Interesting facts about physiology. Interesting facts on physiology Articles on human physiology
PHYSIOLOGY AND MEDICINE
AFTERWORD TO THE SCIENTIFIC SESSION “SCIENCE FOR HUMAN HEALTH”
GENERAL MEETING OF RAS AND RAMS
Yu.V. Natochin
Natochin Yuri Viktorovich- academician, advisor Russian Academy sciences
In 2004, the Presidium of the Russian Academy of Sciences held a series of events dedicated to the 100th anniversary of the award of the Nobel Prize in the category “Physiology or Medicine” to Ivan Petrovich Pavlov. He was the first among Russian scientists to receive this prize. More than once he expressed his attitude to the problem mentioned in the title of the article. The question of fundamental science for medicine in our age of rapid and rapid development of the life sciences requires discussion, since a number of sciences claim this role.
It seemed important to me to write an article on the relationship between physiology and medicine even at a time when the Department of Physiology of the Russian Academy of Sciences existed, which included outstanding experimental researchers involved in solving fundamental problems of medicine, and leading clinicians. They were elected at one time to the Imperial Academy of Sciences and Arts, the Imperial St. Petersburg Academy, and then to the Russian Academy of Sciences. Academy of Sciences of the USSR. In 1725, a year after the creation of the Academy of Sciences by Peter I, the academic department of anatomy and physiology was headed by D. Bernoulli, and in 1726 L. Euler joined him. The greatest specialists in the field of theoretical and clinical medicine were elected to our academy and full members, and corresponding members: N.I. Pirogov (1846), G.A. Zakharyin (1885), N.N. Petrov (1939), N.N. Anichkov (1939), G.N. Speransky (1943) and many others.
In the history of the Academy, the determining role was played by the name, and not by the need to develop one or another area of science. The Academy maintained autonomy, retained a certain degree of independence, maintaining at all times the highest possible intellectual level and ensuring highest degree representation in various fields of science. Of course, there was an unfair disregard for certain outstanding personalities. Many of them are known, and there is hardly any need to repeat their names.
The constant mutual influence of fundamental sciences and medicine was predetermined by both the desire to work for the benefit of people and the possibility of constant communication between specialists in different fields of knowledge within the walls of the academy. Representatives of modern medicine - members of the Department of Physiology, and now the Department of Biological Sciences of the Russian Academy of Sciences - not only contributed huge contribution in the development of problems in the sciences of living things, but also ensured the continuity of knowledge, the implementation of achievements of theoretical disciplines in various areas of medicine: cardiology and oncology, angiology and transplantology, and a number of other areas. The relationship between physiology and medicine has such long-standing and deep roots that the choice of Alfred Nobel, who listed physiology and medicine among the nominations for the prize named after him, cannot be considered accidental.
PHYSIOLOGY IN THE SYSTEM OF LIFE SCIENCES
Modern physiology is a set of physiological disciplines. The first decades of the 20th century. were a time when the principle of “throwing stones” reigned and a number of sciences emerged from the once unified physiology - biochemistry, biophysics, etc. The coming century will probably be different - a time of “collecting stones”. Physicochemical methods and approaches, the data obtained with their help are of paramount importance and cannot be separated from the scientific tree of physiology without compromising the understanding of the nature of the processes occurring in the body, the understanding of the mechanisms of the functions of organs and systems, the functions of living organisms, the functions of humans as the whole. The point is that unraveling the nature of physiological phenomena is impossible without using, along with classical physiological approaches, methods of biophysics and biochemistry, molecular biology and genetics, without data on the ultrastructures in which the processes occurring in a living organism are concentrated. The term “classical” physiological approaches should be deciphered. The ultimate goal of physiological research is to elucidate the mechanisms of the process and its regulation in the body. Experiments are used for this in vivo(in a living [organism]) and in vitro(in vitro), electrophysiological methods, enzyme immunoassay, differential centrifugation, confocal microscopy and much, much more. Classic approach in physiology implies the need to evaluate the phenomenon in the body as a whole in all the complexity of the regulation of this process.
When a physiological phenomenon and its nature are analyzed, various techniques are used to understand the essence of the process, usually aimed at weakening, turning off the entire function or its components, or, on the contrary, at strengthening, hypertrophy. This lays the prerequisites for understanding the progression of events from normal to pathological, among which the next step is the clinic. The chain will be incomplete if you do not try to restore the impaired function by using medications; hence the demand for pharmacology.
It is also necessary to take into account the exceptionally rich material that the clinic daily offers for physiological understanding. It is in the real picture of life that the true dependence and interconnection of physiology, pathology and medicine with the unconditional primacy of the physiological sciences in their broad sense is revealed. Physiology uses many methods modern sciences about life to understand the physiological processes of the individual as a whole in its connection with the environment, in the interaction of the individual with the environment - physical and social.
In the era of anatomical discoveries of the Middle Ages, the primacy of morphology in the fundamental medical sciences and biology was obvious. J. Cuvier rejected the role of comparative physiology in the progress of evolutionary teaching because of the possibility of different organs performing similar functions. However, interest in the functional side of phenomena constantly excited thought. I. Goethe expressed the relationship between form and function: "Funktion ist Form in Tatigkeit gedacht"(“Function – form in action”), conveying a succinct image of physiology.
As an independent branch in the system natural sciences physiology received citizenship rights in the 18th century. It was separated from anatomy, and its task was to analyze the mechanisms of function and activity of living beings. There is no doubt that both at the dawn of civilization and in the era of the development of exact sciences, one of the priority areas creative activity of man was the knowledge of Man in all his diversity, including the mechanisms of his functions various systems, all aspects of his activities. At the 32nd International Physiological Congress, delegates received a book prepared by S. Boyd and D. Noble - “The logic of life”. The words in the title of the book, “the logic of life,” represent a translation Chinese characters, denoting physiology. This phrase - the understanding of the essence of physiology as the logic of life - is more than two thousand years old. The word physiology is of Greek origin ( physics- nature, logos- doctrine), in modern terms, is the science of normal life processes in the body.
