Medical University of Plovdiv
Department of Physiology
15a, Vassil Aprilov Blvd., 4000 Plovdiv, BULGARIA, phone: (032) 602 318


Examination Synopsis of Human Physiology
2008/2009 Academic Year



1. Organization of the cell. Physical structure of the cell. Functional systems of the cell. Properties of the cell membrane and junctions between the cells. Intercellular signalization. Transport of substances through the cell membrane.
2. The human body. Homeostasis. General principles of the homeostatic regulation – regulatory systems and elements of the homeostatic regulatory system. Levels of physiological regulation. 
3. Physiology of the excitatory tissues. Irritability and Excitability. General and specific properties of the excitable cells. Membrane potential – ionic basis of the membrane potentials.
4. Measurement of excitability. Changes in the excitability during excitation. Inhibition. Conduction of the excitation. 
5. Transmission of the excitation (inhibition) from an excitable cell to another. Synapses - types of synapses. Chemical synapses. Transmitters and modulators. Postsynaptic potentials. Summation of the postsynaptic potentials. 
6. Functions of the nervous system – functional morphology of the nervous system. Physiology of the nerve cell. Glial cells. Neuronal circuits and processing of information form group of nerve cells – convergence, divergence, reverberating circuits, inhibition.
7. Reflex regulation of the physiological functions. Type of reflexes according to the mechanism of formation and the characteristics of the involved reflex arc.
8. Nerve centers. Types and properties. Cerebral blood flow. Cerebrospinal fluid.
9. The autonomic nervous system. General organization of the autonomic nervous system. Autonomic nerve centers, ganglia, transmitters and receptors in the autonomic nervous system.
10. Effects of sympathetic and parasympathetic stimulation on specific organs. Autonomic reflexes.
11. Role of the hypothalamus, reticular formation, cerebellum, basal ganglia and cerebral cortex in the control of the autonomic functions. Integration of the central nervous system in the adaptation processes of the body – “alarm” or “stress” response of the sympathetic nervous system.
12. General principles of the humoral control of the physiologic functions. Telecrinia and paracrinia. Classification, synthesis and mechanism of action of the hormones. Control on the hormone secretion.
13. Hypothalamic-neurohypophysial system. Neurosecretion. Hormones of the neurohypophysis. Physiologic effects and control of secretion.
14. Hypothalamo-adenohypophysial system. Hormones of the adenohypophysis. Physiologic effects and control of secretion.
15. Functional morphology of the thyroid gland. Iodine containing thyroid hormones. Physiologic effects and control of secretion. Hyperthyroidism and hypothyroidism. 
16. Functional morphology of adrenal glands. Hormones of the adrenal medulla. Physiologic effects and control of secretion of adrenaline (epinephrine) and noradrenaline (norepinephrine).
17. Hormones of adrenal cortex – glucocorticoids. Physiologic effects and control of secretion. Pharmacologic effects of glucocorticoids. 
18. Hormones of adrenal cortex – mineralcorticoids and adrenal androgens. Abnormalities of adrenocortical secretion. 
19. Endocrine functions of the pancreas – type of hormones, physiologic effects and control of secretion. Diseases of the endocrine pancreas. 
20. Calcium-phosphate homeostasis. Parathyroid hormone, calcitonin, vitamin D - physiologic effects and control of secretion. Impairment of the calcium and phosphate homeostasis. 
21. Physiology of reproduction. Male reproductive system. Spermatogenesis. Male sex hormones (androgens) – types, physiologic effects and control of secretion. Erection and ejaculation. 
22. Physiology of reproduction. Female reproductive system. Ovogenesis. Female sex hormones (estradiol and progesterone) – types, physiologic effects and control of secretion. Regulation of the female monthly rhythm. Pregnancy and lactation. Tests for early pregnancy. 
23. Epiphysis, thymus and non-endocrine organs with endocrine functions. Tissue hormones – types, physiologic effects and control of secretion.
24. Physiology of skeletal muscles – functional morphology, mechanism and energetic of muscle contraction. Types of muscle contractions. Types of muscle fibers. Muscle work and muscle fatigue. Electromyography. 
25. Functional morphology of smooth muscles. Excitation, electrophysiologic characteristics and mechanism of contraction of smooth muscles. 
