІ = _______
 angle =__________.
At normal, the α angle is depends on the
type of constitution.
In normostenic men α = 30 - 69o
in hyperstenic – α = 0 - 29o,
in astenic – α = 70 - 90o.
There are special tables for finding the α
angle. Check the value of α angle which
finding with the data the Dyed’s table.
85
Conclusion:
1.Analysis of cardiac rhythm and conductivity.
Estimation of regularity of cardiac reductions:
Regularity of cardiac reductions is estimated at comparison of duration of intervals of R-R.
Regular or the correct rhythm of heart is diagnosed in case the duration of the measured intervals
of R-R is identical and the difference of the got sizes hesitates in limits ± 10% from middle
duration of intervals of R-R. A abnormal (non-regular) cardiac rhythm is diagnosed in other
cases. The abnormal rhythm of heart (arrhythmia) can be observed at extra systolic, blinking
arrhythmia, sine arrhythmia, etc.
Count of frequency of cardiac contractions:
60
FCC is defining by the formula: FCC =
,
RR
FCC for a healthy man at rest is from 60 to 90 per minute. The increase of FCC (more than
90 per minute) is called tachycardia, and decrease of FCC (less than 60 per minute) – is
bradycardia.
Determination of source of excitation;
For determination of source of excitation, or the driver of rhythm must be estimated base in
number of excitation of atriums and to set the relation of waves.
The sinus rhythm. In a norm electric impulse which arises up in SA – node, spread across atrium
from top to bottom. The vector of depolarization of atrium (P) is here directed in the side of
positive electrode of the standard ligation, and on this ligation of ECG fixed the positive waves
of R. Atriums excitations here always preced excitation of ventricles, and the positive waves of
RII are registered before every complex QRS and in most cases disposed on identical distance
from a complex QRS.
A sinus rhythm is characterized:
 by the presence of standard taking from positive waves of R, which preced every
complex QRS;
 by the permanent identical form of all waves of R.
In terms of absence of these signs, the different variants of non-sinus rhythm are diagnosed.
Estimation of conductivity;
For the estimation of conductivity, measure duration of wave of R (time of distribution of
excitation for atriums), interval of PQ(R) (time of distribution of excitation from atriums to the
AV node, Giss’s bunch), complex QRS (time of distribution of excitation in the ventricles). The
increase of duration of the indicated waves and intervals testifies about the deceleration of
conduction to excitation on the appropriate departments of heart.
2. Determination of position of electric axis of heart.
Distinguish the following variants of position of electric the landmark of heart:
 normal position, when corner α makes from +300 to +690;
 vertical positions are a corner α from +700 to +900;
 horizontal positions are a corner α from +00 to +290;
 rejection of axis to the right is a corner α from +910 to+1800;
 rejection of axis to the left is a corner α from 00 to -900;
Conclusion: Rhythm of heart __________________, _________________. FCC ________ .
Position of electric axis _________________.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Teacher’s signature ___________________
86
Work for the independent exercise
1. Calculate the pulse frequency the state of rest and after the physical loading
(The 20 squat in a middle rate). Define duration of cardiac cycle in both cases, explain the
changes after loading.
Pulse frequency at the resting state = __________, pulse frequency after loading = __________.
Duration of cardiac cycle at rest = ___________,
duration of cardiac cycle after loading = ___________.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
2. Two ECG is written down for different people. On one the duration of interval of PQ =
0,04 sec, and for other – 0,22 sec. When is it possible to think of comparing this value
with the normal?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
3. Draw schematically the places of location of electrodes during registration of ECG in the
pectoral ligations.
4. During preparation to record ECG, by mistake electrodes changed placed on right and left
arms. To what changes of ECG in I standard ligation from extremities will it lead and
why?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
5. Why is atriums repolarization wave absent in ECG?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
6. Duration of interval of R-R is 1,33 sec. What is the driver of heart rhythm?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
7. Duration of complex QRS is equal to 0,15 sec. What does it mean?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
87
8. Explain the mechanism of negative chronotropic effect. Draw AP, which occurs on the
membrane of cardiomyocytes at normal heart work and activated parasympathetic nervous
system.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Norm
PSNS Activation
9. Explain the mechanism of positive chronotropic effect. Draw AP, which occurs on the
membrane of cardiomyocytes at normal heart work and activated sympathetic nervous
system.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Norm
SNS activation
10. Explain the mechanism of negative inotropic effect. Draw AP, which occurs on the
membrane of cardiomyocytes at normal heart work and activated parasympathetic nervous
system.
_____________________________________________________________________________
_____________________________________________________________________________
Norm
PSNS Activation
88
11. Explain the mechanism of positive inotropic effect. Draw AP, which occurs on the
membrane of cardiomyocytes at normal heart work and activated sympathetic nervous
system.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Norm
SNS activation
12. Explain the mechanism of negative bathmotropic effect. Draw excitability changes in
activated parasympathetic nervous system.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Norm
PSNS activation
13. Explain the mechanism of positive bathmotropic effect. Draw excitability changes in
activated sympathetic nervous system.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Norm
SNS activation
89
14. Explain the mechanism of negative dromotropic effect.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
15. Explain the mechanism of positive dromotropic effect.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical class #25
Data_____________________
Theme: “BASICS OF HEMODYNAMICS. PATTERNS OF BLOOD FLOW IN ARTERIAL AND
VENOUS VESSELS. REGULATION OF LOCAL AND SYSTEMIC BLOOD CIRCULATION”
Questions for discussion:
1. Hemodynamic laws.
2. Hemodynamic indexes: the volume of blood vessels, speed of blood, blood pressure,
hemodynamic resistance, blood viscosity, the nature of movement of blood,
hemodynamic factors of vascular wall.
3. Functional classification of blood vessels.
4. Features of movement of blood in arterial vessels: pulse oscillation speed of blood
volume and pressure.
5. Arterial pressure: systolic, diastolic, pulse average. Methods of measuring blood pressure.
Factors that determine this figure.
6. The concept of arterial pulse. Key characteristics. Sphigmogram. Pulse wave velocity.
7. Laws of motion in the venous blood vessels. The concept of venous pressure, venous
pulse, venous return. Factors that provide venous return of blood. Phlebogram.
8. The concept of microcirculation. Structure and function of microcirculatory bed.
9. Mechanisms of change between blood and interstitial fluid: diffusion, filtration,
reabsorbsion, microvesicular transport.
10. Basic mechanisms of regulation of local blood circulation.
11. Lymphatic system. Basic laws of its functioning.
12. Neural mechanisms of regulation of systemic hemodynamic. Role of baro-, chemo- and
mechanoreceptor in regulation of systemic blood circulation. Cardiovascular center, its
characteristics.
13. The role of reflexes in the regulation of systemic blood circulation. Zion-Ludwig reflex,
Hering-Ivanov reflex, Bainbridge reflex, and Parin reflex.
14. Bloodstream when changing body position and physical stress.
Literature:
Guyton, Arthur C. Textbook of medical physiology – p. 161-181, 204-215.
90
Work for the independent exercise
1. Draw sphigmogram, label its part, and explain the mechanism of occurrence.
_____________________________________________________________________________
_____________________________________________________________________________
2. Draw phlebogram, label its part, and explain the mechanism of occurrence.
_____________________________________________________________________________
_____________________________________________________________________________
3. Volumetric blood flow rate is 100 ml/sec, and vessel diameter is 2.5 cm. Calculate the
linear velocity of blood. Which blood vessels did posses this speed?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
4. How much blood will flow through capillaries, if the left ventricle in 1 minute free throws
in the aorta 5 liters of blood? Explain why.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
5. Calculate the value of the resistance of movement of blood in the aorta and pulmonary
artery, blood flow rates is 100 ml/sec, the average dynamic pressure in the aorta of 100
mm Hg, and in the pulmonary artery is 12 mm Hg. How will the defined parameters are
affect the structure of left-and right-heart?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
91
6. In hot weather, as a consequence of heavy sweating, blood viscosity increases. How does
it affect the AP?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
7. What changes occur in the cardiovascular system with increasing blood pressure in the
carotid? Describe the reflex arc of the reflex. Name the author who described the impact
of this reflex from this reflexogenic zone.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
8. What changes occur in the cardiovascular system with increasing blood pressure in the
aorta arc? Name the author who described the reflex influence of this zone. Describe the
reflex arc of this reflex.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
9. What are the reactions of the heart during pressing and after pressing on the eyes? What it
shows? Who first described this reaction?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
10. If human body changes position from horizontal to vertical, FCC increased from 60 per
minute to 72 per minute. Systolic pressure did not change, diastolic pressure increased to
10 mm Hg. Explain this changes.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
11. During research with a dog, weighing 15 kg, 500 ml of blood flowed out of a cut. Which
hemodynamic changes in animal will occur?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
12. In healthy persons slight physical load predefines moderate increase of systolic and
somewhat decrease of diastolic pressure. What is the mechanism of these changes?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
13. Two healthy men took a training load run of 800 m. One of them was a sportsman, the
other was not. What is the change of heart minute volume (HMV) in the sportsman and
poorly trained person?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
92
Practical class #26
Data: _______________
Theme: "Practical skills on the Physiology of heart and blood circulation."
Practical work #1: "Research of apical shove."
Apical shove – rhythmic pulsing of pectoral wall, which arises as a result of heart work, during the systole
of ventricles, in a period tension, in the phase of isovolumic contraction. In this period are closing semilunar valves
and A-V valves. Ventricular pressure increases, and the volume does not change. Increasing pressure leads to a
change in shape of the heart from elipsoid to orbed. Longitudinal diameter of heart is declined and grows a cross.
Above the heart presses to the inside of the chest wall, causing it pulsion – cardiac beat.
Characteristic of cardiac shove:
•
Localized in bicuspid (mitral) area in the fifth left intercostals space.
•
Has a limited area which makes 1-2 cm2.
•
Resistant.
•
Best expressed in people with poorly developed subcutaneous fat layer, and in children.
•
Better defined not in the direct projection, and in reviewing the left side surface of the chest, especially at
small inclination torso forward.
•
Do not determined, if it falls on rib.
Materials and equipments: stethoscopes, object for investigation – human.
Procedure:
1. Clean the earpieces of the stethoscope with an alcohol swab.
2. To trace the presence of cardiac shove by sight in a direct projection and in a lateral
projection.
3. To define the place of localization of apical shove.
4. Define an area and resistant of cardiac shove by palpation method.
Results:
Describe properties of apical shove.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Draw schematically the places of localization of apex shove on a thorax.
Conclusion: 1. Mark which phase of cardiac cycle an apex shove is in.
2. Describe the mechanism of its origin.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
93
Practical work #2: Auscultation of heart sounds
The cycle of mechanical contraction (systole) and relaxation (diastole) of the ventricles can be followed by
listening to the heart sounds with a stethoscope. The contraction of the ventricles produces a rise in intraventricular
pressure, resulting in the vibration of the surrounding structures as the atrioventricular valves slam shut. The valves
on closing, produces the first sound of the heart, usually verbalized as “lub” – 0,12 sec. At the end of the
contraction phase, the blood in the aorta and pulmonary arteries pushes the one-way semilunar valves shut, and the
resulting vibration of these structures produces the second sound of the heart, which is verbalized as “dub” – 0,08
sec. Careful auscultation (listening) to the two heart sounds may reveal two further sounds. This splitting of the
heart sounds into four components is more evident during inhalation than it is during exhalation. During deep
inhalation, the first heart sound may be splited into two sounds because the tricuspid and mitral valves close at
different times. The second heart sound may also be splited into two components because the pulmonary and aortic
semilunar valves closes at different times.
III tone occurs during ventricular diastole (the period of filling, rapid filling phase) as a result of ventricular wall
vibration.
IV tone occurs during systole of atria due to contraction of atria myocardium.
The second method of heart sounds investigation is phonocardiogram. Phonocardiogram (PCG) - examines all tones,
while auscultation examied only I and II tone.
When auscultating heart tones we should observe the following rules:
• The room should be quiet and warm.
• Stethoscope should be warm.
• Experimenter standing on the right side of the measurements.
• The tube should be kept in the rastrub area.
• Stethoscope diaphragm tightly attach to the surface of the body.
• The tube should not face a dressing gown or other objects.
• hear conducted measurements in different positions (vertical, horizontal on the back, left, right side, after a little
physical activity).
Materials and equipments: stethoscopes, object for investigation – human.