It may be more accurate to represent physiology as a system of sciences about the physical and chemical bases of the activities of organisms of different levels of complexity, their regulation in an integrated system. The more than century-old tradition of Russian physiology consists in the desire to characterize functions in the whole organism, which brings physiology closer to its main consumer - clinical medicine. The object of medical research is the whole organism. This correlates well with the main thesis of Russian medicine, so promoted by S.P. Botkin, - it is necessary to treat the patient, not the disease, that is, we are talking about attention to the body as a whole.
At the turn of the XX-XXI centuries. The face of physiology has changed, and the understanding of its role in the system of life sciences has changed. In its extreme expression, the attitude towards it can be summarized as follows. The optimistic approach, which I share, is that integration trends in physiological research and the use of methods of molecular biology, biophysics, cytology (I deliberately use the classical names of sciences) will lead to a holistic image of each of the functions with an understanding of the place and role of chemical and physical processes in the ultrastructures of cells in the whole organism. A pessimistic view of the place of physiology in modern natural science reduces it to a science that played a role in the history of natural science of bygone times. This view became widespread in connection with the outstanding achievements of molecular biology and molecular genetics, when the idea became stronger that these disciplines would solve the main problems of biology and medicine. It is no coincidence that major financial resources have been allocated for research in the field of physical and chemical biology, which are intended for the development of the entire complex of life sciences.
It is hardly possible to agree with the overthrow of physiology. The achievements of any of the sciences about living things acquire a complete form when their role in the realities of the whole organism becomes obvious. It is in this form that they take on the outlines of a filigree-honed sculptural image, and only then can they be perceived by the area of knowledge that is called applied, in our case, clinical medicine.
Since physiology is the science of the functions of organisms, the progress of any other science of life will inevitably contribute to its enrichment with new approaches and knowledge. It should be said right away that physiology is by no means in debt. Modern achievements of molecular biology, genetics, biochemistry, elucidation of the structure and synthesis of various physiologically active substances, cloning of receptors have opened up new facets of regulation of functions. However, it turned out that the functions of receptors, channels, and pumps in isolated form and in vivo differ significantly. Elucidation of the mechanisms of function in a whole organism can bring a lot of unexpected things into the picture drawn from experimental data carried out not only on isolated macromolecules, but even on cellular systems or organs in vitro, on cell cultures.
It is possible to make forecasts for the future of science, its prospects, but in the area basic research their value is very relative. Even after crowned Nobel Prize With the discoveries of J. Watson and F. Crick, was it possible to predict the development of molecular biology and genetics that we have witnessed? Was it possible in the 60s of the last century to imagine the consequences of the information boom, which was caused by the development of computer technology, which changed the face of modern world? At the same time, pessimism or denial of the future of physiology in comparison with new disciplines in the broad panorama of the life sciences is hardly justified. The role of physiology in understanding the functions of living things will never decrease, and its importance in understanding the nature of life phenomena in natural science education will certainly remain. In this context, any penetration into the physical and chemical foundations of the phenomena of life, the functions of the entire organism will inevitably lead to the need to understand the place, role and characteristics of the course of the studied processes and phenomena in the entire organism. This may be the basis for new directions in physiology itself. Its existence is predetermined by the need for man to know living beings and himself, and therefore will last as long as man lives. Naturally, changes are coming internal structure, the methodological content of this architectural structure, but its main purpose will remain unchanged - as it was formulated by the creators of modern physiology - I. Muller, C. Bernard, I. Pavlov.
A natural question is: why are we talking about physiology as a fundamental science in relation to medicine, and not about genetics, molecular biology, cell biology? My explanation is this. Physiology is the science of the functions of the whole organism. Even identical twins, being genetically similar to each other in everything, often react differently to the same stimulus, to the same event. According to available data, about 2 million Americans suffer from schizophrenia. It was assumed that the development of this disease is associated with heredity. A study of the role of genetic factors showed that when one of the identical twins develops schizophrenia, the probability of developing the same disease in the second is 50%. Since all their genes are identical, it is clear that another factor determines the development of the disease. In the search for the causes of schizophrenia, it was found that predisposition to it is determined by many genes. It was assumed that schizophrenia was caused by a disruption in the transmission of nerve signals involving the neurotransmitter dopamine. IN last years main role began to be assigned to another neurotransmitter - glutamate. The same neurotransmitter causes different effects, and different neurotransmitters have the same effects, depending on where their effect is applied. A lack of glutamate contributes to the same weakening of neuronal activity as an excess of dopamine. Obviously, only a physiological analysis will make it possible to understand where the disorder is localized and what routes of pharmacotherapy should be outlined.
Moreover, there is hardly any doubt that the complexity of the organization of a living organism is determined not by the number of genes encoding proteins, but by their regulation in the entire system (Table 1). The number of genes encoding proteins is approximately equal in weeds and humans, and the complexity of their organization is qualitatively different. To understand the function of a physiological phenomenon, it is necessary to correctly decipher all aspects of activity, including physical basis unfolding processes, their chemical content.
Table 1. Number of protein-coding genes
in the genomes of humans, some animals and plants
(data from Celera Genomics)
One of the tasks of physiology is to understand the nature of life processes. Their knowledge inevitably requires studying the functions of cells, membranes, signal transmission within a cell and between cells. All this data is necessary to clarify the mechanisms of the functions of organs, systems, and their interaction in the structures of the whole organism. It is obvious that the study of these processes is impossible without using the latest methods, at present, the progress of physiology is unthinkable without understanding life processes at the molecular level. In this regard, an exceptional role belongs to the methods of new biology, perceived by the entire set of biological disciplines, among which is physiology.
