Pathological Physiology - DA1105340
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This is a mandatory course of study, which is one of the basic theoretical subjects of the profiling foundation. By completing it, the student will acquire knowledge and skills in the field of pathophysiology, which are a prerequisite for further successful study in higher years. Within the course, the student will, for example, have the following knowledge, skills and competencies:
- is able to explain the functions and regulatory mechanisms of the human organism, organs and their parts in health, with a view to understanding the basics of dysfunctions in disease. Familiarity with the basic features of pathological processes and their possible emergence from a physiological basis.
- describe the structures of the human body and, above all, the mechanisms that participate in the control of its functions, from the molecular to the organ level. Apply knowledge of basic scientific medical disciplines in their clinical judgment and in the indication of appropriate interventions and examinations. Poslední úprava: MAXOH6A2 (24.09.2025)
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Explanation of the function of the human organism in pathological conditions. Mastering the basics of clinical thinking so that the student is prepared to master effective diagnostic and therapeutic procedures in clinical subjects. Poslední úprava: MAXOH6A2 (24.09.2025)
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Pro úspěšné zakončení předmětu je nutné vykonat zkoušku formou ústního zkoušení (3 otázky + 1 praktická úloha). Pro přihlášení ke zkoušce je nutný splněný zápočet ze zimního i letního semestru. Pro získání zápočtu za zimní i letní semestr je potřeba: • splnění průběžných testů • aktivní účast na seminářích • nemít více jak 2 absence na seminářích během jednoho semestru (za absenci bude považována i závažná neznalost či pasivita v průběhu semináře) Výjimky řeší přednosta ústavu. Poslední úprava: MAXOH6A2 (13.09.2023)
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Moodle kurz: https://dl1.cuni.cz/course/view.php?id=6503
HAMMER, Gary D.; MCPHEE, Stephen J.; EDUCATION, McGraw-Hill (ed.). Pathophysiology of disease: an introduction to clinical medicine. New York: McGraw-Hill Education Medical, 2014.
https://accessmedicine.mhmedical.com/book.aspx?bookid=2468
SILBERNAGL, S.; LANG, F. Color Atlas of Pathophysiology, Thieme. 2016.
HALL, John E. Guyton and Hall textbook of medical physiology. 13th edition. Philadelphia, PA: Elsevier, [2016]. ISBN 978-1-4557-7005-2.
Ganong’s Review of Medical Physiology: https://accessmedicine.mhmedical.com/Book.aspx?bookid=2525
MCCANCE, K. L.; HUETHER, S. E. Pathophysiology: The Biologic Basis for Disease in Adults and Children. 2019; St. Louis, MO: Elsevier, 2019.
COSTANZO, Linda. Physiology Cases and Problems. Lippincott Williams & Wilkins, 2012.
NEČAS, Emanuel. Obecná patologická fyziologie. Karolinum, 2021, 1 online zdroj (312 stran). ISBN 978-80-246-4669-5.
NEČAS, Emanuel. Patologická fyziologie orgánových systémů. Karolinum, 2009.
NEČAS, Emanuel. Patologická fyziologie orgánových systémů. 2. vyd. V Praze: Univerzita Karlova v Praze, nakladatelství Karolinum, 2009, 2 svazky (379 stran, strana 381-760) . ISBN 978-80-246-1710-7.
Poslední úprava: MAXOH6A2 (18.09.2023)
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RIGOROUS QUESTIONS FROM PATHOLOGICAL PHYSIOLOGY AND CIRCUIT FOR THE PRACTICAL EXAM IN PATHOLOGICAL PHYSIOLOGY (revised, valid from 2025/2026)
GENERAL PATHOPHYSIOLOGY Health, illness, death Disorders of body temperature regulation Types of hypoxia, consequences Ischemia, ischemic-reperfusion injury Oxidative stress, cellular trauma Inflammation - SIRS, sepsis Chemical and toxic damage to the organism Critical developmental periods
PATHOPHYSIOLOGY OF THE INTERNAL ENVIRONMENT Disorders of potassium and chloride metabolism, relationship to ABR Acidosis Alkalosis Hyperhydration Dehydration Investigation of acid-base balance
PATHOPHYSIOLOGY OF THE BLOOD Anemic syndrome Anemia from increased losses Anemia from decreased hematopoiesis Hyperviscosity syndrome Blood clotting and its disorders DIC Hematological examinations
PATHOPHYSIOLOGY OF THE CARDIOVASCULAR SYSTEM Atherosclerosis and other arterial diseases Capillary disorders, edema - types and causes Venous disorders, venous thrombosis Primary hypertension Secondary hypertension Hypovolemic shocks, compensatory mechanisms Distributive shocks Acute heart failure Chronic heart failure Myocardial blood supply disorders, clinical forms of CHD Acute coronary syndrome Hemodynamics of congenital heart defects Hemodynamics of valvular defects Cardiac conduction disorders and arrhythmias, including ECG changes Examination of the cardiovascular system Description of changes on the ECG recording in pathological conditions
PATHOPHYSIOLOGY OF THE KIDNEYS AND URINARY TRACT Renal perfusion disorders Glomerular filtration disorders Nephrotic and nephritic syndrome Disorders tubular function Acute renal failure Chronic renal failure Disorders of the urinary tract (urolithiasis, obstruction) Renal replacement (dialysis and kidney transplantation) Renal function examination
PATHOPHYSIOLOGY OF THE RESPIRATORY SYSTEM Changes in lung and respiratory system compliance Changes in airway resistance Pneumothorax Defensive respiratory reflexes Respiratory regulation, ventilatory response to hypoxia and hypercapnia Disorders of alveolar ventilation, respiratory insufficiency Disorders of the ventilation-perfusion ratio Diffusion disorders, pulmonary edema Pulmonary hypertension and cor pulmonale Pulmonary embolism Bronchial asthma COPD Restrictive lung disease Hypobaria, hyperbaria Artificial pulmonary ventilation, oxygen therapy Examination of lung function
PATHOPHYSIOLOGY OF THE ENDOCRINE SYSTEM Disorders of hormonal regulation Disorders of the adenohypophysis and hypothalamus Hyperthyroidism Hypothyroidism Cushing's syndrome Addison's disease, mineralocorticoid disorders Adrenal medulla disorders Physiology of stress and its endocrine responses, stress and starvation Parathyroid disorders and calcium metabolism Diabetes mellitus, classification and acute complications Chronic complications of diabetes mellitus Sex hormone disorders in ontogenesis, DSD Examination of endocrine glands PATHOPHYSIOLOGY OF THE GASTROINTESTINAL TRACT AND METABOLISM Disorders of the esophagus and stomach Vomiting, diarrhea Passage disorders (constipation, ileus) Eating disorders Nutritional disorders (primary malnutrition, secondary disorders) Obesity, metabolic syndrome, gout Consequences of vitamin deficiency, hypervitaminosis Pancreatic disorders (acute and chronic pancreatitis) Gallbladder and biliary tract disorders Acute liver failure and its complications Chronic liver failure and its complications Icterus Examination of liver and pancreas function