Procedure:
1. Clean the earpieces of the stethoscope with an alcohol swab.
2. To best hear the first heart sound, auscultate the apex beat of the heart by placing the
diaphragm of the stethoscope in the fifth left intercostal space (the bicuspid area).
3. To best hear the second heart sound, place the stethoscope to the right or left of the
sternum in the second intercostal space (the aortic or pulmonic area).
4. Compare the heart sounds in the three stethoscope positions described during quiet
breathing, slow and deep inhalation, and slow exhalation.
Results: 1. Define the properties of I and II tone (duration, amplitude, tonality).
2. Draw schematic point of audition I and II tones.
1)____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
2)
94
Conclusions: 1) Describe the components of I and II tone;
2) Specify which the phase of cardiac cycle they arise.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #3: "Measurement of systolic blood pressure in man by Riv-Rochi’s
method".
Materials and equipments: sphygmomanometer, stethoscopes, stopwatch, object for
investigation – human.
Procedure:
1. Have the subject sit down,with his or her right or left arm resting on a table at the level of
the heart. Wrap the cuff of the sphygmomanometer around the arm about 2.5 cm above
the elbow.
2. Palpate the brachial artery in the cubital fossa and place the bell of the stethoscope where
the arterial pulse is felt. Gently close the screw valve and pump the pressure in the cuff
up to the point where the radial pulse can no longer be felt.
3. Register the pressure at the time of the disappearance of the pulse (P1).
4. Open the screw valve to allow the pressure in the cuff to fall slowly, at a rate of about 2
or 3 mm Hg per second till the pulse begins.
5. Register the pressure at the time of onset pulse (P2).
6. Calculate the value of systolic pressure as the average between P1 and P2.
Results:
1. Index of sphygmomanometer at the time of the disappearance of the pulse P1 = _______
2. Index of sphygmomanometer at the time of occurrence of pulse P2 = _______
3. AP syst. = (P1 + P2): 2 = (______+______): 2 = ________
Conclusions: 1. What motivates the origin of the systolic blood pressure.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #4: "Measuring blood pressure in human by Korotkoff’s method ".
The arterial blood pressure is routinely measured in an indirect manner with a sphygmomanometer, or
blood pressure cuff. This device consists of an inflatable rubber bag connected by rubber hoses to a hand pump and
to a pressure gauge (manometer) graduated in millimeters of mercury (mmHg). The rubber bag is wrapped around
the upper arm at the level of the heart and inflated to a pressure greater than the suspected systolic pressure, thus
occluding the brachial artery. The examiner auscultates the brachial artery by placing the bell of a stethoscope in the
cubital fossa and slowly opening a screw valve on the hand pump (bulb), allowing the pressure in the rubber bag to
fall gradually.
At rest, the blood normally travels through the arteries in a laminar flow—that is, blood in the central axial
stream moves faster than the blood in the peripheral layers, with little or no transverse flow (and thus little mixing)
between these axial layers. Consequently, under normal conditions, an artery is silent when auscultated.
When the sphygmomanometer bag is inflated to a pressure above the systolic pressure, the flow of blood in
the artery is stopped and the artery is again silent. As the pressure in the bag gradually drops to levels between the
systolic and diastolic pressures of the artery, the blood is pushed through the partially compressed walls of the
artery, creating turbulent flow. Under these conditions, the layers of blood are mixed by eddies that flow at right
95
angles to the axial stream, and the turbulence sets up vibrations in the artery that are heard as sounds in the
stethoscope. These sounds are known as the sounds of Korotkoff, after Nikolai S. Korotkoff, the Russian physician
who first described them.
The cuff pressure at which the first sound is heard is the systolic pressure. The cuff pressures at which the
sound becomes muffled and the pressure at which the sound disappears are taken as measurements of the diastolic
pressure.
The pulse pressure is calculated as the difference in these two pressures; and the mean arterial pressure
is equal to the diastolic pressure plus one-third of the pulse pressure.
Materials and equipments: sphygmomanometer, stethoscopes, stopwatch, object for
investigation – human.
Procedure:
1. Have the subject sit down, with his or her right or left arm resting on a table at the level
of the heart. Wrap the cuff of the sphygmomanometer around the arm about 2.5 cm above
the elbow.
2. Palpate the brachial artery in the cubital fossa and place the bell of the stethoscope where
the arterial pulse is felt. Gently close the screw valve and pump the pressure in the cuff
up to 20 mm Hg above the point where sounds disappear, or to 20 mm Hg above the
point where the radial pulse can no longer be felt.
3. Open the screw valve to allow the pressure in the cuff to fall slowly at a rate of about 2 or
3 mm Hg per second.
4. Record the systolic pressure (beginning of phase 1) and the two measurements of
diastolic pressure (beginning of phases 4 and 5). Enter these values in your laboratory
report and compare your pressures with the range of normal values listed in table 7.1.
5. Calculate appropriate indexes of pressures by Volynsky’s formula:
AP syst. = 102 + 0,6 × age;
AP diast. = 63 + 0,4 × age.
6. Compare the value obtained.
7. Calculate the value of pulse pressure and average pressure:
AP pulse = AP syst. – AP diast.
AP mean. = AP diast. + ½ AP pulse. (for the central arteries);
AP mean. = AP diast. + ⅓ AP pulse. (for peripheral arteries).
Results:
1. Indicator of manometer at the time of occurrence tone _______________ mm Hg.
Indicator of manometer at the time of disappearance tones _____________ mm Hg.
2. Appropriate values of pressures:
AP syst. = 102 + 0,6 × age = 102 + 0,6 × ______ = ______ mm Hg.
AP diast. = 63 + 0,4 × age = 63 + 0,4 × _______ = ______ mm Hg.
AP pulse. = AP syst. - AP diast. = ________ – _____ = _______mm Hg.
AP mean. = AP diast. + ⅓ AP pulse. = _____ + ⅓ _____ = _______ mm Hg.
3. The obtained values write down in the table:
Pressure
Systolic
Diastolic
Pulse
Mean
Pressure values
Patient
Appropriate
Conclusion
96
Conclusion: What motivated the origin of the systolic and diastolic blood pressure.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #5: "Investigation of orthostatic test by Martin”
When human change position from horizontal to vertical, a change of hydrostatic pressure occurs and is
related with the redistribution of blood volume. Only in some capacity, vessels temporarily accumulates 400 - 600
ml. of blood. As a consequence of which venous return, central venous pressure, stroke volume and AP syst. are
temporarily reduced. All listed changes is compensated by hemodynamic reactions that triggered signals from
arterial baroreceptors. When human changes position from horizontal to vertical, hydrostatic pressure in the aortic
arc and carotid sinus is reduced, as a result the impulses from baroreceptors decreases this causes the folowing
reflex adaptive reactions:
1) increace of resistance in capacity vessels;
2) increase FCC;
3) increase the secretion of catecholamine adrenal brain substance;
4) activation of renin - angiotensin system;
5) increased secretion of vasopresin and aldosteron.
When human changes position from horizontal to vertical:
- AP avg. - virtually no change;
- Central venous pressure - reduced by 3 mm.Hg.
- FCC - increased by 30%
- stroke volume - decreased by 40%
- Total peripheral resistance - increases by 30%.
If insufficient compensatory mechanisms for maintenance of normal hemodynamic AP can fall below
acceptable levels and blood supply of the brain bloked. Subjective manifestations are dizziness and darkening of the
eyes (orthostatic hypotension); perhaps even loss of consciousness. Similar phenomena may occur in completely
healthy people at high temperate environment. In these conditions canting test load decreases as the expanded
vessel, required for thermoregulation, prevails over vessels constrictions. Reactions that contribute to maintaining
hemodynamic.
Orthostatic tests. Regulations of hemodynamic response to changing situation of course researched by measuring
FCC and AP as determinated through the time periods after the human changed from horizontal to vertical position.
Clinic criterion in assessing the results of orthostatic test for AP diast.
Hemodynamic reactions are considered normal if after 10 min. conversion to vertical position:
AP diast. - reduced no more than 5 mm. Hg;
AP syst. - within 5%;
FCC - an average increase of 30%;
SV - reduced by 40%.
When hyperdiastolic orthostatic hypotension (80-85% of pathological deviations):
AP diast. - increased more than 5 mm. Hg;
AP syst. - reduced by more value.
As a result, pressure oscillation amplitude is significantly reduced. There is a significant increase in FCC
and reduction of stroke volume. Increasing AP diast. is (due to significant constriction resistance vessels) and FCC
at this type of reaction associated with a significant increase in the tone of the sympathetic nervous system.
When hypodiastolic orthostatic hypotension:
AP diast .- decreases;
AP syst. - decreases;
AP puls. - varies slightly;
FCC - almost not increased;
SV - moderately low.
Change AP and FCC at this type of reaction caused by poorly pronounced increase in the tone of the sympathetic
nervous system.
97
Materials and equipments: sphygmomanometer, stethoscopes, stopwatch, couch, object for
investigation – human.
Procedure:
1. Patient lie in couch, relax. Tests start after 10-15 min.
2. In patient measure AP and pulse rate in recumbent position.
3. In patient measure AP and pulse rate in standing position.
Results: These data write down to the table:
Indexes
In recumbent position
In standing position
% change
АP syst. (mm Hg)
АP diast. (mm Hg)
FСС ( bit/min)
Conclusions: Estimate and explain the results of orthostatic test.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #6: “Investigation of the Shalkov’s functional tests (with physical load)”.
In physical stress: AP mean - increased by 20 mm. Hg; Central venous pressure - reduced by 3 mm. Hg;
- FCC - 150 bit/min Stroke volume - increased by 50% Cardiac Output - increases by 400%
- Total peripheral resistance - reduced
After the termination of the AP rather quickly decreases. This is due to first, thet expanded vessels only gradually
contract as a resolt of metabolites and compensated oxygen deficiency, and secondly, the stoped pumping action of
muscles and breathing movements, which helps accelerate the venous return. Cardiac output, FCC, absorption of
oxygen and arterial-venous difference for oxygen return to the original level so slowly, as the load becomes intense.
Materials and equipments: sphygmomanometer, stethoscopes, stopwatch, couch, object for
investigation – human.
Procedure:
1. Patient lie in couch, relax. Tests start after 10-15 min.
2. In patient measure AP and pulse rate in recumbent position.
3. Patient stands up, do 20 sits in 30 seconds.
4. In patient AP and measure pulse rate in standing position after loading, then after 3
minutes, 5 minutes, 10 minutes.
Results: 1. These data write down in the table:
Status of patient
In recumbent position
In standing position after loading
3 minutes after loading
5 minutes after loading
10 minutes after loading
АP mm. Hg
Pulse rate bit/min
98
2. Calculate the change in AP and pulse rate after the load.
AP increased ______%, pulse rate increased _______%.
3. Define the duration of recovery.
The period of recovery _______ min.
Conclusions: Estimate and explain the change of blood circulation during physical stress.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Teacher’s signature ___________________
Practical class #27
Data: _______________
Theme: "Module on the Physiology of heart and blood circulation."
Questions for discussion:
1. Conductive system of heart, its value. Mechanisms of spontaneous generation of impulses
are in the explorer system. Law ―gradient of automatism‖.
2. Functional properties of contractive muscles fibers of heart. Action potential of
contractive myocardiocytes. Ionic mechanisms of origin of it basic phases.
3. A concept about the cycle of cardiac activity. Phase structure of cardiac cycle.
4. Functional classification of blood vessels.
5. Pulse vibrations of blood motion, volumes and pressure in arterial vessels.
6. Laws of blood motion are in venous vessels. A concept about venous pressure, venous
pulse, venous returning.
7. Miogenic, metabolic and histomechanic mechanisms of adjusting of blood local
circulation. A concept about physiology arterial hyperemia.
8. Nervous regulation of local blood circulation. Humoral mechanisms regulation of local
blood circulation.
9. Miogenic mechanisms regulation of heart work. Frank-Starling Law.
10. Immediately mechanisms of adaptation of heart to stress and resistance.
11. Character and mechanisms of influencing of the parasympathetic nervous system is to
heart work.
12. Character and mechanisms of influenc of the sympathetic nervous system on heart work.
13. Nervous mechanisms of hemodynamic system regulation. Characteristic of afferent
central and efferent link regulation.
14. A role of reflexes in circulation regulation.
Literature:
Guyton, Arthur C. Textbook of medical physiology – p. 103-114, 116-138, 161-181, 204-215,
419-427, 429-437, 451-455, 457-468.