And today, physiology is deeply connected with classical biology, and this bears fruit for medicine. Outstanding discoveries in physiology were often predetermined by luck in finding an object of study and the study of successfully found experimental models. Suffice it to recall the Nobel Prize awarded to J. Eccles, A. Hodgkin, and E. Huxley for their study of ionic mechanisms of excitation and inhibition in the peripheral and central parts of nerve cell membranes, as well as the role of experiments on the squid giant axon in this discovery. In this regard, one cannot fail to mention the work performed at biological stations, especially marine ones. Many Russian biologists and physiologists worked at the Neapolitan station, founded by A. Dorn in 1870. At the beginning of the 20th century. research here was carried out by L.A. Orbeli, which apparently led him to study comparative physiology, and then to the development of problems of evolutionary physiology. Zoophysiology, comparative physiology, ontogenetic physiology are not only integral parts of modern physiology, but also sources of development of its fundamental sections, as well as areas of interest for applied physiology and medicine, for example, environmental, space and aviation physiology, age physiology and clinical.
I cannot help but draw attention to the fact that discoveries of exceptional importance for physiology and medicine were not always awarded the Nobel Prize in this category. Suffice it to remember that in 1901 the first prize in physics was received by V. Roentgen for the discovery "the rays that bear his name." In 1955, the prize in chemistry was awarded to V. du Vigneault for his work on biochemically important sulfur compounds, primarily for the synthesis of polypeptide hormones, in particular, oxytocin and vasopressin; The 2003 Chemistry Prize was shared by P. Agri and R. McKinnon for the discovery of the molecular structure of aquaporins and potassium channels in biological membranes. These facts are mentioned to emphasize the main idea: physiology assimilates the data and methods of many sciences in the name of solving its problems - understanding the functions and mechanisms of their regulation, as well as with the aim of using the acquired knowledge in medicine.
THEORETICAL FOUNDATIONS OF MEDICINE
Discussing the relationship between physiology and medicine, I will touch on the thoughts of I.P. Pavlova about the interrelations of these sciences. A few strokes from Pavlov’s biography that are directly related to the problem under consideration. In 1875 he graduated from St. Petersburg University, and on September 25 of the same year he was first enrolled in the second year of the Medical-Surgical Academy, and only when he passed the exam in anatomy (the grade received at the university was not taken into account), on December 29, 1875 was transferred to the third year. This was a conscious choice, as Pavlov writes in his autobiography, he did not intend to become a doctor, but considered it important to have a doctorate in medicine in order to be eligible to occupy the department of physiology.
Pavlov considered physiology as the basis of medicine. On June 29, 1895, in the introductory lecture in the course of physiology, which he gave at the Military Medical Academy (formerly the Medical-Surgical Academy), he gave an extremely clear formulation: “Accurate physiological knowledge, familiarity with the functions of organs and the interconnection of these functions, i.e. a good habit of thinking physiologically will be a precious aid to purely medical knowledge, leading you along the chain of phenomena to the starting point.”[, vol. 5, p. eleven]. This idea was shared by clinicians: in 1924 S.S. Zimnitsky wrote: “The clinic of internal diseases is applied human physiology”[ , With. 7].
For many years, Pavlov headed the Society of Russian Doctors in St. Petersburg and constantly demonstrated the importance of physiology as the foundation of medicine. On October 7, 1893 he said: “An equal and mutually beneficial union is established between theoretical and practical medicine, which is the basis for the progress of medical science, and it is indisputable that a society that has adopted such a view is on the right road.”[ , With. thirty].
Ivan Petrovich’s creative intuition never ceases to amaze. In the second half of the 20th century. There was a revolution in natural science in connection with discoveries that led to the development of molecular biology and molecular genetics. And half a century before that, on October 23, 1897, Ivan Petrovich, in a speech “In Memory of R. Heidenhain” at a meeting of the Society of Russian Doctors in St. Petersburg, said: “Our modern organ physiology... can be considered the harbinger of the last stage in the science of life - the physiology of the living molecule”[ , With. 255]. And again I draw the reader’s attention: Pavlov is not talking about "living molecule" and about "physiology of a living molecule"!
In the 20s of the last century, Pavlov began research in the field of genetics of higher nervous activity. By the way, he came up with the idea to erect a monument to G. Mendel. In Koltushi, a bust of the abbot was erected in the alley in front of the building of the institute where Pavlov worked. In the 1930s, he insisted on the need to create a department of medical genetics at medical institutes. Scientific intuition led Pavlov to the construction of a new physiology, closely related to the achievements of biology, including genetics. In 1923, he wrote a letter to the Presidium of the Academy of Sciences in support of creating conditions for the development of comparative physiological research with the participation of his student E.M. Kreps (later academician). He organized a physiological laboratory at the Murmansk Marine Biological Station, he made a major contribution to the development of evolutionary physiology and biochemistry, and the results of his research were used in clinical and hyperbaric medicine.
In the scientific community, it is customary to treat terms with respect and be sure to use them in the sense that corresponds to the author’s intention. If it is necessary to name a new phenomenon, a new term should be proposed, but, on the other hand, cases in which new names for existing sciences or branches of science are invented in an attempt to become their founders are hardly worthy of respect. These considerations are necessary in order to return again to the statement that it is physiology that is fundamental medicine. Nowadays, some consider such a judgment to be outdated; it has become outdated to consider physiology as the foundation of medicine. Meanwhile, we are talking not so much about the term, but about the essence of the phenomenon, about the essence of the discussions that arise in scientific community and the echoes of which were heard in speeches at the recent scientific session of the Russian Academy of Sciences and the Russian Academy of Medical Sciences.
METHODS OF MODERN PHYSIOLOGY
The development of science is inextricably linked with the possibility of communication, exchange of ideas and results. An objective criterion for the state of physiology can be an analysis of journal articles. It allows us to outline the variety of methods used to solve problems in physiology, changes in priorities in its history and its modern appearance.