PATHOPHYSIOLOGY OF THE NERVOUS SYSTEM Cerebrovascular disease Intracranial hypertension and hypotension syndrome Brain edema, blood-brain barrier and its disorders Epilepsy and epileptic seizures Sleep and consciousness disorders Neurocognitive disorders Schizophrenia and affective disorders Central palsy Peripheral palsy Disorders of neuromuscular transmission and muscles Spinal shock and spinal syndromes Disorders of somatosensory sensation Pain Basal ganglia disorders Disorders of the cerebellum Visual disorders Hearing disorders Disorders of the vestibular system, smell and taste Examination methods in neurology
SECTIONS FOR THE PRACTICAL EXAM IN PATHOLOGICAL PHYSIOLOGY 1. Description of ECG curve (physiological x basic pathological findings) 2. Description of hemodynamic changes (heart failure, valvular defects, hypertension, hypotension) 3. Interpretation of lung function tests (physiological x basic pathological findings) 4. Physical principles in the pathophysiology of respiration (compliance, elasticity, static and dynamic work of breathing, hypobaria, hyperbaria) 5. Principles of dialysis 6. Description of EMG - conduction velocity, H reflex 7. Description of oGTT performance (typical course x diabetes mellitus, malabsorption, hyperthyroidism) 8. Interpretation of laboratory findings - consideration (reference values x patient values) Poslední úprava: MAXOH6A2 (24.09.2025)
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Teaching structure Pathological physiology in the General medicine study program I. General pathophysiology • Health, illness, death • Thermoregulation and its disorders (fever, hyperthermia, hypothermia) • Hypoxia • Ischemia • Ischemic-reperfusion injury • Oxidative stress • Cellular trauma • Inflammation • SIRS and sepsis • Intoxication • Critical developmental periods
II. Pathophysiology of the internal environment • Disorders of ion metabolism (Na⁺, K⁺, Cl⁻, Ca²⁺, phosphates) • Disorders of acid-base balance (acidosis, alkalosis) • Disorders of water and osmotic balance (hyperhydration, dehydration)
III. Pathophysiology of blood • Blood tests and hematological examinations • Anemia (types and mechanisms) • Hyperviscosity syndrome • Coagulation disorders and DIC IV. Pathophysiology of the cardiovascular system • Hypertension (primary and secondary) • Atherosclerosis, other arterial diseases • Venous system disorders (varicose veins, thrombosis) • Capillary disorders (permeability disorders-edema) • Shock states Ischemic heart disease and acute coronary syndrome • Heart failure • Valvular defects and congenital heart defects • Arrhythmias • ECG changes
V. Pathophysiology of the kidneys and urinary tract • Renal perfusion disorders • Glomerular filtration disorders (nephrotic and nephritic syndrome) • Tubular function disorders • Acute renal failure • Chronic renal failure • Urinary tract disorders (urolithiasis, obstruction) • Renal replacement (dialysis and kidney transplantation) • Examination of renal function
VI. Pathophysiology of the respiratory system • Changes in compliance and resistance in the respiratory system • Pneumothorax • Disorders of alveolar ventilation, respiratory insufficiency • Regulation of breathing and defensive reflexes • Disorders of ventilation-perfusion ratio • Diffusion disorders, pulmonary edema • Pulmonary circulation and its disorders (pulmonary hypertension and cor pulmonale, pulmonary embolism) • Obstructive pulmonary disease (bronchial asthma, COPD) • Restrictive pulmonary disease • Hypobaria and hyperbaria • Artificial ventilation, oxygen therapy • Examination of pulmonary functions
VII. Pathophysiology of the endocrine system • Disorders of hormonal regulation • Disorders of the pituitary gland and hypothalamus (adenohypophysis) • Disorders of thyroid function (hypothyroidism, thyrotoxicosis) • Disorders of the adrenal glands (cortical and medullary disorders, stress) • Physiology of stress and its endocrine responses, stress and starvation • Disorders of the parathyroid glands and calcium metabolism • Diabetes mellitus (types, acute and chronic complications) • Disorders of sex hormones in ontogenesis, DSD • Examination of the function of the endocrine glands
VIII. Pathophysiology of the gastrointestinal tract and metabolism • Esophageal and gastric disorders (e.g. dysphagia, gastritis, peptic ulcer, reflux) • Vomiting, diarrhea • Passage disorders (constipation, ileus) • Eating disorders • Nutritional disorders (primary malnutrition, secondary disorders) • Obesity, metabolic syndrome, gout • Consequences of vitamin deficiency and hypervitaminosis • Pancreatic disorders (acute and chronic pancreatitis) • Biliary tract disorders • Liver disorders (Hepatic failure, Portal hypertension, Ascites, Jaundice) • Jaundice • Liver and pancreatic function tests
IX. Pathophysiology of the nervous system • Cerebrovascular diseases • Intracranial hypertension and hypotension syndrome • Cerebral edema and blood-brain barrier disorders • Epilepsy and epileptic seizures (including status epilepticus, developmental and epileptic encephalopathies) • Consciousness disorders • Sleep disorders • Neurocognitive disorders (dementia, mild cognitive impairment) • Schizophrenia, affective disorders • Motor disorders (extrapyramidal disorders, Parkinson's disease, Huntington's disease, dystonia, tic disorders) • Central and peripheral palsies • Muscle disorders (myopathy) • Spinal shock and spinal syndromes • Somatosensory sensory disorders • Pain (nociceptive, neuropathic, nociplastic) • Neuromuscular transmission disorders (myasthenia gravis, Lambert-Eaton syndrome, botulism) • Basal ganglia disorders (hypokinetic and hyperkinetic syndromes) • Cerebellar disorders (ataxia, balance disorders, speech disorders) • Sensory disorders – vision, hearing, smell, taste, vestibular system • Neurological examination methods (neurological examination, CT/MRI, EEG, EMG, cerebrospinal fluid, polysomnography, evoked potentials, PET/SPECT, neurocognitive tests) Poslední úprava: MAXOH6A2 (24.09.2025)
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I. General Pathophysiology – Learning Objectives The student understands the basic concepts of general pathophysiology, especially the difference between health and disease, the basic types of cellular damage and the body's defense reactions. He/she can describe and explain the mechanisms of hypoxia, ischemia, ischemic-reperfusion injury and oxidative stress. He/she masters the principles of inflammation, systemic inflammatory response (SIRS) and sepsis. He/she can describe the consequences of cellular trauma and intoxication. He/she can apply this knowledge in the interpretation of simple clinical situations and distinguish the basic pathophysiological mechanisms in acute conditions. The student is familiar with the regulation of body temperature and can explain the pathophysiology of thermoregulation disorders (fever, hyperthermia, heat stroke, malignant hyperthermia, hypothermia), including the differences between fever and hyperthermia, their main causes, mechanisms and clinical consequences. Understands the importance of critical developmental periods as time windows of increased organism sensitivity and can explain how early insults (nutrition, toxins, stress, hypoxia) lead to irreversible changes in the phenotype and long-term health consequences (fetal alcohol syndrome, IUGR, Barker hypothesis). The goal is to prepare the student for rapid orientation in general disorders of the organism and for integration of acquired knowledge. A. Memorization – What you need to know by heart (definitions, terms): • Definition of health, disease, death. • Types of hypoxia (hypoxemic, anemic, circulatory, histotoxic). • Basic causes of ischemia. • Definition of ischemic-reperfusion injury. • What are free radicals and oxidative stress. • Types of cellular trauma (reversible, irreversible damage). • Phases of acute inflammation. • Definition of SIRS and sepsis. • Basic examples of intoxications. • Definition of fever, hyperthermia and hypothermia. • Basic examples of critical developmental periods (prenatal, perinatal).