99
Practical class # 28
Date: _____________________
Theme: "General characteristics of the respiratory system. Research of external
breathing"
Questions:
1. Structure of the respiratory system. Pulmonary ventilation. Mechanics of pulmonary
ventilation.
2. Breathing stages. General structure and basic functions of the system of external
breathing.
3. Functional description of structural elements of the system of external breathing: thorax,
respiratory muscles, pleura cavity, air ways, lungs.
4. Movement of air in and out of the lungs and the pressures that cause the movement.
14. Pleural pressure and its changes during respiration.
15. Alveolar pressure.
16. Transpulmonary pressure.
5. Compliance of the lungs. Surfactant, surface tension, and collapsing of the alveoli.
6. Effect of the thoracic cage on lung expansibility. ―Work‖ of Breathing.
7. Static indexes of ventilation of lungs. Pulmonary volumes and capacities.
8. Minute respiratory volume equals respiratory rate times tidal volume. Alveolar
ventilation. ―Dead Space‖ and its effect on alveolar ventilation. Rate of alveolar
ventilation.
Literature:
Guyton, Arthur C. Textbook of medical physiology – p. 471-478.
Practical work №1 : "Study of indexes of pulmonary ventilation by method of
spirography."
Materials and equipments: spirograph, object for research is man.
Procedure:
1. Spirograph prepare for work according to instructions for operation.
2. Connect device through tube with the respiratory system of patients.
3. Stop breathing through the nose using clamp for the nose.
4. Perform spirogram record (paper speed 50 mm / min).
- Breathing movements of patient is on a team.
- Registrater respiratory volume: the patient performs 5 quiet inspirations and expirations.
- Registrater inspiratory reserve volume: the patient performs a deep inspiration after
quiet expiration.
- Registration expiratory reserve volume: the patient performs maximum expiration after a
quiet expiration.
Registrater Vital capacity: the patient performs a deep inspiration and a deep expiration.
5. Drow spirogram in the protocol book.
100
Results:
1. To draw spirogram and designate all known indexes on it;
Maximal
Inspiration
Normal
Inspiration
Normal
Expiration
Maximal
Expiration
Residual
air
2. Define the spirogram indexes of pulmonary ventilation:
TV = ______ ml, IRV= _______ ml, ERV= _______ ml, VC = ___________ ml,
RR = _____ t/min, MRV = _____ ml, MAV = _____ ml, VO2 = _____ ml.
3. Define the proper indexes using the tables of Kharris-Benedict:
Weight = ______ kg, height =__________ cm, age =_________,
Number А = _______ kcal, number B = _______kcal, BE =А+В= ________ kcal.
TV = _________ mL, IRV= ________ mL, ERV= ________ mL, VC= ________ mL,
RR= _____ ml, MRV = _____ mL, MAV = _____ mL, VО2 = _____ mL.
4. Calculate the percentage deviation of predicted or got indexes from proper index by a formula:
% deviation 
measured number  predicted number
 100 %
predicted number
% deviation of TV = _______________
% deviation of IRV = ______________
% deviation of ERV = ______________
% deviation of VC = ______________
% deviation of MRV = _____________
% deviation of MAV =______________
If deviation of the found index from the proper index does not exceed 15% its size is considered
normal.
101
5. Gotten indexes are recorded in the table:
Indexes
Measured indexes
of patient
(for SPG)
Proper indexes
(by tables)
% deviation
Conclusion
TV
IRV
ERV
VC
RR
MRV
MAV
VО2
Conclusions: To give an estimation of basic indexes.___________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #2: "Study of indexes of pulmonary ventilation by spirometry."
Materials and equipments: spirometer, cotton, alcohol; object for research is man.
Procedure:
1. Before work with a spirometer it is necessary to wash hands with a soap and disinfect
tube with alcohol.
2. To put a sterile tube on a spirometer.
3. A mark to set against a zero mark on the clock-face of scale.
4. To define tidal volume (TV).
For this purpose a patient does 5 - 6 quiet inspirations through the nose and so much quiet
expirations through a mouth in a spirometer. On a scale, define the size of volumes of breathed
out air and divide it into the phases of expirations. The average number is TV.
5. To define expiratory reserve volume (ERV).
For this purpose, a patient after quiet inspiration does a more deep expiration through the mouth
in to a spirometer. On a scale, define the size of volumes of breathed out air. Subtract from the
registered index, the value of tidal volume. Found difference is expiratory reserve volume. To
receive of more reliable values conduct tests 5 – 6 times, and then find average number.
6. To define the vital capacity of lungs. (VC).
For this purpose patient, upright does maximal inspiration, closes the nose, maximal expiration
in to a spirometer. On a scale, define the size of volume of breathed out air. Found size is VC. To
receive a more reliable values conduct tests 5 – 6 times and then find average number.
7. To define inspiratory reserve volume (IRV).
For this purpose from the found size of VC substract tidal volume and expiration reserve
volume. Found difference is inspiratory reserve volume.
8. Using the Kharris-Benedikt tables, find the proper values to TV, IRV, ERV, and VC.
9. Compare the found indexes to the proper indexes.
102
Results:
1. Indexes, found by a spirometer should be recorded in the table:
Indexes
1 sample
2 sample
3 sample 4 sample 5 sample
Average
number
TV
ERV
VC
IRV
2. Define the proper indexes by tables of Kharris-Benedikt:
Weight = ______ kg, high =_____ cm, age = _____ year old,
Number А = _______ kcal, number В = _______kcal, BE= А+В = ________ kcal.
TV = _____ ml, IRV= _____ ml,
ERV= _____ ml,
VC = _____ ml,
3. Calculate the percentage deviation of predicted or got indexes from proper by a formula:
% deviation 
measured number  predicted number
 100 %
predicted number
% deviation of TV = ____________________________________________________________
% deviation of IRV = ___________________________________________________________
% deviation of ERV = ___________________________________________________________
% deviation of VC = ____________________________________________________________
4. Gotten index is recorded in the table:
Indexes
Given patient
(by spirometer)
Proper indexes
(by tables)
% rejection
Conclusion
TV
IRV
ERV
VC
Conclusions: give an estimation of certain indexes.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Signature of teacher ___________________
103
Work for the independent exercise
1. Determine the indexes:
Tidal volume (TV) –
_____________________________________________________________________________
_____________________________________________________________________________
Inspiratory reserve volume (IRV) –
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Expiratory reserve volume (ERV) –
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Residual volume (RV) –
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Vital capacity of lungs (VC) –
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Inspiratory capacity (IC) –
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Functional residual capacity (FRC) –
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Total lung capacity (TLC) –
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Breath frequency –
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Minute volume of breathing or pulmonary ventilation (MVB; PV) _____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
104
Minute alveolar ventilation (MAV) _____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Maximum ventilation of lung (МVL) –
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Breathing reserve _____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Coefficient of pulmonary ventilation (CPV) _____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Ratio of alveolar ventilation (RАV) _____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
2. Two students of the same age after raceing at the distance of 5000 m recorded a number of
indicators of external respiration. The first student breathing frequency was 40 per minute,
respiratory volume - 500 ml. Pulmonary ventilation rate = 1 / 7. In the second - the frequency of
breath - 27 per minute, respiratory volume - 1200 ml, and the pulmonary ventilation rate = 15.
Rate the intensity and efficiency of breathing in each student. What are your deductions?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
3. Define coefficient of pulmonary ventilation (CPV) alone in human of middle age, if breathing
volume is 460 ml, functional lung volume - 2200 ml. Assess the value received.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
4. Calculate how much alveolar air will be updated in a breath, if the volume of the alveolar air is
2700 ml, respiratory volume - 600 ml, the volume of dead space - 150 ml.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
105
Practical class #29
Data: _______________
Theme: "Gas exchange in the lungs. Transport gases though blood. Regulation of
breathing.”
Questions:
1. Composition and partial pressure of alveolar gas mixture. Factors that determine it.
2. Mechanisms of gaseous exchange between alveoles and blood of lung capillaries.
3. Types of blood oxygen transport. Transport of physically dissolved oxygen in the blood
plasma. Its functional significance.
4. Transport of chemically associated oxygen. Functional characterization of hemoglobin.
The concept of Huphner’s number and oxygen capacity of blood.
5. Dissociation curve of oxyhemoglobin. Functional significance of this form of curve.
6. The concept of dissociation curve shift to right and left. Factors that cause such shifts.
Bohr Effect, its functional significance.
7. Forms of transport of carbon dioxide from tissues to the lungs. Binding curves of carbon
dioxide. Holdeyn Effect and its value.
8. The concept of the respiratory center. Methods of its localization. The notion of
inspiratory and expiratory neurons.
9. Localization and functional characteristics of groups of neurons that are part of the
respiratory center.
10. Mechanisms of rhythmic autonomous activity of respiratory center in quiet conditions
and in increased respiration.
11. Influence of mechanical factors on the activity of respiratory center. Types of
mechanoreceptor in the lungs. Hering-Breuer reflex.
12. Influence of chemical factors on the activity of the respiratory center. Central and
peripheral mechanisms of these influences.
Literature:
Guyton, Arthur C. Textbook of medical physiology – p. 491-501, 514-519.
Practical work #1: "Research of Christi’s test."
The Christi’s test is used for the estimation of the state of elasticity of pulmonary tissue.
Materials and equipment: spirometer, object for research is man.
Procedure:
1. Determine the Vital capacity of lungs (VC) at one-time using dry spirometer.
2. Determine the Tidal volume (TV), Inspiration reserve volume (IRV), Exspiration reserve
volume (ERV) using dry spirometer.
3. Find VC as the sum of separately measured TV, IRV, and ERV.
4. Compare the VC value measured at one-time and size, which is the sum of TV, IRV,
ERV. Normal is considered as deviation within ± 7-15%.
106
Results:
1. Indexes, which got by a spirometer are recorded in the table:
One-time
index
1 sample
2 sample
3 sample
4 sample
5 sample
Average
arithmetic
VC
Indexes
1 sample 2 sample
3 sample
4 sample
5 sample
Average
arithmetic
VC
(sum)
TV
ERV
IRV
2. Calculate % deviation between indexes
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Conclusions : estimate the got result
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #2 : " Research of Votchal’s test."
The Votchal’s test is used for the estimation of width of shallow bronchial tubes and tone of bronchial musculature.
Materials and equipment: spirometer, object for research is man.
Procedure:
Determine VC in the normal respiratory rate using dry spirometer.
Determine VC in quickly forced expiration using dry spirometer.
Compare VC value measured in the normal respiratory rate and magnitude of that obtained in
quickly forced expiration. Considered normal deviation is within ± 300 ml.
Results:
1. Indexes found by a spirometer are recorded in the table:
107
In the normal
respiration
1 sample
2 sample
3 sample
4 sample
3 sample
4 sample
5 sample
Average
arithmetic
VC
In quickly
forced expiration
1 sample
2 sample
5 sample
Average
arithmetic
VC
2. Calculate% deviation between the indices
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Conclusions: estimate the got result
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #3 : "Research of Shtange-Gench’s test with the delay of breathing."
Shtange-Gench’s test is used for assessment of cardiovascular, respiratory and autonomic nervous systems.
Materials and equipment: stop-watch, object for research is man.
Procedure:
1. A patient does quiet inspiration, suspends breathing.
2. Register the time of delay of breathing on inspiration.
3. A patient does quiet expiration, suspends breathing.
4. Register the time of delay of breathing on expiration.
5. Rest between delays must not be less than 5 min.
6. For healthy people the maximal time of delay of breathing after quiet inspiration is 40-60 sec,
after quiet expiration – 30-40 sec.
Results: 1. Define the time of delay of breathing (sec):
a) after a quiet inspiration _______________;
b) after a quiet expiration _______________.
Conclusion: estimate the got result
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
108
Practical work #4 : " Research Shaffranovsky’s test."
Shaffranovsky’s test is used to assess fatigue and allows you to adjust the training load.
Materials and equipment: spirometer, object for research is man.
Procedure:
1. Determine VC in the normal respiratory rate using dry spirometer.
2. A patient executes 20 sitting down during 30 sec.
3. In patient determine VC after physical exercises using dry spirometer.
4. Compare the got sizes after the physical loading, VC does not decrease or increase. A
decline of VC is the index of the promoted fatigue ability).