The first specialized periodical in which the results of physiological research were published was “Archiv fur Anatomy, Physiologie und wissenschaftliche Medizin”; its publication began by S. Reil in Germany in 1795. Almost a quarter of a century later in France, under the editorship of F. Magendie, a journal dedicated only to physiology began to be published. In Russia, the publication of a special physiological journal was carried out for the first time by I.P. Pavlov in the spring of 1917. It was the Russian Physiological Journal named after. THEM. Sechenov", which is published regularly to this day. It is already more than 80 years old, and during this time it changed its name to “Physiological Journal of the USSR named after. THEM. Sechenov", these days - on the "Russian Physiological Journal named after. THEM. Sechenov." When familiarizing yourself with its contents, as well as with the contents of modern foreign physiological journals - “Journal Physiology” (London), “American Journal Physiology”, “European Journal Physiology” - you can see a wide range of research methods used to solve physiological problems in the interests of medicine . Among these methods are electrophysiological, knockout of individual genes, methods analytical chemistry, electron microscopic methods using antibodies to membrane receptors, X-ray microanalysis, confocal microscopy and many others. It is more difficult to say which methods developed in related sciences are not used than those used in physiological research. The latter differ in the formulation of the problem: various approaches are used to assess the mechanism of function and methods of its regulation, and to determine the causes of dysfunction.
Modern physiology is unthinkable without the methods of almost all natural sciences, but for it they are not an end in themselves, but a way of understanding function. I will demonstrate the application of methods and approaches of several sciences using the example of studying the mechanism of maintaining constant blood osmotic pressure with the participation of the kidneys (Table 2).
Table 2. Components of the osmoregulation system, their functions and dysfunctions
| System components | Function | Dysfunction |
| Osmoreceptor Neuron of the supraoptic nucleus Blood, vasopressinase Kidney, V2 receptor Kidney, adenylate cyclase Kidney, cAMP phosphodiesterase Kidney, aquaporin 2 Kidney, glomerular filtration Accumulation of osmolytes in the renal medulla Blood flow, renal medulla Number of nephrons Concentration of Ca ions in the blood Concentration of catecholamines in tissue Prostagladin E2 |
Perception of osmolality, signal to the brain Vasopressin secretion Vasopressin destruction Interaction with vasopressin cAMP formation Destruction of cAMP Increased water permeability Volume of urine fluid Creation of an osmotic gradient Maintaining an osmotic gradient Efficiency of counterflow system Regulation of cell response to vasopressin Changes in cell response to vasopressin Decreased cell response to vasopressin |
Areactivity, polyuria Decreased secretion, polyuria Increased activity, polyuria Defect, polyuria Decreased activity, polyuria Enzyme inhibition, oliguria Defect, polyuria Decreased, defective osmotic concentration Increased, impaired osmotic concentration Decreased, defective osmotic concentration Increased, decreased response to vasopressin Change in secretion, polyuria, oliguria |
Related Sciences
Analytical chemistry, bioorganic chemistry, biophysics,
biochemistry, genetics, histology, mathematics,
molecular biology, physics, cytology
Thirst occurs when water is lost and blood osmolality increases. A person quenches his thirst with a few sips of water, at the same time the kidney increases the absorption of water in the tubules in order to maintain a constant level of osmotic pressure of the blood and the total concentration of dissolved substances in it. This is very important for maintaining a stable volume of each cell in the body. In parts of the brain, in a number internal organs There are osmoreceptors - cells that are sensitive to changes in the concentration of substances in the blood, and they report information to the brain, to the hypothalamus. In a standard situation, neurons of the supraoptic nucleus synthesize antidiuretic hormone, it enters the posterior lobe of the pituitary gland and is secreted from it into the blood. The absorption of water in the kidney tubules depends on the concentration in the blood of this nonapeptide hormone - arginine vasopressin; normally its concentration in humans is very low and is about 10 -12 M/l. In recent years, it has been possible to establish the sequence of molecular processes that ensure an increase in osmotic permeability in renal tubular cells. At the initial stage, the antidiuretic hormone interacts with the V2 receptor on the surface of the cell membrane; at the final stage, the permeability of the cell membrane to water increases due to the fact that the water channel - aquaporin 2 - is inserted into the cell membrane of the renal tubule. Various renal structures are involved in the process of saving water for the body; osmotic concentration of urine requires normal level blood flow, glomerular filtration, the proper number of nephrons and many other factors (see Table 2). As a result, more water is absorbed into the blood and the water balance is restored.
Physiological studies provide insight into paradoxical situations, for example, increased reabsorption of water in the renal tubules with increased urine output in patients with osmotic diuresis or nocturnal enuresis. Let's look at the principle of how the kidney works when producing urine. First, protein-free liquid enters the lumen of the tubule from the blood plasma as a result of ultrafiltration, then in the tubules all the substances necessary for the body and most of the water are absorbed into the blood, and what the body does not need is removed. It would seem that in the case of increased urine output, the absorption of water in the tubules should always decrease. That's right... but with nocturnal enuresis in children, an unusual picture was observed: urination increased at night, but at the same time, as a rule, the absorption of osmotically free water in the kidney tubules increased. (The term “osmotically free water” in physiology means chemically pure water not associated with any substances.) After numerous studies, it was possible to understand the mechanism of this physiological paradox: in one of the parts of the renal tubule physiologically active substances are secreted - autacoids, which inhibit absorption of Na +, K + and Ca ++ ions from the tubule into the blood, due to which large volumes of fluid enter the collecting ducts. Vasopressin acts on their cells; when a larger volume of fluid flows through the collecting ducts, more water is absorbed from them into the blood, but more of it is excreted by the kidney.
Deciphering the mechanism of the paradoxical phenomenon described above and outlining an effective treatment regimen helped not only the use of data on the molecular mechanisms of action of the hormone vasopressin and autacoids, but also knowledge of the physiological basis of kidney function. A similar situation arose when deciphering the symptom of nocturia, which worries many older people. These examples are given only to convince the reader of a truth that is obvious to me: physiology assimilates the achievements of many sciences and builds a foundation for medicine based on an understanding of the mechanisms of functions and dysfunctions of the human and animal body.