B. Understanding – What you need to understand and be able to explain: • The difference between hypoxia and ischemia and their mechanisms. • How ischemic-reperfusion injury occurs and how it is related to oxidative stress. • How cells respond to hypoxia and oxidative stress (adaptation, damage, death). • How acute inflammation occurs and progresses, and when it transitions to SIRS. • What are the main pathophysiological steps in the development of sepsis. • How symptoms of intoxication occur and why they are life-threatening. • The difference between fever and hyperthermia, the principle of hypothalamic set-point shift. • The pathophysiology of heat stroke and malignant hyperthermia. • The importance of critical developmental periods for long-term health.
C. Application – What you need to be able to use with examples: • Explain hypoxia and ischemia using the example of myocardial infarction. • Describe ischemic-reperfusion injury after cardiac arrest. • Explain the importance of free radicals in reoxygenation after shock. • Identify risk situations for the development of SIRS (e.g. polytrauma, pancreatitis). • Assign clinical symptoms to the development of sepsis. • Recognize the basic manifestations of intoxication according to clinical scenarios. • Explain the collapse of thermoregulatory mechanisms using the example of heat stroke. • Explain the consequences of critical periods using the example of fetal alcohol syndrome.
D. Analysis – What you will analyze and distinguish: • Causes and consequences of hypoxia in various clinical conditions (e.g. anemia vs. infarction). • Differences between localized and systemic inflammation. • Factors that determine the transition of infection to sepsis. • Critical moments in the treatment of SIRS and sepsis (circulatory support, oxygenation). • Differentiate between fever and hyperthermia based on the mechanism of occurrence. • Factors influencing the course of development in critical periods.
E. Synthesis – What you will be able to compile and connect: • Compile a diagram of the progression from hypoxia to cell death. • Synthesize the development of SIRS from an infectious or non-infectious insult. • Propose basic preventive measures against ischemic-reperfusion injury. • Compile a diagram of body temperature regulation and its disorders. • Connect prenatal and postnatal factors with long-term consequences (Barker's hypothesis). F. Evaluation – What you will be able to critically evaluate: • Evaluate the clinical severity of hypoxia according to symptoms and laboratory data. • Evaluate the risk of developing sepsis based on the patient's clinical condition. • Critically assess the role of oxidative stress in tissue damage and the possibilities of influencing it. • Critically differentiate between fever and hyperthermia from the point of view of therapy. • Evaluate the risks of long-term consequences of damage during critical developmental periods.
II. Pathophysiology of the internal environment – Learning objectives The student understands the principles of maintaining the internal environment of the organism and the mechanisms of its disorders. He/she can explain the nature and consequences of disorders of water distribution between compartments, disorders of ion metabolism (sodium, potassium, chloride, calcium and phosphate) and acid-base balance. He/she can describe compensatory mechanisms in acidoses and alkaloses. He/she is able to apply this knowledge to the assessment of basic clinical conditions (dehydration, hyperhydration, disorders of ion balance, ABR disorders) and interpret basic laboratory findings in the context of disorders of the internal environment. A. Memorization – What you need to know by heart (definitions, terms): • Definition of osmolality and tonicity. Types of fluid distribution disorders: dehydration (hypotonic, hypertonic, isotonic), hyperhydration (hypotonic, hypertonic, isotonic). • Normal values of the main ions in the blood (Na⁺, K⁺, Cl⁻, Ca²⁺, phosphates). • Definition of acidosis and alkalosis. • Differentiation between respiratory and metabolic disorders of ABR. B. Understanding – What you need to understand and be able to explain: • Mechanisms of fluid movement between compartments (intracellular and extracellular). • Causes and consequences of hypo- and hypernatremia, hypo- and hyperkalemia, calcium and phosphate disorders. • Principle of the development of metabolic and respiratory acidosis and alkalosis. • Compensatory mechanisms in ABR disorders (buffer systems, respiratory and renal compensation). C. Application – What you need to be able to use with examples: • Apply knowledge of ionic disorders to clinical scenarios (e.g. hypokalemia in vomiting, hyperkalemia in renal failure). • Interpret basic blood gas results (pH, pCO₂, HCO₃⁻) and determine the type of acid-base disorder. • Explain the development of edema based on changes in hydrostatic and osmotic pressure. • Use the principles of fluid distribution to explain the development of dehydration or edema. D. Analysis – What you will analyze and distinguish: • Distinguish between individual types of dehydration and hyperhydration based on the clinical picture and laboratory findings. • Analysis of combined ABR disorders (e.g. simultaneous metabolic acidosis and respiratory alkalosis). • Analysis of the differences between hypoosmolar and hyperosmolar dehydration. E. Synthesis – What you will be able to compile and connect: • Compile a procedure for interpreting blood gas and ionogram findings. • Synthesize the relationships between ionic disorders, fluid volume changes and acid-base balance. • Suggest basic therapeutic measures for internal environment disorders (e.g. correction of dehydration, ionic abnormalities). F. Evaluation – What you will be able to critically evaluate: • Evaluate the severity of internal environment disorders according to the clinical and laboratory picture. • Evaluate the effectiveness of compensatory mechanisms in acid-base disorders. • Critically assess the risk of complications in ionic and volume disorders.