Results:
1. Indexes, found by a spirometer are recorded in the table:
In the normal
respiration
1 sample
2 sample
3 sample
4 sample
3 sample
4 sample
5 sample
Average
arithmetic
VC
After exercises
1 sample
2 sample
5 sample
Average
arithmetic
VC
Conclusions : estimate the got result
_____________________________________________________________________________
_____________________________________________________________________________
Signature of teacher ___________________
Work for the independent exercise:
1. Draw oxyhemoglobin dissociation curve. Indicate what factors cause the shift of the curve.
109
2. In a patient with damaged spinal cord (full gap) at the first thoracic vertebra as a result of
injuries. What happens to breathing? Explain effect.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
3. After working at a sea depth of 200 m, increased diving was observed, due to the threat of
hypoxia. What phenomena can develop here in the organism? Explain the mechanism of their
origin. How are they prevented?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
4. What phenomena can develop in the human body in a cabin of passenger aircraft at an altitude
of 6000 meters where the atmospheric pressure of 355 mm Hg? Explain the mechanism
justifying their settlement.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
5. How will a dog’s external respiration in the experiment, which had a two-sided cut of vagus
nerves under local anesthesia change. Explain mechanism.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
6. What changes in external respiration occur in human if he (she) is to breathe through a tube
length of 3 m and a diameter of 3 cm?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
7. Define the oxygen capacity of blood if the hemoglobin content is 110 g / liter. Assess the
value received.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
110
Practical class #30
Data: _______________
Theme: "Investigation of energy metabolism. Thermoregulation."
Questions for discussion:
1. Physiological significance of proteins, fats and carbohydrates. The concept of nitrogen
balance.
2. Dissipation of energy in the body. Methods of energy metabolism: direct and indirect
calorimeters.
3. Caloric equivalent of oxygen and respiratory rate, their value in studies of metabolism.
4. The notion of primary metabolism. Factors that influence its value. The specific-dynamic
action of food.
5. Energy costs of organism during physical and mental activity.
6. Physiological bases of rational nutrition. Light ratios of nutrients.
7. The concept of core and shell as the body temperature zones.
8. Periodic fluctuations in body temperature, body temperature changes in physiological
conditions.
9. Properties and physiological reactions of the body that determines the intensity of heat.
10. Center of thermoregulation, its structure and basic principles of operation.
11. Afferent and efferent binds of thermoregulation.
Literature:
Guyton, Arthur C. Textbook of medical physiology – p. 829-857, 865-878, 889-897.
Practical work #1 : "Investigation of human body energy changes (metabolism) by HarrisBenedict’s tables"
Materials and equipment: medical scales, measuring tape, sphygmomanometer, stethoscope,
Harris-Benedict’s tables, object for investigation – human.
Procedure:
1. Measure height weight, and age of the patient.
2. From Harris-Benedict’s tables find basic exchange of patient. To do this:
a) find the number A (by weight);
b) find the number B (according to height and age);
c) find the basic exchange, sum of numbers A and B.
3. Measure arterial pressure of patients by the Korotkov`s method.
4. Count pulse rate.
5. Calculate percentage deviation of metabolism from the norm by Rid’s formula:
Ri( % ) = 0,75 × (PR + AP pulse. × 0,74) - 72.
Normal is considered a deviation from the norm by  15%.
6. Calculate deviation of basic exchange using Ri (kcal).
7. Calculate basic metabolism (or basic exchange BE) using the deviation of basic
metabolism.
Results:
1. Weight = ______ kg, height =_____ cm, age = _____ year old,
2. Number А = _______ kcal, number В = _______kcаl,
3. AP = _____/_____ mm Hg,
BE = А+В = ________ kcаl.
AP pulse = ______ mm Hg.
111
4. PR = ______ bit/min.,
5. Ri (%) = 0,75 × (PR + AP pulse × 0,74) – 72 = 0,75 × ( ____ + _____× 0,74) – 72 =______%
6. Value of deviation of basic exchange (dBE) using Ri (kcal).
BE (kcal) _____ is 100%
dBE (kcal)
is Ri % _____
dBE = _________________________(kcal)
7. Basic metabolism using the deviation of basic metabolism.
BM = BE + dBE
BM = ____________kcal
Conclusions: Give determination of basic exchange. Mark the size of basic exchange for a
patient and its deviation from norm.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #2 : "Determination of daily human energy costs by method of incomplete
gas analysis."
Materials and equipment: spirograph, Harris-Benedict’s tables, objects for investigation –
human.
Procedure:
1. Record the patients spirogram during quiet breathing for 5 min.
2. Define by spirogram minute absorption of oxygen by displacement of the curve up.
3. Calculate the basic exchange by the formula:
BE daily = VO2 × OVB ×1440.
OVB – oxygenic volume of blood.
4. Calculate appropriate basic exchange by Harris-Benedikt tables
Results:
1. The scheme recorded spirogram:
2. Minute absorption of oxygen (VO2) = ________,
3. BE daily = VO2×OVB×1440 = _______ ×_______×1440 = _______
4. Appropriate basic exchange by Harris-Benedikt tables
112
Weight = ______ kg, height =_____ cm, age = _____ year old,
Number А = _______ kcal, number В = _______kcаl,
BE = А+В = ________ kcаl.
5. These data are recorded in the table:
BE by spirogram (kkаl)
% deviation BE
Conclusions
Conclusions: mark the size of basic exchange for a patient and its deviation from norm.
_____________________________________________________________________________
_____________________________________________________________________________
Practical work #3 : "Determination of daily human energy costs at different kinds of
activity."
Materials and equipment: Harris-Benedict’s tables, objects for investigation – human.
Procedure:
1. Define daily basic exchange of patient by the Harris-Benedikt tables with the Rid’s
amendment.
2. Calculate a basic exchange for 1 hour (BE by hours = BE daily : 24).
3. Calculate daily energy expenses in accordance with the order of day taking into account the
coefficient of expense of energy and working raised at the different types of activity.
Order of day:
Sleep
– 8 hours;
Practical classes – 6 hours;
Study time
– 4 hours;
Free time
– 6 hours.
The coefficients of charges of energy are:
a) During sleep
– 0,9;
b) Practical classes – 1,45;
c) Study time
– 1,6;
d) Free time
– 2,2.
Results:
1. Daily basic exchange = _______ kcаl ,
3. Given % deviation of BE = ________ kcаl.
5. BE per hour = _______ kcаl.
2. Ri(% )= ________
4. BM = ________
6. Daily energy costs:
a) Sleeping
= ______×8 ×0,9 = ______ kcal,
b) Practical classes = ______× 6 ×1,45 = ______ kcal,
c) Study time
= ______× 4 ×1,6 = ______ kcal,
d) Free time
= ______× 6 ×2,2 = ______ kcal.
Total = (a) + (b) + (c) + (d) = kcal.
Total = ______ + _______+ _______+ _______ = ____________ kcal. (E1)
113
Conclusions: mark the size of energy cost in patients.
_____________________________________________________________________________
_____________________________________________________________________________
Teacher’s signature ___________________
Work for the independent exercise:
1. The workers of refrigeration meat workshop periodically work in the conditions of low
temperatures (-400oC). What mechanisms of thermoregulation must be included for support
of body temperature at permanent level during the first month of studies for a man who
passes internship here?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
2. If will be a worker to work in the refrigeration meat workshop during 10 hour in the
conditions of low temperatures, how will he maintain constancy of body temperature?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
3. Explain the value of the respiratory coefficient (RC) during the cleavage of proteins, fats,
carbohydrates in the mixed diet. In which case RC is different from the normal values?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
4. Experimentally per day 432 liters of CO2 allocated to expirated air. Volume of air O2 that
is absorbed is 462 liters. Calculate the breathing rate. Indicate what nutrients prevail in
his food intake.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
5. Calculate how much protein learned, if the day in the athlete with the food received 136 g
of protein from urine excrete 10.8 g nitrogen and 7.4 g nitrogen from feces. Rate nitrogen
balance.
_____________________________________________________________________________
_____________________________________________________________________________
____________________________________________________________________________
6. What is the normal basal metabolism in woman 27 years old, weighing 60 kg and height
164 cm, if the pulmonary ventilation is 6 liters and expiratory air contain 16.3% oxygen
and 3.7% CO2?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
114
Individual work of student:
"Drafting of food ration".
Procedure:
1. Calculate daily energy costs (you can use the practical work number 3 of practical class 9).
2. Daily energy costs is divided into 3 meals (breakfast - 30%, lunch - 50%, dinner - 20% of the
total).
3. Make a menu, taking into account:
• calorie food ration to cover subsistente energy costs;
• the daily number of proteins, fats and carbohydrates, respectively 1:0,8:4,2 not less than 1 kg
body mass;
• calorie ratios of nutrients, which is 4.1 kcal for protein, carbohydrates - 4.1 kcal, fat - 9.3
kcal);
• the number of proteins and fats of animal origin must be 50% and 70% respectively.
Results:
1. Daily energy costs (Е1) __________ kcal
2. For calculation of daily amount of proteins, fats and carbohydrates, which are needed for daily
energy costs, we must determine ration coefficient – X.
(1X  m (kg)  4.1) + (0.8Xm (kg)  9.3) + (4.2X m (kg)  4.1) = E1
(1X______  4.1) + (0.8X ______  9.3) + (4.2X ______  4.1)= ___________
____________X + ____________X + ____________X = ___________
____________X = _____________
X = ____________
3. Each day the patient must take:
Proteins
= 1 × X × m = ______________________________ g;
Fats
= 0.8 × X × m = ______________________________ g;
Carbohydrates = 4.2 × X × m = ______________________________ g.
4. Eating this amount of nutrients will lead to the formation of such amount in kcal:
By protein
______ g × 4,1 kcal = ______ kcal;
By fat
______ g × 9,3 kcal = ______ kcal;
By carbohydrates ______ g × 4,1 kcal = ______ kcal
If the calculation was correct E1 = E2
Breakfast ___________ g;
p_________________________
f_________________________
c_________________________
.
Lunch ___________ g;
p_____________________
f______________________
c_____________________
Dinner ____________ g
p_____________________
f_____________________
c_____________________
Food
Products
Breakfast
Mode of
food
115
Lunch
Total per breakfast
Mass
(g)
Proteins
(g)
Fats (g)
Carbohydrate
s (g)
Energy
value
(kcal)
116
Dinner
Total per lunch
Total per dinner
Total per day
Teacher’s signature ___________________
117
Practical class #31
Data:_______________
Theme: "General characteristics of the digestive system. Digestion in the mouth and
stomach.”
Questions for discussion:
1. Physiological basis of hunger and satiety. Food Center.
2. Common structural and functional characteristics of the digestive system. The notion of
types of digestion.
3. Overview of the mechanism of digestion. Gastrointestinal hormones.
4. Basic research methods of digestive functions of the channel.
5. Oral cavity role of cavity in primary division of the digestive system.
6. Composition, properties and importance of saliva. Mechanisms and regulation of
salivation.
7. Gustatory analyzer, its structure and meaning.
8. Mechanical processing of food. Mechanisms of mastication and swallowing.
9. Value of stomach in the process of digestion.
10. Gastric juice, its composition, properties and values of major components. Mechanisms
of gastric secretion.
11. Neural and humoral mechanisms of regulation of gastric secretion.
12. Phases of gastric secretion. Influence of different food regimes on gastric secretion.
13. Gastric motor function. Mechanisms of conversion of food in the stomach in the
duodenum.
14. Vomiting reflex, its causes and mechanisms.
Literature:
Guyton, Arthur C. Textbook of medical physiology – p. 771-786.
Work for the independent exercise:
1. Why, does a man’s mouth dry up when he worms? Explain the mechanisms of this
phenomenon. Complement an answer with a scheme.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
2. What changes occur in salivation after entty into the body of atropine (M-holinobloker). Draw
a scheme of regulatory mechanisms, explain it.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
118
Practical class #32
Data:_______________
Theme: «Digestion in the intestine. The role of the liver and pancreas. The absorption in
the gastrointestinal tract."
Question for discussion:
1. Role of small intestine in the process of digestion.
2. Pancreatic juice, its composition, properties and values of major components.
3. Influence of various food substances on secretion of pancreatic juice.
4. Neural and humoral mechanisms of regulation of pancreatic secretion.
5. Bile, its composition, properties and values of major components.
6. Mechanisms of bile allocation and regulation of this process.
7. Protective (barrier and antitoxic), metabolic and hemodynamic functions of the liver.
8. Intestinal secretion. Composition, properties and values of key components of intestinal
juice.