Underestimating the role of physiology in building the building of modern medicine is harmful both for the development of science and for the applied use of its achievements, be it medicine or solving national security problems. In recent years, the Russian Academy of Sciences has been doing a lot to create barriers to bioterrorism; the need for these measures is obvious and deserves full support. But even in this case, physiological approaches are important, primarily in order to take into account the reaction of the individual as a whole. Thus, the possibility of transformation of the mousepox virus was recently shown, which led to 100% lethal outcome, but the contagiousness of this strain disappeared. The interaction of the agent under study and the organism, the peculiarities of its response to the influence belong to the field of physiology, which studies different levels, including molecular, the reaction of the individual as a whole.
In an effort to avoid an overly subjective assessment of what should be attributed to the progress of physiology of past decades, in an effort to avoid the reproach not only of biased assessment, but also of true bias, one should choose, if possible, a more objective criterion for the achievements of physiology. They can serve as research in the field of physiology and medicine, awarded the Nobel Prize. This strategic approach allows us to outline the appearance of modern physiology, focus on the points of its growth, the essence of the progress achieved and interaction with related disciplines, but while preserving physiology as a science in its modern understanding.
PHYSIOLOGY AND HIGHER MEDICAL EDUCATION
A diverse education and extensive knowledge in the field of fundamental science are an important condition in the medical training system. In one of the stories D. Granin quoted an ancient saying: “A doctor cannot be a good doctor if he is only a doctor.” When making a diagnosis and prescribing treatment, the doctor must have accurate physiological knowledge and an understanding of the characteristics of deviations from the norm in molecular processes that ensure functions, which will help prescribe adequate pharmacotherapy to the patient. Creative intuition is of great importance. To paraphrase the words that begin Anna Karenina - " All happy families are similar to each other, each unhappy family is unhappy in its own way,”— we can say that healthy people are similar to each other in terms of the physiological mechanisms of their functional systems, but everyone is sick in their own way. Using modern knowledge, the doctor is able to reveal the mechanisms of individual reactions. The physiological reaction can be compared to a branched chemical reaction in which many components are involved. They reveal themselves over time and determine the final outcome of the reaction itself. Pavlov's method of physiological analysis of functions in the whole organism is Ariadne's thread in the search for the correct diagnosis and treatment.
The above requires a diversity of approaches in implementing a unified state standard of medical education. There is no need to prove or justify the idea that centuries-old history higher education There was a high standard of training for doctors; in our time, the requirements have increased even more. A feature of medical education has always been the desire not for a narrow professional approach, but for a broad education that only a university could provide, where representatives of a wide variety of fields of knowledge work under one roof. In accordance with the idea of Peter the Great, the Academy of Sciences was founded in St. Petersburg and a university and a gymnasium were established under it. In the provision considered on January 22, 1724 at a meeting of the Senate, there is a remarkable clause about the opening of four faculties, "namely: 1 - feology, 2 - jurisprudence, 3 - medicine and 4 - philosophy"[ , With. 36, 37].
The idea of creating a university at the academy, which would have a medical faculty, marked the transition from medical-surgical schools with narrowly professional training, also created by decree of Peter 1 of May 25, 1706, to university education of doctors. Modern university medical education is characterized by a wide range of natural science disciplines, including physics, chemistry and biology, and humanities, without which becoming a doctor is unthinkable. Naturally, a lot of time should be devoted to the clinical disciplines themselves.
In recent years, by the will of fate, I was able, in the educational process when teaching the same disciplines, to compare the standards of requirements in the field of fundamental science at an academic institute and a classical university. The contradiction between these two forms of activity is obvious. A researcher can achieve success in a narrow field professional activity, the teacher must have a deep knowledge of all sections of the course presented. I.P. wrote about this on October 21, 1900. Pavlov in the preface to the textbook “Human Physiology” by R. Tigerstedt (1901):
“The vast majority of textbooks represent a collection, a warehouse of numerous individual facts and all kinds of opinions available in science. There can hardly be much sense from such a presentation. A beginner—and textbooks are written primarily for them—gets lost in the mass of facts and absolutely does not know where to stop or what, at least to begin with, to adhere to. Among the forest of details, the main thing slips away, and the thought remains idle. Textbook of Prof. Tigerstedt is written differently. The author forms a personal opinion about everything, citing and discussing facts both for and against... Finally, as a well-thought-out work, this textbook in many places amazes with its simplicity of presentation.”(cited from [, vol. 6, pp. 163,164]).Pavlov combined intensive research work in the laboratory with a physiology course he constantly taught at the department of the Military Medical Academy. Almost a century has passed since then, the content of physiology has changed, but its importance in medical knowledge and medical education has remained the same. Of course, a different content and a different quality of textbooks for physiology courses in universities are required; they should include the achievements of the entire complex of life sciences, but the teacher is obliged to give modern ideas about the mechanisms of each of the processes occurring in a living organism. In an attempt to implement such a course, some authors of textbooks and manuals change the name of the subject of presentation. In some cases, a physiology textbook for medical schools is called “Human Physiology,” although it is obvious that the basis is based on animal research data, but adapted to an understanding of functions in humans. One of the best American textbooks on physiology, Physiological Foundations of Medical Practice, published under the editorship of foreign member of the Russian Academy of Sciences J. West, has gone through more than ten editions since 1937, it contains more than 1,300 pages. Another textbook on human physiology, published under the editorship of R. Greger, a foreign member of the Russian Academy of Sciences, and W. Windhorst, has the subtitle “From Cellular Mechanisms to Integration”, it contains more than 2500 pages. Both textbooks reflect the main trend in the development of sciences relating to medicine as applied knowledge. Their content is well comparable to the main idea of this article concerning the place and role of physiology in modern science.
In our country, medical education is provided mainly medical institutes(most of them have now become universities or academies). Only a few classical universities have (or were opened in the 1990s) medical faculties. What can the opening of new faculties in such large universities of the country as Moscow and St. Petersburg give for medical education? In my opinion, this initiative will have a beneficial effect on the development of medical education in the country. This is not about changing the number of doctors in the country (enrollments in medical faculties of classical universities are very small and should not increase), positive changes are expected in the content educational process, structure and quality of education.