III. Pathophysiology of blood – Learning objectives The student understands the basic mechanisms of blood component disorders, especially the development of anemia, hyperviscosity syndrome and blood coagulation disorders including disseminated intravascular coagulation (DIC). He/she can explain the causes, consequences and basic manifestations of these conditions. They can apply this knowledge in interpreting laboratory results of blood tests (blood count, coagulation tests) and in evaluating clinical situations associated with hemocoagulation disorders or anemia. The student has basic orientation in examination methods in hematology. A. Memorizing – What you need to know by heart (definitions, terms): • Definition of anemic syndrome. • Types of anemia according to cause (loss, production, hemolytic). • Definition of hyperviscosity syndrome. • Basic components of hemostasis (primary and secondary). • Definition of DIC. B. Understanding – What you need to understand and be able to explain: • Principles of anemia due to bleeding, decreased hematopoiesis and increased erythrocyte destruction. • How changes in blood viscosity affect circulatory conditions. • Mechanism of activation of the coagulation cascade and its regulation. • How DIC occurs and what are its clinical manifestations. C. Application – What you must be able to use with examples: • Interpret basic blood count parameters in various types of anemia. • Explain the development of hyperviscosity syndrome in polycythemia. • Assign clinical manifestations to individual types of coagulation disorders. • Explain the results of basic coagulation tests (PT, APTT, fibrinogen). D. Analysis – What you will analyze and distinguish: • Differentiate between anemias according to laboratory findings (e.g. MCV, MCHC). • Analyze the differences between bleeding and thrombophilic states. • Analyze clinical and laboratory findings in DIC. E. Synthesis – What you will be able to compile and connect: • Compile a classification scheme for anemias according to the mechanism of occurrence. • Design a basic diagnostic procedure for suspected DIC. • Synthesize knowledge about primary and secondary hemostasis in the management of bleeding conditions. F. Evaluation – What you will be able to critically evaluate: • Evaluate the severity of anemia based on clinical symptoms and laboratory data. • Critically assess the risk of thrombosis in hyperviscosity syndrome. • Evaluate the prognosis in a patient with DIC based on the dynamics of laboratory markers.
Types of fluid distribution disorders: dehydration (hypotonic, hypertonic, isotonic), hyperhydration (hypotonic, hypertonic, isotonic). • Normal values of the main ions in the blood (Na⁺, K⁺, Cl⁻, Ca²⁺, phosphates). • Definition of acidosis and alkalosis. • Differentiation between respiratory and metabolic disorders of ABR. B. Understanding – What you need to understand and be able to explain: • Mechanisms of fluid movement between compartments (intracellular and extracellular). • Causes and consequences of hypo- and hypernatremia, hypo- and hyperkalemia, calcium and phosphate disorders. • Principle of the development of metabolic and respiratory acidosis and alkalosis. • Compensatory mechanisms in ABR disorders (buffer systems, respiratory and renal compensation). C. Application – What you need to be able to use with examples: • Apply knowledge of ionic disorders to clinical scenarios (e.g. hypokalemia in vomiting, hyperkalemia in renal failure). • Interpret basic blood gas results (pH, pCO₂, HCO₃⁻) and determine the type of acid-base disorder. • Explain the development of edema based on changes in hydrostatic and osmotic pressure. • Use the principles of fluid distribution to explain the development of dehydration or edema. D. Analysis – What you will analyze and distinguish: • Distinguish between individual types of dehydration and hyperhydration based on the clinical picture and laboratory findings. • Analysis of combined ABR disorders (e.g. simultaneous metabolic acidosis and respiratory alkalosis). • Analysis of the differences between hypoosmolar and hyperosmolar dehydration. E. Synthesis – What you will be able to compile and connect: • Compile a procedure for interpreting blood gas and ionogram findings. • Synthesize the relationships between ionic disorders, fluid volume changes and acid-base balance. • Suggest basic therapeutic measures for internal environment disorders (e.g. correction of dehydration, ionic abnormalities). F. Evaluation – What you will be able to critically evaluate: • Evaluate the severity of internal environment disorders according to the clinical and laboratory picture. • Evaluate the effectiveness of compensatory mechanisms in acid-base disorders. • Critically assess the risk of complications in ionic and volume disorders.
III. Pathophysiology of blood – Learning objectives The student understands the basic mechanisms of blood component disorders, especially the development of anemia, hyperviscosity syndrome and blood coagulation disorders including disseminated intravascular coagulation (DIC). He/she can explain the causes, consequences and basic manifestations of these conditions. They can apply this knowledge in interpreting laboratory results of blood tests (blood count, coagulation tests) and in evaluating clinical situations associated with hemocoagulation disorders or anemia. The student has basic orientation in examination methods in hematology. A. Memorizing – What you need to know by heart (definitions, terms): • Definition of anemic syndrome. • Types of anemia according to cause (loss, production, hemolytic). • Definition of hyperviscosity syndrome. • Basic components of hemostasis (primary and secondary). • Definition of DIC. B. Understanding – What you need to understand and be able to explain: • Principles of anemia due to bleeding, decreased hematopoiesis and increased erythrocyte destruction. • How changes in blood viscosity affect circulatory conditions. • Mechanism of activation of the coagulation cascade and its regulation. • How DIC occurs and what are its clinical manifestations. C. Application – What you must be able to use with examples: • Interpret basic blood count parameters in various types of anemia. • Explain the development of hyperviscosity syndrome in polycythemia. • Assign clinical manifestations to individual types of coagulation disorders. • Explain the results of basic coagulation tests (PT, APTT, fibrinogen). D. Analysis – What you will analyze and distinguish: • Differentiate between anemias according to laboratory findings (e.g. MCV, MCHC). • Analyze the differences between bleeding and thrombophilic states. • Analyze clinical and laboratory findings in DIC. E. Synthesis – What you will be able to compile and connect: • Compile a classification scheme for anemias according to the mechanism of occurrence. • Design a basic diagnostic procedure for suspected DIC. • Synthesize knowledge about primary and secondary hemostasis in the management of bleeding conditions. F. Evaluation – What you will be able to critically evaluate: • Evaluate the severity of anemia based on clinical symptoms and laboratory data. • Critically assess the risk of thrombosis in hyperviscosity syndrome. • Evaluate the prognosis in a patient with DIC based on the dynamics of laboratory markers.