26. Physiology of the blood. Functions of the blood. Composition and volume of the circulating blood – regulation of the volume. Blood plasma – composition and its regulation. Hematocrit. Blood reservoirs. 
27. Erythrocytes. Count and functions. Erythrocyte sedimentation rate. Hemoglobin. Erythrocyte indices. Iron metabolism. Hemolysis. Control of erythropoiesis and erythrocyte count in the bloodstream.
28. Blood types. Physiological and clinical significance. ABO and Rh blood type systems. Methods of analysis. Principles of blood transfusion. 
29. Leukocytes. Count and functions of the different leukocyte types. Control of leukopoiesis and leukocyte count in the bloodstream. Immunity.
30. Hemostasis and hemocoagulation. Vascular-trombocyte and coagulation hemostasis. Fibrinolysis and anticoagulational mechanisms. Control of hemostasis.
31. Physiology of lymphatic system. Formation, composition and functions of lymph. Physiological role of the spleen.
32. Cardiovascular system. Systemic and pulmonary circulation. Heart as an organ – functional morphology of the pericardium, endocardium and myocardium. Nerve supply. Myocardial blood supply. 
33. Functional morphology and physiological characteristics of the excitatory and conductive system of the heart. Automaticity. Cardiac rhythm. Abnormalities of conductivity.
34. Physiological characteristics of the working myocardium. Excitation and contraction. Refractory periods. Extrasystoles, flutter and fibrillation. Myocardial metabolism.
35. Electrical events during cardiac performance. Origin, registration and evaluation of the electrocardiogram. 
36. Dynamics of the cardiac contractions – cardiac cycle. States of the valvular apparatus during different phases of the cardiac cycle.
37. Functions of the heart valves of the heart. Heart sounds. Methods of examination. Stenosis and insufficiency of the valves. Correlation between a synchronous phonocardiographic and electrocardiographic record.
38. Heart rate. Stroke volume and cardiac output and their changes during different physiological conditions. 
39. Control of the cardiac performance – intrinsic (self-control). Energetics of the heart pumping.
40. Extracardial neural regulation of the cardiac performance – characteristics of the sympathetic and parasympathetic effects. Humoral factors affecting cardiac performance.
41. Functional characteristics of blood vessels. Hemodynamic principles – characteristics of the vessels and the blood. Hemodynamic indices. Volume and linear velocity of the blood flow through the various parts of vascular system and factors determining them.
42. Blood pressure in the various parts of the cardiovascular system. Arterial blood pressure – methods of measurements and normal values. Factors determining the blood pressure levels.
43. Arterial blood flow. Arterial pulse. Sphygmography. Characteristics of the arterial pulses. Venous blood flow. Venous pulse. Phlebography. 
44. Physiology of the microcirculation. Functional organization of the microcirculation unit. Organ–related peculiarities of the capillaries. Control of the microcirculation. 
45. Vascular tone. Basal tone of blood vessels. Local, neural and humoral regulatory mechanisms of the vascular tone.
46. Control of the circulation. Characteristic and localization of the receptors. Vasomotor center. Supramedular control of the circulation.
47. Control of the arterial blood pressure. Mechanisms of the quick short-term, quick ongoing, and long-term regulation.
48. Physiology of respiration. External respiration. Functional organization of the airways, lungs and thoracic basket. Mechanics of breathing. Intrapleural and intrathoracic pressure. Role of surfactant. Defense reflexes – cough and sneeze. 
49. Rate and rhythm of breathing. Pulmonary and alveolar ventilation. Elastic and non-elastic resistance to breathing. Air flow during breathing. Work of breathing.
50. Static lung volumes and capacities and their functional concern. Anatomic and physiologic dead space. Estimation of the external respiration. 
51. Physical basis of gas exchange. Solubility, diffusion coefficient and diffusion capacity of the gases. Composition of the gases in air, lungs and blood. Diffusion of gases across the alveolocapillary membrane. Ventilation-perfusion ratio. 
52. Transport of O2 in the blood. Oxyhemoglobin dissociation curves. Oxygen exchange in lungs and tissues. 
53. Transport of CO2 in the blood. Carbon dioxide exchange in lungs and tissues.
54. Control of respiration. Respiratory center and rhythm of breathing. Chemical control of respiration. Reflex control of respiration. Effects of the cerebral cortex on the respiratory functions. 