Similarities educational standard does not at all mean that the content of the courses is identical. This statement is fully consistent with the thought of V. Shklovsky: “In parallelism, the sense of discrepancy with similarity is important”[ , With. 23]. More in-depth training in the field of basic sciences and the development of a physiological approach to the analysis of clinical situations is important in the education of a modern doctor.
MEDICINE IS SCIENCE AND ART
As I have already said, the same disease, the same dysfunction can have different outward manifestations in different patients - each is sick in their own way. It is up to the clinician to catch these features. The diversity of the phenomenon is inherent not only in medicine and pathology, it is reflected in many other cases. An example would be translating the same string from foreign language into Russian, which depends not only on the talent of the translators, but also on different visions, the use of different shades of meaning of words and their combinations. To illustrate this idea, I will give several translations of one verse from Shakespeare's sonnet. The choice fell on sonnet 118 because of its “closeness” to the topic of the article: the sonnet mentions the word drug- medicine:
Another example is sculpture. Elusive and tangible, close in theme, but different not so much in details as in the conveyance of image, sensation, soul and spirit... These thoughts arise when you rejoice looking at sculptural portraits created by Auguste Rodin, Camille Claudel, Anna Golubkina. Both Claudel and Golubkina are students of the same master, they worked with Rodin for a long time, the sculptural images born of the talent of each of them are related by the similarity of feelings in the appearance of their heroes, but we distinguish the handwriting of each Master. The above applies to the doctor’s creativity - the work of his thought, the images that arose in him on the basis of sensations, intuition, the ability to identify a disease by subtle signs and symptoms and outline ways to treat it.
Medicine is unique in its unity of science and art in the broad sense of the meaning of these words. Physiology as a fundamental science and its branches late XIX- early 20th century biochemistry and biophysics have provided clinicians with methods and helped develop approaches for the diagnosis and targeted treatment of many diseases. The art of the clinician is to create an individual image of the form of pathology in a given patient, based on patient examination data, intuition, and a subtle and accurate assessment of differences from the norm that are often invisible to the untrained eye, and to develop an individual method of treatment. The outstanding clinician of the last century S.S. Yudin (fate gave me the opportunity to be his student) expressed a very important thought: “There are no boundaries between true science and the creative quest of an artist”[ , With. 82]. In the book Reflections of a Surgeon, written during his imprisonment at Lubyanka, he wrote:
“No other branch of human activity combines so many different special properties as in surgery. What is needed here is the clarity and speed of the fingers of a violinist and pianist, the fidelity of the eye and the vigilance of a hunter, the ability to distinguish the slightest nuances of color and shades, like the best artists, the sense of shape and harmony of the body, like the best sculptors, the care of lacemakers, silk and bead embroiderers...”[ , With. 17, 18].There is a seeming difference between the physiological experience and the clinical approach. In a physiological experiment, of course, a pattern must ultimately be revealed, reproducible and confirmed by a sufficiently large number of observations, the value of statistical reliability. The internal inconsistency of the behavior strategy of the physiologist and clinician is that the conditions of physiological experience must be extremely pure, standard, constant, seemingly “unnecessary” details are excluded if possible, but at the same time they must not only be noticed, but also not missed, their meaning must be analyzed , for they are often very valuable. The clinician must pay attention to both the form of the pathology and the individuality of the course of the disease process.
I will give an example (and there are many of them in scientific life) of how in a physiological experiment a detail can be of fundamental importance. This is one example related to the work of our laboratory in recent years. At the turn of the 60s of the last century, a new object for studying the molecular mechanisms of action of antidiuretic hormone (ADH)—the amphibian bladder—entered the practice of physiological laboratories. In the USA, toads were used for this purpose Bufo murinus, in our country - frogs Rana temporaria. At both sites, the start of the experiment was preceded by a sufficiently long control period, when the bladders were in Ringer's solution so that the permeability of their membranes to water decreased, the normal low osmotic permeability of the membranes was established, and they began to respond in the same way to the addition of a standard concentration of ADH . This form of experiment was necessary because in some cases a rather high initial permeability of the bladder wall to water was observed, as if ADH were already present in the Ringer's solution, although no hormone was added.
The standard explanation suggested itself: the hormone could have been introduced from an animal along with bladder- either the hormone could be in the blood vessels, or in the extracellular fluid, or, finally, be associated with the corresponding receptors on the surface of the plasma membranes of the cell. This assumption dictated an obvious way experimental verification these possibilities: change the Ringer's solution several times successively and wash away traces of ADH preserved in the solution, or in tissue and cells, or in another form not taken into account by us. The result of the experiment was as unexpected as its consequence: than larger number Once the Ringer's solution at the serous membrane of the bladder was replaced with a fresh one, the permeability of the epithelial cells to water became higher. Poorly permeable epithelial membranes became increasingly permeable to water absorption along an osmotic gradient, as if a large amount of ADH had been dissolved in pure physiological solution [,].
Without continuing the story about the consequences of this fascinating, almost detective experiment, I will only say that it made it possible to reveal functional role another level of functional regulation, in particular in the kidney, bladder and other osmoregulatory organs. It turned out that cells constantly secrete a physiologically active substance into the pericellular environment surrounding them; it is active in a concentration of 10 -12 M/l; this substance is an autacoid, which continuously reduces the permeability of membranes to water. It is important that we were able to show the role of autacoids in pathology, clarify their physiological and clinical significance, and outline methods for treating pathological conditions caused by altered secretion of autacoids and which we called autacoidoses.
The differentiation of sciences, which was such a clear trend of the 20th century, is being replaced in our time by the integration of knowledge, the use of data from many branches of fundamental science to understand human nature, and the involvement of a wide range of biological disciplines in the process of knowledge. An outstanding achievement of the 20th century. became organ transplantation - the clinical embodiment of one of the many achievements of physiology, which at one time were laboratory exercises for physiologists. We are talking about the experiments of V.P. Demikhov on organ transplantation. They found fruition in what had recently seemed like fantastic achievements in heart and kidney, liver and bone marrow transplants, giving suffering people many years of life. The implementation of equally fantastic projects using stem cells, in vitro fertilization and, ultimately, infertility treatment has become a reality. In clinical medicine, principles based on basic science data remain important. The above is in good agreement with the thoughts of V.Ya. Danilevsky that, based mainly on physiological considerations, modern medicine considers a sick person not as a mechanical complex of healthy and diseased organs, but as an integral personality.