IV. Pathophysiology of the cardiovascular system – Learning objectives The student understands the mechanisms of heart and vascular function disorders, especially the pathogenesis of hypertension, atherosclerosis, heart failure, shock states and rhythm disorders. He can explain the causes and consequences of blood flow disorders, changes in blood pressure, capillary permeability disorders and hemodynamic changes in congenital and acquired heart defects. He can apply this knowledge in the analysis of clinical situations and the interpretation of basic ECG findings. The student is able to identify the main pathophysiological mechanisms of acute and chronic cardiovascular disorders. A. Memorization – What you need to know by heart (definitions, concepts): • Definitions and division of hypertension (primary and secondary). • Basic concepts: atherosclerosis, ischemic heart disease (IHD), heart failure. • Types of shock states (hypovolemic, cardiogenic, distributive, obstructive). • Definition of edema, thrombosis. • Basic types of arrhythmias and conduction disorders. B. Understanding – What you need to understand and be able to explain: • Pathophysiology of primary and secondary hypertension. • Formation of atherosclerotic plaque and its complications. • Principles of acute and chronic heart failure. • Pathogenesis of individual types of shock states and differences between them. • Formation of edema based on changes in capillary permeability and hydrostatic/osmotic pressure. • Mechanisms of arrhythmias and their effect on cardiac output. C. Application – What you need to be able to use with examples: • Apply knowledge of the pathogenesis of hypertension when explaining organ damage (heart, kidneys, brain). • Explain the clinical picture of myocardial infarction based on knowledge of myocardial ischemia. • Interpret basic ECG findings (ischemia, infarction, arrhythmia). • Apply knowledge of shock states when evaluating hypotension in a clinical scenario. • Explain the cause of pulmonary edema in left-sided heart failure. D. Analysis – What you will analyze and distinguish: • Differentiate between types of shock states according to clinical symptoms. • Differentiate between deep vein thrombosis and thrombophlebitis • Analyze pathophysiological differences between systolic and diastolic heart failure. • Analyze hemodynamic changes in valvular and congenital heart defects. E. Synthesis – What you will be able to compile and connect: • Compile a model of atherosclerosis progression from early changes to acute coronary syndrome. • Synthesize the hemodynamic consequences of various types of heart failure. • Design basic acute care procedures for individual types of shock. F. Evaluation – What you will be able to critically evaluate: • Evaluate the severity of hypertension and its organ consequences. • Evaluate the prognosis of a patient with acute coronary syndrome based on ECG and clinical parameters. • Critically assess the risk of thrombosis in a patient with atherosclerosis.
V. Pathophysiology of the kidneys and urinary tract – Learning objectives The student understands the basic pathophysiological mechanisms of kidney and excretory urinary tract disorders. He/she can explain the nature of kidney perfusion disorders, glomerular filtration, tubular function, the development of acute and chronic kidney failure, nephrotic and nephritic syndrome. Understands the principles of urinary tract obstruction, the development of urolithiasis and the subsequent consequences. Can apply this knowledge in the interpretation of clinical conditions and laboratory findings. The student has basic orientation in indications for dialysis treatment and transplantation approaches. A. Memorizing – What you need to know by heart (definitions, terms): • Definition of acute and chronic renal failure. • Definition of nephrotic and nephritic syndrome. • Classification of causes of acute renal failure (prerenal, renal, postrenal). • Definition and basic characteristics of urolithiasis. • Basic terms dialysis (hemodialysis, peritoneal dialysis). B. Understanding – What you need to understand and be able to explain: • Mechanisms of acute and chronic renal failure. • Pathophysiology of nephrotic and nephritic syndrome (protein loss, hematuria, edema). • Consequences of glomerular filtration and tubular reabsorption disorders. • The origin and consequences of urinary tract obstruction. • Basic principles of dialysis and indications for its initiation. C. Application – What you must be able to use on examples: • Interpret laboratory findings in acute and chronic renal failure (creatinine, urea, ions). • Recognize clinical symptoms of nephrotic and nephritic syndrome. • Explain the development of edema in nephrotic syndrome. • Apply knowledge of urinary tract obstruction in explaining the development of hydronephrosis. • Describe the basic procedure for the indication of acute dialysis. D. Analysis – What you will analyze and distinguish: • Differentiate between prerenal, renal and postrenal renal failure based on clinical and laboratory data. • Analysis of the differences between nephrotic and nephritic syndrome. • Analysis of the consequences of urolithiasis on kidney and urinary tract function. E. Synthesis – What you will be able to compile and connect: • Compile a logical sequence of events leading to the development of acute renal failure. • Propose a diagram of the development of edema in various renal disorders. • Synthesize the relationships between urinary tract obstruction, changes in pressure in the kidneys and a decrease in glomerular filtration. F. Evaluation – What you will be able to critically evaluate: • Evaluate the severity of renal function disorders according to laboratory and clinical data. • Critically assess the risk of progressive loss of renal function in chronic renal insufficiency. • Evaluate the indication for acute dialysis therapy.