9. Cavity and membrane hydrolysis of nutrients in the small intestine.
10. Motor activity of small intestine and its role in the etching.
11. Digestion in the large intestine. Value gut micro flora. Motor activity of the large
intestine. Act of defecation.
12. Mechanisms of absorption in various departments of the digestive system.
13. Absorption of water, minerals, products of hydrolysis of proteins, fats and carbohydrates.
Literature:
Guyton, Arthur C. Textbook of medical physiology – p. 786-806, 859-862.
Work for the independent exercise:
1. Draw the scheme of transformation and absorption of proteins in the alimentary canal.
119
2. Draw the scheme of transformation and absorption of fats in the alimentary canal.
3. Draw the scheme of transformation and absorption of carbohydrates in the alimentary canal.
120
4. In the patient due to self-antibiotics, there was a sharp reduction of the gut micro flora. What
can occur as a result?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
5. How does limited income bile in the gut affect digestion?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
6. How will the process of hydrolysis change in intestine if enterokinase is absent in juice
composition?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
7. In disorder of what amino acid is there fat infiltration of liver in the meal of man?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Practical class # 33
Data:_______________
Theme: "Module on the physiology of respiration, energy metabolism, thermoregulation,
digestion.”
Respiratory system
1. Breathing stages. General structure and basic functions of the external breathing system.
2. Elastic traction of lungs. Surphactants, their values.
3. Breathing biomechanics. Mechanisms of inspiration and expiration.
4. Static indexes of lungs ventilation. Concept about pulmonary volumes and capacities.
5. Dynamic indexes of lungs ventilation. Minute volume breathing, its determination.
6. Mechanisms of gas exchange between alveoli and blood through pulmonary capillaries.
7. Transport forms of oxygen through blood. Transport the physically dissolved oxygen in
plasma of blood. Its functional value.
8. Transport the chemically dissolved oxygen. Functional characteristic of hemoglobin. A
concept is about the Khyuffner’s number and oxygen capacity of blood.
9. Curve of dissociation of oxihemoglobin. Functional value of form of this curve. Concept
about the change of the curve dissociation of oxihemoglobin to the right and to the left.
Factors which cause such changes. Bor Effect, its functional value.
10. Transport forms of carbon dioxide are from tissues to lungs. Binding curves of carbon
dioxide. Holding Effect, its value.
121
11. Localization and functional characteristic of neurons groups which enter in the
complement of respiratory center.
12. Mechanisms of autonomic rhythmic activity of respiratory center are in the conditions of
the quiet and increased breathing.
13. Influence of mechanical factors is on respiratory center activity. Types of
mechanoreceptors are in lungs. Hering-Brewer Reflex.
14. Influence of chemical factors is on respiratory center activity. Central and peripheral
mechanisms of these influencing.
Energy metabolism. Thermoregulation
1. Physiological significance of protein, fats and carbohydrates. The concept of nitrogen
balance.
2. Dissipation of energy in the body. Methods for studying energy metabolism: direct and
indirect Calorimetry.
3. Caloric equivalent of oxygen and respiratory rate, their value in studies of metabolism.
4. The notion of primary metabolism. Factors that influence its value. Specific - dynamic
action of food.
5. Energy costs organism during physical and mental activity.
6. Physiological bases of rational nutrition. Caloric coefficients of nutrients
7. The concept of core and cover as the body temperature zones.
8. Periodic fluctuations in body temperature, body temperature changes in physiological
conditions.
9. Mechanisms of heat formation. The notion of contractile and non-contractile
thermogenesis.
10. Mechanisms of heat output. Environmental factors that affect the warmth returns.
11. Properties and physiological reactions of the organism, which means the intensity of heat
output.
12. Center thermoregulation, its structure and basic principles of operation.
13. Afferent and efferent link of thermoregulation.
Digestive system
1. Common structural and functional characteristics of digestion. The concept of digestion
types.
2. Overview of the mechanism of digestion. Hastrointensynal hormones.
3. Value of oral cavity as a primary division of the digestive system.
4. Composition, properties and importance of saliva. Mechanisms of regulation of
salivation.
5. Mechanical processing of food. Mechanisms of mastication and swallowing.
6. Gustatory analyzers, its structure and values.
7. Value stomach during digestion.
8. Gastric juice, its composition, properties and values of major components. Mechanisms
of gastric secretion.
9. Neural and humoral mechanisms of regulation of gastric secretion.
10. Phases of gastric secretion. Influence of different food regimes on gastric secretion.
11. Gastric motor function. Mechanisms of conversion of food to the stomach in the
duodenum.
12. Vomiting reflex, causes and mechanisms.
13. Value enteritis in the process of digestion.
14. Pancreatic juice, its composition, properties and values of major components.
122
15. Influence of various food substances on secretion of pancreatic juice.
16. Neural and humoral mechanisms of regulation of pancreatic secretion.
17. Bile, its composition, properties and values of major components.
18. Mechanism of bile excretion and regulation this process.
19. Protective (barrier and antitoxic), metabolic and hemodynamic functions of the liver.
20. Intestinal secretion. Composition, properties and values of base components of intestinal
juice.
21. Cavity and membrane hydrolysis of nutrients in the small intestine.
22. Motor activity of small intestine and its role in the digestion.
23. Digestion in the large intestine. Value of intestine’s micro flora. Motor activity of the
large intestine. Act of defecation.
24. Mechanisms of absorption in various departments of the digestive system.
25. Absorption of water, mineral salts, hydrolysis products, fats and carbohydrates.
Practical class # 34
Data:_______________
Theme: "General characteristics of the excretion system. Regulation of the kidneys."
Questions for discussion:
1. The basic characteristic of excretory system. Functions of kidneys.
2. Nephron as a functional unit of kidneys.
3. Blood supply of kidneys.
4. Processes which provide formation of urine.
5. Description of processes of filtration in kidneys. An estimation of filtration in a clinic.
6. Tubular reabsorption and their mechanisms.
7. Mechanisms of reabsorption in Henle’s loop.
8. The secretary functions of the tubules.
9. Diuresis. Composition of primary and second urine.
10. Research methods of excretory function of kidneys.
11. Regulatory mechanisms of kidney work.
12. Incretory kidney function. Renin-angiotensin-aldosteron system, mechanisms of
activation, physiological importance.
13. Kidney’s role in the regulation of water and salt exchange.
14. Kidney’s role in regulation of acid-base balance.
Literature:
Guyton, Arthur C. Textbook of medical physiology – p. 307-363.
Practical work #1: "Estimation of clinical analysis of urine."
Materials and equipments: clinical analysis of urine.
Procedure:
1. Estimate the clinical analysis of urine of patient, explain the changes of different indexes.
123
Results:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Conclution:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Teacher’s signature ___________________
Work for the independent exercise:
1. What are the processes involved in maintaining renal acid-base balance?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
2. Draw the scheme of acidogenesis. Give it a value in the proximal and distal convoluted
tubules.
124
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
2. Draw the scheme of amoniogenesis. What is the significance of this process?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
3. Draw the scheme of bicarbonate reabsorption. How independent is reabsorption of bicarbonate
from carbon dioxide tension in arterial blood?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
125
EXAM QUESTIONS:
General physiology of excitable structures
1. Differences between the chemical composition of the extracellular fluid and intracellular
environment. Mechanisms of transport of substances through cell membranes.
2. Resting Potential: definition, mechanisms of ionic origin, physical characteristics.
3. Active Potential: identification, structure, basic physical and physiological
characteristics. Ion mechanisms of AP.
4. Excitability: identify options that determine it. Excitability change during stimulation.
Excitability changes in conditions and diseases of pharmacological agents.
5. Parameter values constant electric current to cause excitation.
6. The mechanism of action potential spread of nerve and muscle fibers. Peculiarities of
excitation of myelin fibers. Laws of the South on nerve and muscle fibers. Classification
of nerve fibers by Erlanger-Gasser.
7. Structural and functional organization of neuromuscular synapses. Laws of excitement
through the synapse.
8. Physiological characteristics of muscle movement: load, force, length, speed, work wear
and tear.
9. Features smooth muscle contractile apparatus and their types. Steps to reduce smooth
muscle.
Nervous control of body functions
1. Biological regulation, its types and importance of the body. The role of feedback in
the regulation.
2. The concept of the reflex. Classification of reflexes (examples). Reflex arc structure
and function of its parts.
3. Receptors and their classification, mechanisms of excitation.
4. Properties of the nerve centers: summation, the transformation rate, tone, fatigue,
high sensitivity to oxygen.
5. The principles of integrative central nervous system: subordination, feedback,
dominant, co-ordination.
6. Description exciting and brake postsynaptic potentials.
7. Classification of mediators, their overall performance.
8. Mechanisms and patterns of transmission of excitation in the central synapses.
9. Types of central inhibition. Mechanisms of presynaptic and postsynaptic braking.
1.
2.
3.
4.
5.
6.
7.
8.
The role of CNS in the regulation of motor functions
Functions of the spinal cord. Motor reflexes of the spinal cord, they reflex aches,
physiological significance.
Functions of back brain.
Functions of middle brain.
Cerebellum and its functions, symptoms.
Functions of thalamus.
Limbic system, hypothalamus, its functions.
Basal nucleus, their function, symptoms.
Sensory, associative and motor areas of cerebral cortex and their functions.
126
The role of the autonomous nervous system in the regulation of visceral functions
1. General plan structure of autonomous nervous system. Autonomic reflexes, their reflex
arc.
2. Synapses autonomous nervous system and their mediators, Cyto-receptor and blockers
transmission of excitation in synapses.
3. Influence of the sympathetic nervous system in visceral functions.
4. Influence of parasympathetic nervous system in visceral functions.
5. Role of metasympatyc system in the regulation of visceral functions.
Humoral regulation of visceral functions and role of the endocrine glands in
regulation
1. Basic features of humoral regulation of functions. Regulation of humoral factors, their
characterization and classification.
2. The concept of hormones. Properties hormones. Classification of hormones.
3. The concept of endocrine function of components: regulation of the endocrine glands.
The mechanism of secretion of hormones and forms of transport, machinery
cytoreception.
4. Hypothalamic- hypophysial system. Role of liberyns and statins.
5. Neurohypophysis Hormones: chemical nature, the regulation of the selection mechanism
of action and functional effects.
6. Adenohypophysis Hormones: chemical nature, the regulation of the selection mechanism
of action, functional, metabolic and structural effects.
7. Adrenal cortex hormones: chemical structure, regulation of the selection mechanisms of
action, biological effects. Hypo- and hyper functions of adrenal cortex.
8. Catecholamines: chemical structure, regulation of the selection mechanisms of action,
biological effects.
9. Thyroid hormones: chemical structure, regulation of the selection mechanisms of action,
biological effects. Effects of hypo-and hypersecretion of thyroid hormones in childhood
and adulthood.
10. The role of hormones in the regulation of phosphate-calcium metabolism.
11. Endocrine function of pancreas. Insulin and glucagon: chemical structure, regulation of
the selection mechanisms of action, biological effects. Diabetes.
12. Hormones epiphysis: chemical structure, regulation of the selection mechanisms of
action, biological effects.
13. Thymus hormones: chemical structure, regulation of the selection mechanisms of action,
biological effects. Thymic-lymphatic status.
14. Male sex hormones: chemical structure, regulation of the selection mechanisms of action,
biological effects.
15. Female sex hormones: chemical structure, regulation of the selection mechanisms of
action, biological effects. Female sexual cycle. Characteristics of its individual periods.
1.
2.
3.
4.
5.
6.
7.
Physiology of sensory systems
The concept of sensory systems (analyzers).
General principles of structure and basic functions of analysis.
Properties analyzers.
The notion of absolute and differential threshold of feeling. Weber-Fechner Law.
Functional organization analysis.
Classification of receptors and their function.
The functions of conduction and central departments analyzers.
127
8. Structural-functional organization of somato-sensory system (cutaneous and proprioseptic
sensitivity).
9. Physiological bases of pain. Nociception, physiological characteristics and classification
nociceptors.
10. Nociassociation or pain system, its structural and functional organization, leading
ways and levels of processing. Physiological significance of pain.
11. Antinociassociation system, its structural and functional organization opiatic and nonopiatic mechanisms, physiological role. Physiological bases of anesthesia.
12. Structural-functional organization of taste sensory systems. Types of tastes
mechanisms of their perception, physiological role.
13. Structural-functional organization of olfactory sensory system. Classification of smells,
theory of perception.
14. Structural-functional organization of the visual analyzer.
15. The optical system of the eye. Mechanism of refraction and accommodation. Refractive
errors eyes.