ROLE OF BASIC SCIENCE IN DIAGNOSIS
The diagnostic process includes a clinical examination. It begins with questioning, inspection, studying the condition of individual systems, and the use of additional research methods. This allows you to identify symptoms on the basis of which the diagnosis is determined. Sometimes a number of symptoms are detected, their combination is a syndrome when the symptoms are united by a common pathogenesis. These are the steps to making a diagnosis and developing a treatment strategy. However, physiology is often forgotten.
A natural question: why do they forget about science, the importance of which for medicine, in my opinion, is undeniable? Without physiological analysis, there is no deep and versatile approach to diagnosis, and therefore to consequences, because after making a diagnosis it is necessary to prescribe treatment. The role of physiological data and approaches is to help the doctor not only understand which functional system is suffering, but also to establish the cause of the patient's illness. Constantly, when it comes to the development of science, they turn their eyes to the West, “there is no prophet in his own country.” I will also refer to foreign experience: the importance of physiology in the training of doctors in the USA can be judged from the textbook “Physiological Foundations of Medical Practice”.
The journal "Bulletin of the Russian Academy of Sciences" is not intended for the analysis of symptoms and syndromes, but I wanted to open up for specialists in other fields of knowledge the logic of making a diagnosis, the need to use methods and achievements of various sciences, and above all physiology, to solve current problems medicine. The current situation causes bewilderment when a large layer of natural phenomena, subject only to physiological analysis, leaves the discussion; physiology finds itself outside the circle of fundamental sciences designed to solve issues of human health and medicine. This article was written in an attempt to explain my point of view, to find allies in an effort to restore the balance of science in our academy.
Let's try to understand the logic of a doctor's diagnosis, his prescription of treatment that is adequate to the disease in a given patient, and to understand the role of physiological sciences in the daily practice of a clinician. For discussion I have chosen symptoms that are clear to every reader. Using two examples I will try to show how much data large number sciences are required to decipher the mechanism of the disease, make a diagnosis, and prescribe not symptomatic, but pathogenetic treatment. Let me explain the meaning of these terms. In the first case we are talking about eliminating the symptom, in the second - the cause that caused the symptom. If the temperature is high, the patient can be given aspirin and it can be reduced, or the cause of the fever can be eliminated. For severe coughs, you can use a medicine that reduces the sensitivity of the center in the nervous system that is responsible for the cough. Pathogenetic treatment will consist of eliminating the cause of the cough. The patient is recommended to take antibacterial substances, for example, antibiotics, which will eliminate the cause of bronchitis, and the cough will stop and the temperature will normalize.
I’ll start with an ordinary situation that the reader encounters all the time. During periodic follow-up, the doctor first of all gives a referral for blood and urine tests. Let us select two from the entire long list of analysis points: the volume of fluid secreted by the kidney and its osmolality, osmotic pressure. Excessive excretion of fluid by the kidney can be determined by an increase in water consumption or a change in its excretion by the kidneys; this value in patients can reach 25 liters per day. It is necessary to decide on an alternative: is thirst, the desire to drink water a consequence of inadequate stimulation of the nerve center in the brain for an unknown reason or the result of loss of excess fluid by the kidney? The causes of intense fluid loss may be various options diabetes (and there are more than 20 forms!). Let's choose one of the forms - diabetes insipidus, its cause is either the inability of neurons to secrete vasopressin into the blood, or the lack of response of kidney tubular cells to this hormone. Its function is to promote the absorption of water in the kidney tubules.
Let us move on to a physiological analysis of the mechanisms of only one of the listed conditions, associated with the action of vasopressin, an antidiuretic hormone. The patient has polyuria, what reasons could underlie this condition? A genetic defect in the neurosecretory cells of the supraoptic nucleus in the brain is possible when the secretion of vasopressin is impaired (according to its chemical structure, it is a peptide consisting of nine amino acids). Possible toxic, traumatic, inflammatory damage to brain cells secreting the hormone. But even with completely normal functioning of these cells, vasopressin may not be formed if the function of osmoreceptors is impaired. These sensitive structures respond to changes in osmotic pressure in the blood, the concentration of osmotically active substances in it and transmit information to the nerve centers. If the receptors are insensitive (unresponsive), if their connection with the nerve centers is damaged, then the signal does not reach the supraoptic nucleus in the brain - the neurohypophysis, and the hormone does not enter the blood in the required quantities. Vasopressin will not be in the blood, the kidney will lose the effect of the hormone, and water will not be absorbed in the required quantities - large volumes of fluid will be removed from the body by the kidney. This will make you feel thirsty.
Physiological analysis shows (and there are both experimental data and clinical examples) that the regulatory system can function normally, the secretion of antidiuretic hormone (vasopressin) into the blood occurs, but tens of liters of fluid per day (!) will still be removed from the body by the kidney . In this case, one of the reasons may be a defect in the V2 receptor, which should be influenced by vasopressin. The receptor is embedded in the plasma membrane of the tubule cell and is located on the surface of the renal collecting duct cells. Normally, it interacts with vasopressin coming from the blood into the extracellular fluid and triggers a chain of reactions in the cell, which ultimately leads to an increase in the permeability of its membranes to water. A reaction with the hormone will not occur if the structure or function of the V2 receptor is disrupted, if enzymes in the cell quickly destroy the secondary messenger formed as a result of stimulation of the V2 receptor, and finally, if there is a defect in the water channel of the membranes of this cell - aquaporin 2. Possible reasons Cell reactivity may be a genetic defect in the hormone receptor, water channel protein, or the effect of toxic substances on tubule cells. A decrease in the absorption of ions in the renal tubules will entail increased excretion of salts, the latter will cause a loss of water osmotically associated with these ions.