VI. Pathophysiology of the respiratory system – Learning objectives The student understands the basic pathophysiological mechanisms of respiratory system disorders. He/she can explain the nature of ventilation, perfusion, diffusion and respiratory regulation disorders. He/she understands the causes of obstructive and restrictive lung diseases, pulmonary embolism, epulmonary edema and pneumothorax. Can apply knowledge in interpreting clinical conditions associated with hypoxemia, hypercapnia and respiratory insufficiency. The student masters the basics of indications and principles of oxygen therapy and artificial lung ventilation. A. Memorizing – What you need to know by heart (definitions, terms): • Definition of alveolar ventilation and perfusion disorders. • Definition of hypoxemia and hypercapnia. • Division of obstructive and restrictive lung diseases. • Basic terms: pneumothorax, pulmonary edema, pulmonary embolism, pulmonary hypertension. • Definition of hypobaria and hyperbaria. B. Understanding – What you need to understand and be able to explain: • Mechanisms of hypoxia and hypercapnia. • How ventilation, perfusion and diffusion disorders lead to respiratory insufficiency. • Principles of pathophysiology of bronchial asthma and COPD. • Mechanism of pulmonary edema and pneumothorax. • Formation of pulmonary embolism and its hemodynamic consequences. • Principles of respiratory regulation and the influence of disorders on the respiratory pattern. C. Application – What you must be able to use with examples: • Explain the clinical picture of respiratory insufficiency based on changes in pO₂ and pCO₂. • Apply knowledge of the mechanisms of hypoxia in the evaluation of patients with pulmonary embolism or pulmonary edema. • Explain changes in the respiratory pattern in patients with damage to the respiratory center. • Recognize risk factors and clinical manifestations of obstructive pulmonary diseases. • Apply the principles of oxygen therapy and indications for artificial ventilation. D. Analysis – What you will analyze and distinguish: • Differentiate between hypoxic and hypercapnic respiratory insufficiency. • Analyze the differences between obstructive and restrictive ventilation disorders. • Analyze the hemodynamic consequences of pulmonary embolism. • Distinguishing the causes of pneumothorax and their clinical manifestations. E. Synthesis – What you will be able to compile and connect: • Compile a diagnostic procedure and basic solution for acute respiratory insufficiency. • Propose a diagram of the mechanisms leading from pulmonary embolism to right-sided heart failure. • Synthesize the relationships between ventilation, perfusion and diffusion in the development of hypoxemia.
F. Evaluation – What you will be able to critically evaluate: • Evaluate the severity of ventilation and perfusion disorders based on blood gases and clinical symptoms. • Critically assess the indication for oxygen therapy and mechanical ventilation. • Evaluate the risks associated with hyperbaric and hypobaric environments.
VII. Pathophysiology of the endocrine system – Learning objectives The student understands the basic pathophysiological mechanisms of endocrine regulation disorders. Can explain the principles of hypo- and hyperfunction of individual endocrine glands, including the pituitary, thyroid, adrenal, parathyroid and gonads. Can describe the nature of diabetes mellitus, its acute and chronic complications, and understands the pathophysiology of the stress response. Is able to interpret basic hormonal findings and apply knowledge in the evaluation of clinical conditions associated with endocrine system disorders. A. Memorization – What you need to know by heart (definitions, terms): • Definition of hyperfunction and hypofunction of endocrine glands. • Types of diabetes mellitus (type 1, type 2, MODY, LADA). • Definition of Cushing's syndrome and Addison's disease. • Definition of hypothyroidism and thyrotoxicosis. • Basic terms: stress response, hypocalcemia, hypercalcemia. B. Understanding – What you need to understand and be able to explain: • Mechanisms of hypo- and hyperfunction of the pituitary, thyroid, adrenal and parathyroid glands. • Pathophysiology of diabetes mellitus type 1 and 2, including acute (DKA, HHS) and chronic complications (nephropathy, retinopathy, neuropathy). • Principles of hormonal regulation of metabolism in the context of the stress response. • Causes of calcium metabolism disorders (hypo- and hypercalcemia). C. Application – What you need to be able to use on examples: Mechanisms of sex hormone disorders during development and in adulthood • Apply knowledge in explaining clinical symptoms of hypothyroidism and thyrotoxicosis. • Interpret hormonal findings in cases of suspected pituitary insufficiency. • Explain the development of diabetic ketoacidosis and hyperosmolar hyperglycemic state. • Recognize the symptoms of Cushing's syndrome and Addison's disease. • Apply knowledge of calcium metabolism in explaining tetany or the risk of osteoporosis. D. Analysis – What you will analyze and distinguish: • Differentiate between primary and secondary endocrine disorders (e.g. primary hypothyroidism vs. central hypothyroidism). • Analyze laboratory findings in the diagnosis of diabetes mellitus and its complications. • Analyze the causes of hypocalcemia and hypercalcemia. E. Synthesis – What you will be able to compile and connect: • Compile a summary of the mechanisms leading from autoimmune destruction of β-cells to the development of type 1 diabetes. • Propose a scheme of the stress hormonal response and its consequences on metabolism. • Synthesize the relationships between hormonal disorders and clinical manifestations at different stages of life. F. Evaluation – What you will be able to critically evaluate: • Evaluate the severity of hormonal dysregulation based on clinical and laboratory findings. • Evaluate the risk of acute and chronic complications of diabetes mellitus. • Critically assess the impact of stress reactions to metabolism and health status.
VIII. Pathophysiology of the gastrointestinal tract and metabolism – Learning objectives The student understands the basic pathophysiological mechanisms of digestive system and metabolic disorders. He/she can explain the essence of disorders of the esophagus, stomach, intestines, pancreas and liver, including disorders of passage, secretion and absorption. He/she understands the pathogenesis of obesity, metabolic syndrome, primary malnutrition and malabsorption. He/she can describe the consequences of vitamin metabolism disorders and recognize the main complications of portal hypertension. The student is able to apply this knowledge in the evaluation of clinical conditions and laboratory findings in patients with GIT and metabolic disorders. A. Memorization – What you need to know by heart (definitions, terms): • Definition of dysphagia, gastroesophageal reflux disease, gastritis, peptic ulcer. • Definition of vomiting, diarrhea, constipation and ileus. • Definition of malabsorption syndrome. • Types of liver failure and portal hypertension. • Definition of jaundice, ascites. • Definition of obesity, metabolic syndrome and primary malnutrition. B. Understanding – What you need to understand and be able to explain: • Mechanisms of motility, secretion and absorption disorders in the GIT. • Principles of the development of vomiting, diarrhea, constipation and intestinal obstruction. • Pathophysiology of acute and chronic pancreatitis. • Mechanism of the development of portal hypertension and its complications (ascites, varices). • Pathophysiology of jaundice (prehepatic, hepatic, posthepatic). • Development of obesity and metabolic syndrome based on disorders of energy metabolism. • Principles of the development of malnutrition and malabsorption. • Causes of hypovitaminosis and hypervitaminosis and their consequences. • Causes and mechanisms of hyperuricemia and gout C. Application – What you need to be able to use with examples: • Explain the development of jaundice based on liver or biliary tract disorders. • Interpret symptoms and laboratory findings in liver failure. • Recognize the clinical picture of portal hypertension and ascites. • Apply knowledge of the mechanisms of obesity and metabolic syndrome in clinical practice. • Explain the mechanism of diarrhea and malabsorption in intestinal diseases. • Identify symptoms of vitamin deficiency or excess. D. Analysis – What you will analyze and distinguish: • Distinguish types of jaundice based on clinical and laboratory data. • Analyze the causes of ascites in the context of portal hypertension and hypoalbuminemia. • Distinguish between the causes of primary and secondary malnutrition. • Analyze symptoms and laboratory findings in acute vs. chronic pancreatitis. E. Synthesis – What you will be able to compile and connect: • Compile a diagram of the development of portal hypertension and its complications. • Propose an approach to the diagnosis and treatment of patients with malabsorption. • Synthesize the pathophysiological mechanisms of obesity and metabolic syndrome. F. Evaluation – What you will be able to critically evaluate: • Evaluate the severity of liver failure and the need for urgent treatment. • Evaluate the clinical significance of vitamin deficiencies. • Critically assess the risks of complications in metabolic syndrome.