16. Pupillary reflex, its physiological significance.
17. Receptor apparatus visual analyzer. Structure and function of individual layers of the
retina.
18. Photochemical and electrical phenomena in the retina.
19. Light and Contrast Sensitivity of view. The notion of adaptation view.
20. Modern understanding of the mechanisms of perception of color. Major violations
perception of color.
21. Basic visual function and physiological basis of their research.
22. Overview of the hearing analyzer. Features external and middle ear.
23. Structural-functional organization of the inner ear. The mechanisms of perception of
sounds.
24. Analyze frequency and strength of sounds. Characteristics of sound sensations.
25. Structural-functional organization of the vestibular analyzer. Vestibular reactions.
1.
2.
3.
4.
5.
6.
7.
8.
9.
1.
2.
3.
4.
5.
6.
Physiological basis of behavior
General characteristics of congenital and acquired forms of behavior.
Comparison of conditional and unconditional reflexes.
Conditional reflexes: general characteristics, properties, conditions of formation and
preservation. Mechanism of closure of the temporary connection.
Braking conditional reflexes, brake types, their physiological significance.
Memory. Types and mechanisms of memory.
Structure holistic act behavior (by P.K. Anokhin).
The role of motivation in the implementation of behavioral reactions.
The mechanism of formation and biological significance of emotions.
Sleep, its phase, the development of mechanisms and biological significance for the
organism.
Higher nervous activity of man
Concept about first and second signal system.
Functions of new part of the brain and higher nervous activity of man.
Functional asymmetry using a large hemisphere of the brain, the concept of dominant
hemisphere function non-dominant hemisphere interaction hemisphere.
Language. Functional language. Physiological bases of its formation. Age of higher
nervous activity in man.
Types of higher nervous activity, their classification, physiological bases, methods. The
role of education.
Types of nervous system in humans, methods of research.
128
7. Thinking. Role of brain structures in the process of thinking. Consciousness.
Blood System
1.
2.
3.
4.
5.
The main physiological function of blood.
Functional significance of water and electrolytes of blood plasma.
Proteins of blood plasma. Their composition and basic functions.
General characteristics of erythrocytes. Their function.
Hemoglobin as a major component of erythrocytes. The structure of hemoglobin. Basic
forms and compounds of hemoglobin.
6. Characteristic of blood group systems AB0.
7. Characteristic of Rh blood group system.
8. Blood transfusion (hemotransfusion), its stages.
9. The main functions of certain types of leukocytes.
10. The role of vascular wall and platelets in hemostasis.
11. Mechanisms of vascular-trombotsytic haemostasis: arterioles spasm, adhesion and
aggregation of platelets, release reaction, consolidation thrombus.
12. Mechanisms of coagulation hemostasis. Blood coagulation system. Phases of blood
coagulation, their essence.
13. Characteristic of anticoagulation blood system.
14. Characteristics of fibrinolysis system.
Circulation system
1. Leading system of heart, its value. Mechanisms of spontaneous generation of impulses
are in the explorer system. Law ―gradient of automatism‖.
2. Functional properties of contractive muscles fibers of heart. Action potential of
contractive myocardiocytes. Ionic mechanisms of origin of it basic phases.
3. A concept is about the cycle of cardiac activity. Phase structure of cardiac cycle.
4. Functional classification of blood vessels.
5. Pulse vibrations of blood motion, volumes and pressure in arterial vessels.
6. Laws of blood motion are in venous vessels. A concept is about venous pressure, venous
pulse, venous returning.
7. Miogenic, metabolic and histomechanic mechanisms of adjusting of blood local
circulation. A concept is about physiology arterial hyperemia.
8. Nervous regulation of local blood circulation. Humoral mechanisms regulation of local
blood circulation.
9. Miogenic mechanisms regulation of heart work. Frank-Starling Law.
10. Immediately mechanisms of adaptation of heart to stress and resistance.
11. Character and mechanisms of influencing of the parasympathetic nervous system is to
heart work.
12. Character and mechanisms of influencing of the sympathetic nervous system is to heart
work.
13. Nervous mechanisms of hemodynamic system regulation. Characteristic of afferent
central and efferent link regulation.
14. A role of reflexes is in circulation regulation.
Respiratory system
15. Breathing stages. General structure and basic functions of the external breathing system.
16. Elastic traction of lungs. Surphactants, their values.
17. Breathing biomechanics. Mechanisms of inspiration and expiration.
18. Static indexes of lungs ventilation. Concept about pulmonary volumes and capacities.
129
19. Dynamic indexes of lungs ventilation. Minute volume breathing, its determination.
20. Mechanisms of gas exchange between alveoli and blood through pulmonary capillaries.
21. Transport forms of oxygen through blood. Transport the physically dissolved oxygen in
plasma of blood. Its functional value.
22. Transport the chemically dissolved oxygen. Functional characteristic of hemoglobin. A
concept is about the Khyuffner’s number and oxygen capacity of blood.
23. Curve of dissociation of oxihemoglobin. Functional value of form of this curve. Concept
about the change of the curve dissociation of oxihemoglobin to the right and to the left.
Factors which cause such changes. Bor Effect, its functional value.
24. Transport forms of carbon dioxide are from tissues to lungs. Binding curves of carbon
dioxide. Holding Effect, its value.
25. Localization and functional characteristic of neurons groups which enter in the
complement of respiratory center.
26. Mechanisms of autonomic rhythmic activity of respiratory center are in the conditions of
the quiet and increased breathing.
27. Influence of mechanical factors is on respiratory center activity. Types of
mechanoreceptors are in lungs. Hering-Brewer Reflex.
28. Influence of chemical factors is on respiratory center activity. Central and peripheral
mechanisms of these influencing.
Energy metabolism
3. Physiological significance of protein, fats and carbohydrates. The concept of nitrogen
balance.
4. Dissipation of energy in the body. Methods for studying energy metabolism: direct and
indirect Calorimetry.
5. Caloric equivalent of oxygen and respiratory rate, their value in studies of metabolism.
6. The notion of primary metabolism. Factors that influence its value. Specific - dynamic
action of food.
7. Energy costs organism during physical and mental activity.
8. Physiological bases of rational nutrition. Caloric coefficients of nutrients.
Thermoregulation
14. The concept of core and cover as the body temperature zones.
15. Periodic fluctuations in body temperature, body temperature changes in physiological
conditions.
16. Mechanisms of heat formation. The notion of contractile and non-contractile
thermogenesis.
17. Mechanisms of heat output. Environmental factors that affect the warmth returns.
18. Properties and physiological reactions of the organism, which means the intensity of heat
output.
19. Center thermoregulation, its structure and basic principles of operation.
20. Afferent and efferent link of thermoregulation.
Digestive system
26. Common structural and functional characteristics of digestion. The concept of digestion
types.
27. Overview of the mechanism of digestion. Hastrointensynal hormones.
28. Value of oral cavity as a primary division of the digestive system.
29. Composition, properties and importance of saliva. Mechanisms of regulation of
salivation.
130
30. Mechanical processing of food. Mechanisms of mastication and swallowing.
31. Gustatory analyzers, its structure and values.
32. Value stomach during digestion.
33. Gastric juice, its composition, properties and values of major components. Mechanisms
of gastric secretion.
34. Neural and humoral mechanisms of regulation of gastric secretion.
35. Phases of gastric secretion. Influence of different food regimes on gastric secretion.
36. Gastric motor function. Mechanisms of conversion of food to the stomach in the
duodenum.
37. Vomiting reflex, causes and mechanisms.
38. Value enteritis in the process of digestion.
39. Pancreatic juice, its composition, properties and values of major components.
40. Influence of various food substances on secretion of pancreatic juice.
41. Neural and humoral mechanisms of regulation of pancreatic secretion.
42. Bile, its composition, properties and values of major components.
43. Mechanism of bile excretion and regulation this process.
44. Protective (barrier and antitoxic), metabolic and hemodynamic functions of the liver.
45. Intestinal secretion. Composition, properties and values of base components of intestinal
juice.
46. Cavity and membrane hydrolysis of nutrients in the small intestine.
47. Motor activity of small intestine and its role in the digestion.
48. Digestion in the large intestine. Value of intestine’s micro flora. Motor activity of the
large intestine. Act of defecation.
49. Mechanisms of absorption in various departments of the digestive system.
50. Absorption of water, mineral salts, hydrolysis products, fats and carbohydrates.
Excretory system
1. General characteristics of the selection. Kidneys’ function.
2. Nephron, as a functional unit of kidney. Features of renal blood flow.
3. Processes that ensure the formation of urine. Mechanism of glomerular filtration.
4. Tubular reabsorption, its mechanisms.
5. Tubular secretion. Its mechanism.
6. Regulation activities of the kidneys.
7. Diuresis. Composition of primary and secondary urine.
8. Methods excretory kidney function.
9. Inretorna kidney function. Renin-angiotensin system, mechanisms of activation, the
physiological significance.
10. Role of kidney in regulation of water-salt metabolism and acid-base balance.
131
BASIC PHYSIOLOGICAL PARAMETERS
Table #1 Blood plasma content
Inorganic part:
Fe (iron)
K (potassium)
Na (sodium)
Ca (calcium)
Mg (magnesium)
P (phosphorus)
Chlorides of blood
Filtrate nitrogen (not-protein)
Urea
Creatinine
Creatine
Men
Women
Uric acid
Men
Women
Organic part:
Total protein
Albumins
Lactatedehydrogenase (LDH)
Aldolase
α-amilase (diastase of blood)
Aspartateaminotransferase (AST)
Alaninaminotransferase (ALT)
Cholinesterase
Basic phosphatase
Creatinkinase
Creatinphosphokinase (KPK)
Lipase
Globulins
Total bilirubin
Free bilirubin
(indirect, not conjugated)
conjugated bilirubin (direct)
Lipids (total amount)
Triglicerids
Total cholesterol
Lipoproteins of very low density
low density
high density
Chylomicrons
Glucose of the blood
Glycolized hemoglobin
8,53 - 28,06 mkmol/l
3,8 - 5,2 mmol/l
138-217 mkmol/l
0,75 - 2,5 mkmol/l
0,78 – 0,91 mkmol/l
0,646 - 1,292 mkmol/l
97 - 108 mkmol/l
14,28 - 25 mkmol/l
3,33 - 8,32 mmol/l
53 - 106,1 mkmol/l
15,25 - 45,75 mkmol/l
45,75 - 76,25 mkmol/l
0,12 - 0,38 mkmol/l
0,12 - 0,46 mkmol/l
65 – 85 g/l
35 – 50 g/l (52 – 65%)
< 7 mmol (hour/l)
0,2 – 1,2 mmol (hour/l)
12 – 32 g/l (hour/l)
0,1 – 0,45 mmol (hour/l)
0,1 – 0,68 mmol (hour/l)
160 – 340 mol (hour/l)
0,5 – 1,3 mmol (hour/l)
0,152–0,305mmol (hour/l)
to 1,2 mmol
0,4 – 30 mmol (hour/l)
3 – 35 g/l (35 – 48%)
8,5 – 20,5 mkmol/l
1,7 – 17,11 mkmol/l
0,86 – 5,1 mkmol/l
5 – 7 g/l
0,59 – 1,77 mmol/l
2,97 – 8,79 mmol/l
1,5 – 2,0 g/l (0,63 -0,69 mmol/l)
4,5 g/l (3,06 – 3,14 mmol/l)
1,25 – 6,5 g/l (1,13 – 1,15 mmol/l)
0 – 0,5 g/l (0 – 0,1 mmol/l)
3,3 – 5,5 mmol/l
4 – 7%
132
Table #2 Normal Values for Erythrocyte and Leukocyte Measurements
Hemoglobin
Hematocrit
Erythrocyte count (male)
(female)
Leukocyte count
Differential Leukocyte Count
Neutrophils
Eosinophils
Basophils
Lymphocytes
Monocytes
13–18 g/dL (males);
12–16 g/dL (females)
42–52% (males);
37–48% (females)
4.5–6.0 × 106/mm3
4.0–5.5 ×106/mm3
5 × 103–10 × 103/mm3
55–75%
2–4%
0.5–1%
20–40%
3–8%
Table #3 Main indicators of acid-base status of blood
pH of arterial blood
venous blood
PCO2
in arterial blood (men)
(women)
in venous blood
PO2 in arterial blood
in venous blood
O2 % saturation
7.38-7.42
7.36
32-45 mm Hg
35-48 mm Hg
42-55 mm Hg
75-100 mm Hg
37-42 mmHg
95-98 %
Plasma bicarbonate, standard
in arterial blood
in men
in women
in venous blood
Buffer bases (BB)
Excess bases (EB)
H2CO3
24 mmol/L
23.4-27.2 mmol/L
21.8-27.2 mmol/L
22-29 mmol/L
43.7-53.6 mmol/L
0+2.3mmol/L
22.2-27.9 mmol/l
Table #4 Coagulogram
Time of blood sedimentation
Venous blood
Duration of bleeding
Tromboelastography
time of reaction (R)
time of coagulation (C)
max amplitude (MA)
Prothrombin index
Plasma recalcification time
Plasma fibrinogen
Capillary resistance
Refraction of a blood clot
5-10 min
start 30 sec.-2 min.
finish 3-5 min.
till 4 min.