55. Gastrointestinal system – functions. Digestion in the Mouth: processes of mastication, secretion, enzyme destruction and absorption. Swallowing – phases and regulation.
56. Motor functions of the Stomach – hunger contractions, storage function, mixing and propulsion of food. Emptying of the Stomach. Control of the Stomach motor activity. Vomiting.
57. Secretion, enzyme destruction and absorption in the Stomach. Gastric juice: composition, mechanism of secretion and functions. Gastric secretion and its control: cephalic, gastric and intestinal phases. Protective potentialities of the gastric barrier.
58. Small Intestine – motor activity: type of movements and regulation; secretion, digestion and absorption. 
59. Colon – type of movements and their regulation; secretion, digestion and absorption. Defecation.
60. Pancreatic juice – composition and functions. Control of the pancreatic secretion.
61. Processes of formation and secretion of Bile. Composition and functions of the Bile. Regulation of the Bile secretion. Functions of the Liver.
62. Digestion and absorption of Proteins, Fats and Carbohydrates in the Gastrointestinal Tract. Absorption of Salts, Water and Vitamins.
63. Metabolism of the Nutrients in the organism. Metabolism of Carbohydrates: the level and regulation of Glucose in the circulating blood. Metabolism of Proteins and its control. Metabolism of Lipids and its control.
64. Energy metabolism in the organism. Energy values of the Nutrients. The Energy Equivalent of Oxygen. The measurement of the Metabolic Rate: Direct and Indirect Calorimetry. The Basal Metabolic Rate and the Daily Energy Requirements for different physiologic states.
65. Feeding: main principles in defining the physiologic standards– plastic and energy needs of the organism. Physiologic mechanisms of Starvation and Satiety.
66. Temperature regulation. Body temperature and isothermia. Mechanisms of heat production and heat loss. Neurophysiologic bases of temperature regulation. Hyperthermia and hypothermia. Acclimatization. Regulation of body temperature within exsercise. 
67. Excretion functions of the organism and systems, accomplishing them. The Kidneys – functional structure. Peculiarities of the kidneys blood supply and innervation. Mechanism and control of glomerular filtration. Methods of glomerular function assesment.
68. Functions of renal tubules. Transport processes within the different parts of the tubules. Mechanisms for excretion of a dilute urine and a concentrated urine. Renal excretion.
69. Renal clearance tests. Volume of the urine and its components. Micturition. Endocrine and metabolic functions of the kidneys. Control of the renal functions.
70. Water-electrolyte balance of the organism. Body fluids and electrolytes. Dynamics of body fluids volume and osmolality. Control of Water-Salts homeostasis. Thirst – physiologic mechanisms.
71. Acid-Base Balance of the organism. Buffer systems of the body fluids. Respiratory regulation of pH. Renal regulation of pH. Abnormalities in Acid-Base Balance.
72. Sensory systems. Functional morphology. General principles of sensory systems information coding and processing. Sensory systems adaptation.
73. General sensation. Somatosensory system – organization and modalities. Mechanisms of thermo- and mechanoreception. Pain sensation. Itch.
74. Vision sensory system. Functional morphology of the eye – the optics of the eye; the mechanism of accommodation; errors of refraction. The pupillary reflex. Eyes movements and their control. Protective appliances of the eyes. 
75. Detection, transmission and processing of the information in the retina. Central neurophysiology of vision. Light and dark adaptation. Visual acuity. Color vision.
76. The sense of hearing. Functional morphology of the external, middle and inner ear. Processing of the sound signal. Central auditory mechanisms. Vestibular apparatus. Central mechanisms of the maintenance of equilibrium. Vestibular reflexes.
77. Physiology of the chemical senses - taste and smell. Peripheral and central mechanisms of taste and smell sensations.
78. General characteristics of motor control. Muscle receptors – functions of the muscle spindles and tendon receptors. Spinal cord control of motor activity. The spinal cord reflexes. Motor control from higher levels of the brain.
79. States of brain activity and sleep. The role of the different neuronal structures in the maintenance of the brain activity. Physiologic changes within sleep. Electroencephalography.
80. Higher nerve activity – types and characteristics. Learning and memory: types and physiologic bases. Primary and secondary signalling systems. Communicative capabilities of man. Reading and writing speech. Auditory and visual gnosia.