IX. Pathophysiology of the nervous system – Learning objectives The student understands the basic pathophysiological mechanisms of central and peripheral nervous system disorders. He/she can explain the principles of the development of cerebrovascular diseases, epilepsy, disorders of consciousness, sleep, dementia, motor disorders, sensation, neuromuscular transmission and sensory perception. Can apply this knowledge in interpreting clinical symptoms of neurological disorders and is able to analyze the basic pathophysiological mechanisms leading to acute and chronic conditions of the nervous system. A. Memorization – What you need to know by heart (definitions, terms): • Definition of ischemic and hemorrhagic stroke (CMP). • Definition of cerebral edema and types of edema (cytotoxic, vasogenic, interstitial). • Definition of epilepsy, status epilepticus. • Definition of consciousness and disorders of consciousness (quantitative and qualitative). • Types of neurocognitive disorders (e.g. Alzheimer's disease, vascular dementia). • Types of schizophrenia and affective disorders • Types of central and peripheral palsies. • Definition of neuropathy, myasthenia, Parkinson's disease, cerebellar disorders. • Types of sensory perception disorders (vision, hearing). B. Understanding – What you need to understand and be able to explain: • Mechanisms of ischemic and hemorrhagic brain damage. • Pathophysiology of cerebral edema and its effect on intracranial pressure. • Principle of epileptic seizure and status epilepticus. • Mechanisms of consciousness disorders and sleep disorders. • Basics of pathogenesis of neurodegenerative diseases leading to dementia. • Basics of pathogenesis of schizophrenia and affective disorders • Mechanisms of paralysis (central vs. peripheral). • Pathophysiology of neuromuscular transmission disorders (e.g. myasthenia gravis). • Development of motor disorders in Parkinson's disease and cerebellar disorders. • Mechanisms of sensory perception disorders (visual and auditory disorders). C. Application – What you need to be able to use on examples: • Apply knowledge of the vascular supply of the brain when interpreting clinical symptoms of stroke. • Recognize symptoms of epileptic seizure and status epilepticus. • Interpret symptoms of central vs.peripheral palsy. • Apply knowledge of the pathophysiology of dementia in the assessment of cognitive impairment. • Explain the clinical picture of Parkinson's disease based on basal ganglia disorders. • Recognize the symptoms of sensory perception disorders in a clinical context. D. Analysis – What you will analyze and distinguish: • Differentiate between ischemic and hemorrhagic stroke based on clinical symptoms. • Analyze the causes and consequences of increased intracranial pressure. • Differentiate between the symptoms of central and peripheral palsy. • Analyze the differences between different types of epileptic seizures. • Differentiate between types of dementia according to clinical and pathophysiological signs. E. Synthesis – What you will be able to compile and connect: • Compile a diagram of the development of cerebral edema and its clinical consequences. • Design a diagnostic and first aid procedure for an epileptic seizure. • Synthesize the relationships between damage to specific brain areas and manifestations of motor and sensory disorders. • Create a diagram of neuromuscular transmission disorders. F. Evaluation – What you will be able to critically evaluate: • Evaluate the prognosis of a patient after ischemic stroke according to the extent of impairment. • Evaluate the risk of developing epilepsy after traumatic brain injury. • Critically assess the severity of consciousness disorders and the need for urgent intervention. • Evaluate the clinical severity of dementia based on the degree of impairment of cognitive functions.
Poslední úprava: MAXOH6A2 (24.09.2025)
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General Pathophysiology – Entry Requirements Before starting the study of general pathophysiology, the student is expected to have basic knowledge of anatomy, biology, biochemistry and physiology necessary to understand the processes leading to dysfunction of cells and organ systems. The student should understand the structure and function of cells, the principles of substance transport, energy metabolism and regulation of the internal environment. He must be able to explain the importance of oxygen for cells and the organism, know the basics of blood circulation, respiration and immune response. This knowledge is necessary to understand key mechanisms such as hypoxia, ischemia, oxidative stress, cell damage, inflammation, systemic inflammatory response (SIRS), sepsis, thermoregulation disorders and the importance of critical developmental periods. Required knowledge: • The structure and function of cell organelles (cell membrane, mitochondria, endoplasmic reticulum, nucleus, lysosomes). • Principles of passive and active transport of substances across the cell membrane (including the importance of osmotic and hydrostatic pressure). • Basics of energy metabolism (glycolysis, Krebs cycle, oxidative phosphorylation, ATP formation). • The role of oxygen in cellular metabolism and the principles of oxygen transport in the blood (hemoglobin function, saturation, partial pressure of oxygen). • Mechanisms of body temperature regulation (thermogenesis and heat loss). • Basic principles of innate and adaptive immunity (including basic knowledge of the inflammatory response). • The importance of free radicals and a basic overview of antioxidant mechanisms. • The principle of homeostasis and basic compensatory mechanisms of the organism in the event of a disturbance in the internal environment. • Anatomy and physiology of the circulatory and respiratory systems. • Basic overview of prenatal and postnatal human development and its key periods (organogenesis, perinatal period, early childhood). • Knowledge of factors that can affect the development of the fetus and newborn (nutrition, hypoxia, toxins, infections).