5-7 min.
3-7 min.
25-55 mm
90-105 %
60-120 sec.
2-4 g/L
Petechiae till 1 mm, number till 10
44-65%
133
Table #5 Standard indices of gastric secretion
Name of index
Fasting
Basic
Submaximal
dose of histamine
(0.008 mg/kg)
Volume of gastric juice
pH
Total acidity, mmol/L
Maintenance free HCl, mmol/L
Debit-hour HCl, mmol/L
Debit-hour free HCl, mmol/L
Volume of acid component, ml/hour
Volume of the base component, mg/hour
Digestive strength by Mette
0 – 50
1.4 – 1.3
0 – 40
0 – 20
till 21
till 29
3
50 – 100
1.4 – 2.0
28 – 48
20 – 40
1.5 – 5.5
1–4
21 – 51
29 – 49
3–6
100 – 140
1.1 – 1.2
78 – 98
70 – 90
8 – 14
6.5 – 12
68 – 90
30 – 50
3–8
Table #6 Value of caloric equivalent of 1 liter of oxygen for different values of the
respiratory coefficient
Respiratory
coefficient
0.70
0.71
0.72
0.73
0.74
0.75
0.76
0.77
0.78
0.79
0.80
0.81
0.82
0.83
0.84
0.85
Caloric equivalent of
oxygen
4.686
4.690
4.702
4.714
4.727
4.739
4.752
4.764
4.776
4.789
4.801
4.813
4.825
4.838
4.850
4.863
Respiratory
coefficient
0.86
0.87
0.88
0.89
0.90
0.91
0.92
0.93
0.94
0.95
0.96
0.97
0.98
0.99
1.00
Caloric equivalent of
oxygen
4.875
4.887
4.900
4.912
4.924
4.936
4.948
4.960
4.973
4.985
4.997
5.010
5.022
5.034
5.047
Table #7 Definition of the body surface for the growth performance and body weight (the
method of Dyubua)
Growth,
cm
190
185
180
175
170
165
160
155
150
50
1.70
1.67
1.64
1.61
1.57
1.54
1.50
1.46
1.42
55
1.77
1.74
1.71
1.67
1.63
1.60
1.56
1.52
1.48
60
1.84
1.80
1.77
1.73
1.69
1.66
1.62
1.58
1.54
Body weight, kg
65
1.90
1.86
1.83
1.79
1.75
1.72
1.68
1.64
1.60
70
1.96
1.92
1.89
1.85
1.81
1.78
1.73
1.69
1.65
75
2.02
198
1.95
1.91
1.86
1.83
1.78
1.74
1.70
80
2.08
2.04
2.00
1.96
1.91
1.88
1.83
1.79
1.75
134
Table #8 Due basic exchanges for women and girls (by Harris-Benedict)
a) Number of calories according to weight (number A)
Weight
Number of
calories
Weight
Number of
calories
Weight
Number of
calories
Weight
Number of
calories
50
51
52
53
54
55
56
57
58
59
1133
1143
1152
1162
1172
1181
1191
1200
1210
1219
60
61
62
63
64
65
66
67
68
69
1229
1238
1248
1258
1267
1277
1286
1296
1305
1315
70
71
72
73
74
75
76
77
78
79
1325
1334
1344
1353
1363
1372
1382
1391
1401
1411
80
81
82
83
84
85
86
87
88
89
1420
1430
1439
1449
1458
1468
1478
1487
1497
1506
b) Number of calories according to growth and age for women 16-28 (number B)
Stature
(cm)
Age (years old)
16
17
18
19
20
21
22
23
24
25
26
27
28
148
152
156
160
164
168
172
176
180
184
206
221
235
250
263
276
289
302
315
318
201
215
229
243
255
267
279
291
303
313
197
210
224
239
250
263
274
287
298
309
192
206
220
234
246
258
270
282
294
304
188
198
209
219
229
239
249
259
268
277
178
183
190
198
205
213
220
227
235
242
170
178
186
193
200
208
215
223
230
237
167
174
181
188
196
203
211
218
225
233
131
169
176
184
191
199
206
213
221
228
156
164
172
179
186
194
201
209
216
223
152
160
167
174
182
189
197
204
211
219
147
155
162
170
177
184
192
199
207
214
142
150
158
165
172
180
187
195
202
209
Basic exchange (kcal/day) = number A + number B
135
Due basic exchange for men and boys (by Harris-Benedict)
a) Number of calories according to weight (number A)
Weight
Number of
calories
Weight
Number of
calories
Weight
Number of
calories
Weight
Number
of calories
Weight
Number of
calories
50
51
52
53
54
55
56
57
58
59
754
768
782
795
809
823
837
850
864
878
60
61
62
63
64
65
66
67
68
69
892
905
918
933
947
960
975
988
1002
1015
70
71
72
73
74
75
76
77
78
79
1029
1043
1057
1070
1084
1098
1112
1125
1139
1153
80
81
82
83
84
85
86
87
88
89
1167
1180
1194
1208
1222
1235
1249
1263
1277
1290
90
91
92
93
94
95
96
97
98
99
1304
1318
1332
1345
1359
1373
1387
1400
1414
1428
Stature
(cm)
b) Number of calories according to growth and age for men 16-28 years (number B)
16
17
18
19
20
21
22
23
24
25
26
27
28
156
160
164
168
172
176
180
184
188
192
725
761
794
820
840
860
880
903
920
940
713
743
773
803
828
843
863
883
903
923
698
726
755
785
806
825
845
865
885
906
678
708
738
768
788
808
828
848
868
888
661
690
721
745
760
788
809
830
850
871
639
659
679
699
719
729
759
779
799
819
632
652
672
692
712
732
752
772
792
812
625
645
665
685
705
725
745
765
785
805
618
638
658
678
698
718
738
758
779
799
612
632
652
672
692
712
732
752
772
792
605
625
645
665
685
705
725
745
765
785
598
618
638
658
678
698
718
738
758
778
591
611
631
651
671
691
711
731
751
771
Age (years old)
Basic exchange (kcal/day) = number A + number B
136
Indexes of pulmonary and ventilation volumes (in ml), proper the size of basic exchange for
women
Tidal volume
Reserve
volume of
inspiration @
expiration
Vital capacity
of lungs
Breathing
reserve
Maximal
ventilation
of lungs
Absorption of
oxygen per
minute
Alveolar
ventilation per
minute
Volume of
breathing per
minute
Size of basic
exchange
Pulmonary and Ventilation Volumes
1200
4242
2545
170
48300
44058
2760
1214
332
1210
4277
2566
171
48685
44408
2783
1224
335
1220
4312
2587
172
49105
44793
2806
1234
338
1230
4347
2608
174
49490
45143
2829
1244
341
1240
4382
2629
175
49910
45528
2852
1254
344
1250
4420
2652
176
50295
45875
2875
1265
346
1260
4455
2673
178
50715
46260
2898
1275
348
1270
4490
2694
179
51100
46610
2921
1285
351
1280
4525
2715
181
51520
46995
2944
1295
354
1290
4560
2736
182
51905
47345
2967
1305
357
1300
4595
2757
184
52325
47750
2990
1315
360
1310
4630
2771
185
52710
48080
3013
1325
363
1320
4667
2800
186
53130
48463
3036
1335
366
1330
4700
2820
187
53480
48780
3056
1344
368
1340
4737
2842
189
53935
49198
3082
1356
370
1350
4772
2863
191
54320
49548
3105
1366
373
1360
4805
2883
192
54740
49935
3128
1381
377
1370
4842
2905
194
55125
50283
3151
1385
379
1380
4877
2926
195
55545
50668
3174
1396
382
1390
4915
2949
197
55930
51015
3197
1406
385
1400
4950
2970
198
56350
51400
3220
1416
388
1410
4985
2991
199
56735
51750
3243
1426
391
1420
5020
3012
201
57155
52135
3266
1437
394
1430
5055
3033
202
57540
52485
3289
1446
396
1440
5090
3054
204
57960
52870
3312
1457
398
1450
5125
3075
205
58345
53220
3335
1467
401
1460
5162
3097
206
58765
53603
3358
1477
404
1470
5197
3118
208
59150
53953
3381
1487
407
1480
5232
3139
209
59570
54338
3404
1497
410
1490
5257
3154
210
59955
54698
3427
1507
413
1500
5300
3180
212
60375
55050
3450
1518
415
1510
5337
3212
213
60760
55403
3473
1528
417
1520
5372
3223
215
61180
55808
3496
1538
420
1530
5410
3246
216
61565
56155
3519
1548
423
1540
5445
3267
218
61985
56540
3542
1558
426
1550
5480
3288
219
62370
56890
3565
1568
429
137
1560
5515
3309
321
62790
57275
3588
1578
432
1570
5550
3330
222
63175
57625
3611
1588
435
1580
5585
3351
223
63595
58010
3634
1598
437
1590
5620
3372
225
63980
58360
3657
1609
439
1600
5657
3394
226
64400
58743
3680
1619
442
1610
5692
3415
228
64785
59093
3703
1629
445
1620
5721
3436
229
65205
59478
3726
1639
448
1630
5762
3457
230
65590
59828
3749
1649
451
1640
5797
3478
232
66010
60213
3772
1659
454
1650
5832
3499
233
66395
60563
3795
1669
457
1660
5867
3520
235
66815
60948
3818
1679
460
1670
5905
3543
236
67200
61295
3841
1690
462
1680
5935
3571
273
67620
61685
3864
1700
464
1690
5975
3586
239
68005
62030
3887
1710
467
1700
6010
3605
240
68425
62415
3910
1720
470
1710
6045
3627
242
68810
62765
3933
1730
473
1720
6080
3648
243
69230
63150
3956
1740
476
1730
6115
3669
245
69615
63500
3979
1750
478
1740
6152
3691
246
70035
63882
4002
1761
480
1750
6187
3712
247
70420
64233
4025
1771
483
1760
6225
3735
294
70840
64615
4048
1781
486
1770
6257
3764
250
71225
64968
4071
1791
488
1780
6292
3775
252
71645
65353
4094
1801
491
1790
6327
3796
253
72030
65703
4117
1811
495
1800
6362
3817
254
72450
66088
4140
1821
198
1810
6100
3840
256
72835
66435
4163
1831
501
1820
6435
3861
257
73255
66820
4186
1841
504
1830
6470
3882
259
73640
67140
4209
1851
506
1840
6505
3903
260
74060
67555
4234
1862
508
1850
6540
3924
262
74445
67905
4255
1872
511
1860
6575
3945
263
74865
68290
4278
1882
514
1870
6610
3966
264
75250
68640
4301
1892
517
1880
6647
3988
266
75670
69023
4324
1902
520
1890
6690
4014
268
76055
69365
4347
1912
523
1900
6717
4030
269
76475
69758
4370
1922
526
138
Indexes of pulmonary and ventilation volumes (in ml), proper the size of basic exchange for
men
Tidal volume
Reserve
volume of
inspiration @
expiration
Vital capacity
of lungs
Breathing
reserve
Maximal
ventilation
of lungs
Absorption of
oxygen per
minute
Alveolar
ventilation per
minute
Volume of
breathing per
minute
Size of basic
exchange