Pathophysiology of the internal environment - entry requirements Before starting the study of pathophysiology of the internal environment, the student should master the basic knowledge of the composition and regulation of body fluids, the principles of ionic balance, acid-base balance and the mechanisms of transport of substances across membranes. Furthermore, he should know the basics of kidney function in maintaining fluid volume and acid-base balance, and have an overview of the examination methods of the internal environment (blood ionogram, blood gases). Required knowledge: • Structure and function of cell membranes (principles of passive and active transport, osmotic and hydrostatic pressure). • Distribution of body fluids (intracellular and extracellular space). • Normal composition of blood plasma (main ions: Na⁺, K⁺, Cl⁻, Ca²⁺, phosphates). • Basics of kidney function: filtration, reabsorption, secretion, concentration capacity. • Principles of acid-base balance and buffer systems (bicarbonate, phosphate, proteins). • The importance of blood gases (pH, pCO₂, pO₂, bicarbonate).
Pathophysiology of blood - entry requirements Before starting the study of pathophysiology of blood, the student should master the basic knowledge of the structure and function of blood, the principles of blood element formation and the mechanisms of hemostasis. He must understand the composition of the blood picture, the basic parameters of red blood cells and plasma blood clotting factors. This knowledge is necessary for understanding the pathophysiological changes in anemia, blood clotting disorders and hyperviscosity syndrome. Required knowledge: • Structure and function of red blood cells, white blood cells and platelets. • Basics of hemopoiesis (development of blood elements). • Principles of the blood picture and the importance of the parameters (MCV, MCH, Hb, Ht). • Plasma composition and function of the main plasma proteins. • Basic principles of hemostasis (primary - platelet phase, secondary - coagulation cascade). • Functions of basic coagulation factors and the importance of anticoagulant systems.
Pathophysiology of the cardiovascular system - entry requirements Before starting the study of pathophysiology of the cardiovascular system, the student should master basic knowledge of the anatomy and physiology of the heart and blood vessels, the principles of blood pressure regulation, cardiac output and vascular resistance. He must understand the mechanisms of action potential generation in the heart and its propagation, know basic cardiovascular reflexes and principles of blood volume regulation. Required knowledge: • Anatomy of the heart, large and small blood circulation. • Basic principles of the cardiac cycle and generation of cardiac output. • Mechanism of action potential in the working myocardium and in the conduction system. • Blood pressure regulation (baroreceptor reflex, RAAS system). • Factors influencing cardiac contractility, preload, afterload. • Principles of hemodynamics (blood flow, vascular resistance, blood pressure) Pathophysiology of the kidneys and urinary tract - entry requirements Before starting the study of pathophysiology of the kidneys and urinary tract, the student should master the basic knowledge of the anatomy and physiology of the kidneys and urinary tract, the principles of glomerular filtration, tubular reabsorption and secretion, the regulation of volume and osmolality of body fluids and the basic principles of acid-base balance. Required knowledge: • Anatomy of the kidneys, urinary tracts and renal vascular supply. • Principles of glomerular filtration and tubular function. • Regulation of fluid volume and ions (ADH, RAAS, natriuretic peptides). • Mechanisms of urine concentration (countercurrent mechanism, action of ADH). • Basic principles of acid-base regulation by the kidneys. • The importance of creatinine and urea as markers of renal function.
Pathophysiology of the respiratory system - entry requirements Before starting the study of pathophysiology of the respiratory system, the student should master basic knowledge of the anatomy of the respiratory tract and lungs, the physiology of ventilation, perfusion and diffusion of gases, the principles of respiratory regulation and the importance of oxygen and carbon dioxide transport in the blood. Required knowledge: • Anatomy of the respiratory tract, alveolar system and pulmonary vascular supply. • Principles of respiratory mechanics (tidal volume, vital capacity, lung compliance). • The importance of ventilation/perfusion (V/Q ratio) and its regulation. • Principles of gas diffusion across the alveolar-capillary membrane. • Regulation of breathing (chemoreceptors, respiratory centers in the medulla oblongata). • Transport of oxygen and carbon dioxide by blood (role of hemoglobin, O₂ saturation, pCO₂).
Pathophysiology of the endocrine system - entry requirements Before starting the study of pathophysiology of the endocrine system, the student should have basic knowledge of the anatomy and physiology of the endocrine glands, the principles of hormonal regulation and feedback, and a basic overview of the functions of the main hormones and their effects on target tissues.
Required knowledge: • Anatomy of the pituitary gland, hypothalamus, thyroid gland, parathyroid glands, adrenal glands and gonads. • Principles of hormonal regulation (negative and positive feedback). • Basic functions of hormones: insulin, glucagon, cortisol, aldosterone, thyroid hormones, parathyroid hormone, calcitonin, estrogens, testosterone. • Basics of glucose, fat and protein metabolism under the influence of hormones. • Basic overview of the stress response and its hormonal mechanisms.
Pathophysiology of the gastrointestinal tract and metabolism - entry requirements Before starting the study of pathophysiology of the gastrointestinal tract and metabolism, the student should master basic knowledge of the anatomy and physiology of the digestive system, principles of secretion of digestive juices, absorption of nutrients, function of the liver and pancreas and regulation of energy metabolism. Required knowledge: • Anatomy of the esophagus, stomach, intestines, liver, gallbladder, pancreas. • Functions of digestive enzymes and the mechanism of secretion of digestive juices. • Principles of absorption of water, electrolytes, glucose, amino acids and lipids in the intestine. • Liver function in carbohydrate, fat and protein metabolism, bile formation and excretion. • Pancreas function (exocrine and endocrine components). • Principles of glucose, lipid and protein metabolism under resting and stress conditions.
Pathophysiology of the nervous system - entry requirements Before starting the study of pathophysiology of the nervous system, the student should master basic knowledge of the anatomy and physiology of the central and peripheral nervous system, functional anatomy of brain areas and the basics of reflex activity, motor control, consciousness and sensory perception. Required knowledge: • Anatomy of the brain (cortex, basal ganglia, cerebellum, brainstem), spinal cord and peripheral nerves. • Vascular supply of the brain and basic vascular territories. • Physiology of nerve impulse and neuromuscular transmission. • Functional division of motor and sensory pathways. • Physiology of sleep, consciousness and cognitive functions. • Principles of sensory perception (sight, hearing, feeling). Poslední úprava: MAXOH6A2 (24.09.2025)
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