Pulmonary and Ventilation Volumes
1350
4772
2863
191
61425
56653
3510
1544
422
1360
4805
2883
192
61880
57075
3536
1556
424
1370
4842
2905
194
62335
57493
3562
1567
428
1380
4877
2926
195
62790
57913
3588
1578
432
1390
4915
2949
197
63245
58330
3614
1590
434
1400
4950
2970
198
63700
58750
3640
1601
438
1420
5020
3012
201
64610
59590
3692
1624
444
1430
5050
3033
202
65065
60010
3718
1635
448
1440
5090
3054
204
65520
60430
3744
1647
450
1450
5125
3075
205
65975
60850
3770
1658
454
1460
5162
3097
206
66430
61268
3796
1690
456
1470
5197
3118
208
66885
61688
3822
1681
460
1480
5232
3139
209
67340
62108
3848
1693
462
1490
5257
3154
210
67795
62538
3874
1704
466
1500
5325
3195
212
68250
62925
3900
1716
467
1510
5337
3212
213
68705
63368
3926
1727
472
1520
5372
3223
215
69160
63778
3952
1738
476
1530
5410
3246
216
69515
64105
3978
1750
478
1540
5445
3267
218
70070
64625
4004
1761
482
1550
5480
3288
219
70425
64945
4030
1773
484
1560
5515
3309
221
70780
65265
4056
1784
488
1570
5550
3330
222
71435
65885
4082
1796
490
1580
5595
3351
223
71890
66305
4108
1807
494
1590
5620
3372
225
72345
66725
4134
1818
498
1600
5657
3395
226
72800
67143
4160
1830
500
1610
5692
3415
228
73255
67563
4186
1841
504
1620
5727
3436
229
73710
67983
4212
1853
506
1630
5762
3457
230
74165
68403
4238
1864
510
1640
5797
3478
232
74620
68823
4264
1876
512
1650
5832
3499
233
75075
69234
4290
1887
516
1660
5867
3520
235
75530
69663
4316
1899
518
1670
5905
3543
236
75985
70080
4342
1910
522
1680
5935
3571
237
76440
70505
4368
1921
526
1690
5975
3585
239
76895
70920
4394
1933
528
139
1700
6010
3606
240
77350
71340
4420
1944
532
1710
6045
3627
242
77805
71760
4446
1956
534
1720
6080
3648
243
78260
72180
4472
1967
538
1730
6115
3669
245
78715
72600
4498
1979
540
1740
6152
3691
246
79170
73018
4624
1990
544
1750
6187
3712
247
79725
73538
4550
2002
546
1760
6225
3735
249
80080
73855
4576
2013
550
1770
6257
3754
250
80535
74278
4602
2024
554
1780
6292
252
252
80990
74698
4628
2036
556
1790
6327
3796
253
81445
75118
4654
2047
560
1800
6362
3817
254
81900
75538
4680
2059
562
1810
6400
3840
356
82355
75955
4706
2070
566
1820
6435
3861
257
82810
7637
4732
2082
568
1830
6470
3882
259
83265
76795
4758
2093
572
1840
6505
3903
260
83755
76250
4787
2104
576
1850
6540
3924
262
84175
77635
4810
2116
578
1860
6575
3945
263
84630
78055
4836
2127
582
1870
6610
3966
264
85085
78475
4862
2139
584
1880
6647
3988
266
85640
78993
4888
2150
588
1890
6690
4014
268
85995
79305
4911
2162
590
1900
6717
4030
269
86450
79733
4940
2173
594
1910
6751
4051
270
86905
80163
4966
2185
596
1920
7687
4072
271
87360
80573
4992
2196
600
1930
6822
4093
273
87815
80993
5018
2207
604
1940
6857
4114
274
88270
81413
5044
2219
606
1950
6895
4137
276
88725
81830
5070
2231
608
Name of food
Apples
Apricots
Bacon
Bananas
Bean salad
Beans
Beans in tomato sauce
Beef
Beef heart
Beef liver
Beef tongue
Beer
Biscuits
Boiled beans
Boiled pasta
Boiled rice
Boiled rice with vegetables
Bread
Bread grain
Broccoli
Buckwheat
Proteins
0.4
0.9
22.6
1.5
7.7
6.0
11.0
18.9
15.0
17.4
13.6
0.6
8.0
8.4
3.0
3.0
3.1
7.7
7.0
4.5
12.6
Fats
20.9
6.9
0.1
1.0
12.4
3.0
3.1
12.1
17.9
0.6
0.5
0.3
0.7
2.4
3.6
0.5
2.6
Carbohydrates
9.0
10.5
22.4
15.8
8.3
31.0
4.0
64.9
20.6
33.3
21.5
18.2
53.4
33.4
3.2
61.0
Table
#9
Protei
n, Fat,
and
Carbo
hydra
te
Conte
nt of
Differ
ent
Foods
kcal (in 100 g)
34
45
275
91
150
58
181
187
87
97
163
18
453
117
150
100
90
254
194
35
310
140
Buckwheat boiled
Butter
Cabbage
Cabbage stewed
Cabbage stewed with beans
Carp 16.0
Carrot
Cheese
Cherry
Chicken
Chicken liver
Chocolate biscuits
Cofe 3 in 1 (12,5g)
Condensed milk
Corn
Crab
Cream 10%
Cream 20%
Crucian
Cucumbers
Dark chocolate
Dates
Dry apples
Dry apricots
Dry cherry
Dry milk
Dry pear
Dry peas
Dry pineapple
Egg
Eggplant
Figs
Flounder
Fruit salad
Grapefruit
Grapes
Green onion
Green sweet pepper
Grits
Honey
Ice cream light
Jam
Kefir 1.0%
Kefir 2.5%
Kefir 3.2%
Ketchup
Lamb liver
Limon
Marmalade
Mayonnaise 25%
Mayonnaise 35%
Mayonnaise 55%
4.4
0.6
1.8
0.8
3.5
16.0
1.3
26.8
0.8
20.8
5.2
8.0
1.9
7.2
8.0
16.0
3.0
2.8
17.7
0.8
5.6
2.5
3.2
5.0
1.5
4.0
2.3
23.0
1.3
12.7
0.6
0.7
16.1
0.9
0.9
0.4
1.3
1.3
11.9
0.8
2.2
1.0
4.5
2.9
4.2
1.0
18.7
0.9
4.0
1.0
3.0
1.2
82.5
3.0
2.9
3.6
0.1
27.3
8.8
9.1
24.5
116
8.5
2.2
0.5
10.0
20.0
1.8
28.7
2.5
1.2
0.4
11.5
0.1
2.6
5.8
2.5
1.0
2.5
3.2
1.0
2.9
0.1
25.0
35.0
55.0
20.0
0.9
6.1
5.3
10.5
6.5
11.3
0.6
1.6
55.5
77.7
56.0
40.0
4.0
8.0
3.0
59.8
72.1
68.0
65.3
73.0
6.7
62.1
53.3
65.0
0.7
5.5
13.9
7.9
7.3
17.5
4.3
4.7
65.4
72.0
27.9
49.0
3.0
4.0
4.7
19.0
5.0
77.7
4.0
2.6
2.6
100
748
31
51
80
96
33
352
48
165
109
474
422
329
211
69
118
221
87
15
511
298
283
275
298
65
257
311
268
157
24
56
87
35
31
69
22
23
361
291
142
200
39
50
62
86
101
24
312
257
329
517
141
Mayonnaise 67%
Melon
Milk 2.5%
Milk 3.5%
Milk chocolate
Milk chocolate with nuts
Milk sausages
Multifruit juice
Mushrooms
Oil
Onion
Orange
Parsley
Pasta
Peach
Peanuts
Peanuts in chocolate
Pear
Pineapple
Pistachios (1=0.65g)
Pizza
Plums
Pollack
Pomegranate
Pork
Pork heart
Pork liver
Pork sausages
Pork tongue
Potato
Rabbit
Raisins
Red sweet pepper
Redfish
Salad
Salt cucumbers
Shrimp
Soup with mushrooms
Soup with peas
Squid
Sugar
Sweet “Baunty” (1=57g)
Sweet “Halls” (1=3,7g)
Sweet “Rafaello” (1=10.4g)
Sweet “Tweeks” (1=58g)
Sweet cherry
Sweet chocolate (1=10g)
Sweet grits
Sweet muesli
Sweet yogurt 1.2%
Sweet yogurt 1.5%
Sweet yogurt 2.2%
3.1
0.6
2.7
2.6
6.6
8.2
12.3
4.2
1.7
0.9
3.7
10.4
0.9
26.3
8.7
0.4
0.4
21.2
8.0
0.8
15.9
0.9
13.0
15.1
18.8
11.8
14.3
2.0
20.7
2.3
1.3
17.6
1.5
18.0
1.7
3.4
18.0
0.3
7.0
1.5
9.3
5.2
1.1
4.7
11.0
4.9
2.1
2.8
3.1
67.0
2.5
3.2
28.6
34.1
25.3
1.0
99.9
1.1
45.2
14.1
38.8
12.0
0.7
60.5
3.2
3.6
30.8
16.8
0.1
12.9
5.2
0.8
0.3
1.0
0.3
15.0
47.8
24.7
29.1
5.5
8.5
1.2
1.5
2.2
2.6
9.6
4.7
4.7
58.4
53.0
12.0
0.1
9.5
8.4
8.1
71.5
10.4
9.7
71.8
9.6
11.8
14.3
45.0
9.9
11.8
19.7
71.2
5.7
5.9
4.0
4.2
8.1
99.5
65.0
95.0
38.8
63.0
12.3
56.4
64.0
78.5
13.4
14.5
14.5
627
36
52
58
517
545
277
48
26
899
43
37
45
334
44
550
430
38
47
491
320
43
75
49
596
89
107
334
208
83
199
294
27
117
16
12
83
25
54
74
399
423
386
622
495
52
506
349
359
73
82
90
142
Sweet yogurt 2.8%
Sweet yogurt 3.7%
Sweet yogurt 4.2%
Sweet yogurt 4.7%
Sweet yogurt 7.3%
Tomato juice
Veal
Vegetables juice
Walnuts
Watermelon
Yogurt actimel
Zucchini
3.7
6.7
5.1
5.4
5.4
0.5
19.7
0.5
13.8
0.7
2.8
0.6
2.8
3.7
4.2
4.7
7.3
1.2
61.3
1.6
0.3
15.9
11.9
17.4
17.5
17.3
4.3
5.8
10.2
8.8
12.8
5.7
103
107
127
134
155
19
90
26
647
38
76
27
Table #10 Evaluation of the results tapping test
Total number of key
presses for 2 minutes
More than 875
875…807
806…756
755…634
633…585
584…541
540 and less
Number of key presses
The first 10 sec.
In the last 10 seconds
More than 82
More than 68
82…78
68…64
77…73
63…59
72…60
58…50
59…54
49…46
53…43
45…41
Less than 48
Less than 41
Assessing level
Very high
High
Higher than middle
Middle
Less than middle
Low
Very low
Table #11 Estimation of the number of received signals
The number of received signals for 120 seconds
More than 231
From 223 to 230
From 213 to 222
From 203 to 212
From 194 to 202
From 184 to 193
From 176 to 183
From 166 to 175
From 153 to 165
Less than 152
Points
10
9
8
7
6
5
4
3
2
1
Table #12 Normal Values for Pulmonary Function Tests
Measurement
Vital capacity
Inspiratory capacity
Expiratory reserve volume
Residual volume
Value
4 – 5 L (men), 3 – 4 L (women)
2–4L
1–2L
1–2L
143
Functional Residual capacity
Total lung capacity
Forced expiratory volume, 1 second (FEV1.0)
FEV1.0 as a percent of vital capacity
Arterial oxygen tension (PaO2)
Arterial carbon dioxide tension (PaCO2)
Arterial blood pH
2–3L
6 – 7 L (men), 5 – 6 L (women)
over 3 L (men), over 2 L (women)
over 60% (men), over 70% (women)
95±5 mm Hg
40±2 mm Hg
7.40 ± 0.02
Table #13 Normal Values for Renal Function Tests and Urine Constituents
Measurement
Inulin Clearance (GFR), males
Inulin Clearance (GFR), females
Creatintne clearance
Urea clearance
Color
Consistency
Odor
Sterility
Specific gravity
pH
Protein
Potassium
Sodium
Glucose
Ketone Bodies (Acetone)
Blood
Value
Renal Function Tests
124 ± 25.8 mL/min.
119 ± 12.8 mL/min.
91 – 130 mL/min.
60 – 100 mL/min.
Urine Constituents
Straw, amber, or transparent
Clear liquid
Faint aromatic
No microorganisms present
1.002 – 1.028
5 – 7.5
Under 150 mg/L
25 – 100 mEq/L (varies)
100 – 260 mEq/L
0.01 – 0.03 g/ 100 ml
Not present
Not present