Here is a list of conditions associated with increased (polyuria) and decreased (oliguria, anuria) urine production:
Polyuria
| Kidney amyloidosis Pregnancy (high serum vasopressinase activity) Absorption of transudates, exudates Hydronephrosis (recurrent polyuria) Dipsogenic polyuria Dystrophic enterocolitis in heart disease Diabetes insipidus Nephrogenic diabetes insipidus Osmotic diuresis (injection of glucose, mannitol, urea into a vein) Pellagra Primary wrinkled bud |
The period of swelling disappearance Pyelitis Psychogenic polyuria Diabetes Shriveled kidney Sprue Stage of latent decompensation during decompensation of the cardiovascular system (nocturia) Kidney tuberculosis (in the initial stage) Iatrogenic polyuria |
Oliguria
Anuria
Another important point in urine analysis is the total concentration of all substances dissolved in it, urine osmolality. A decrease in the ability to form urine with an osmolality above 1000 mOsm/kg of water (this function is characteristic of the kidney of a healthy adult) is impaired in many pathological processes in the kidney:
| Analgesic nephropathy Brain amyloidosis Amyloid-wrinkled kidney Areactivity of osmoreceptors Hydronephrosis Hyperthyroidism Hyperparathyroidism Hypocorticism Prostatic hyperplasia Hypothermia Diabetic glomerulosclerosis Kidney calcification Low protein diet Microcystic Multiple myeloma Diabetes insipidus Nephroangiosclerosis Nephrosclerosis Drink plenty of fluids Osmotic diuresis Acute renal failure (recovery period) |
Acute tubular necrosis in the diuretic phase Primary polydipsia Primary aldosteronism Post-obstructive uropathy Polycystic kidney disease Kidney stone disease Kidney failure (early stages) Taking diuretics (furosemide, ethacrynic acid, etc.) Taking V2 receptor antagonists, clonidine, lithium, methoxyflurane, prostaglandin E2, phenothiazine, chlorpromazine, ethanol Psychogenic polydipsia Diabetes Compression of the urinary tract by tumors Cushing's syndrome Sickle cell anemia Transplanted kidney Chronic pyelitis Chronic pyelonephritis Chronic renal failure Decreased glomerular filtration rate Shock Dieselelectrolythemia |
Much less often, persistently increased urine osmolality is detected. It is associated with such pathological processes as hyperthermia, limited drinking, acute infectious diseases, increased secretion or injection of vasopressin, stress, syndrome of inappropriate secretion of antidiuretic hormone. I will especially focus on the last case. As already noted, normally antidiuretic hormone (vasopressin) is formed in the hypothalamus and secreted into the blood in the posterior lobe of the pituitary gland. However, conditions have been described in humans when this hormone begins to be secreted into the blood during tumor metastases to the lungs. We observed such a picture in acute pneumonia in children; Increased secretion of vasopressin was detected in meningitis, encephalitis and other diseases. So, by changing the osmolality of urine, it is sometimes possible to detect diseases of various organs and systems and outline adequate treatment.
Let's look at another example that many people understand. The patient has elevated blood pressure. Functionally, this means that the volume of blood in the vessels does not correspond to the capacity of the vascular bed; it is necessary to reduce the volume of fluid in the vessels or dilate the vessels, or do both. It is necessary to find out the cause of hypertension in the patient: whether the lumen of the vessels is narrowed or the volume of blood in them has increased. Vascular tone decreases under the influence of various endogenous regulators - angiotensin II, adrenaline, norepinephrine, vasopressin, endothelin, etc. For treatment in each of these cases, it is necessary to use different and very active pharmacological drugs. Experts in the field of biochemistry, molecular biology, and physicochemical biology have had their say in understanding these problems. They installed chemical structure the physiologically active substances listed above, the structure of the receptors with which they interact. Genetic analysis made it possible to identify which genes are activated and are involved in the development of hypertension. But an important question for the patient remains open: what underlies the development of the disease, what processes and what combination of factors determine shifts in the regulatory system in in this case, what caused the rise in blood pressure in him, and not in the average patient? Consequently, understanding the nature of the disease includes the comparison of a large number of information from a number of scientific disciplines, but only their physiological analysis will help to reveal the cause of dysfunction and localize it, which will provide the doctor with a path to developing adequate treatment. Only the joint efforts of representatives of many sciences included in the complex of life sciences will allow us to penetrate into the secrets of life Human, his health and illness.
Recognition of the multi-level organization of the regulatory system (nerve impulse ® hormone secretion ® interaction with the cell receptor ® restructuring of the cell) is combined with a variety of physiologically active substances acting on the same cell (mediators of the nervous system, hormones, autacoids, ions). How does a cell, a set of cells in tissues, organs and systems, find the only correct answer that provides optimal living conditions for an individual in its relationship with the external environment? The second half of the 20th century was marked by major achievements in the knowledge of the molecular foundations of life; in the current century we are still waiting for insight into the secrets of the systemic organization of biological objects.
Medicine is heterogeneous, clinical medicine coexists with preventive medicine. The job of a doctor, his purpose is not only to treat, but also to prevent illness, which is why preventive medicine is so important. Applied physiology has developed greatly, making it possible to determine the reserve capabilities of various body systems. It is hardly possible to share the merits of physiology and medicine in human exploration of outer space and the depths of the World Ocean [,].
Physiological approaches make it possible, at each level of scientific development, to synthesize facts into a mosaic panel, which will present the structure of the system of regulation of various functions in the whole organism. I will try to convey to the reader my vision of this image, but in the language not of emotions, but of strict scientific knowledge. A patient's "medical problems" arise when reserves are exhausted, when function turns into dysfunction. This may be the result of dysplasia, a violation of the ratio of cell types, cells and intercellular substance, a shift in the course of chemical reactions and changes in the concentration of any of chemical compounds, disruption of the functioning of a particular gene and the formation of a protein dependent on it, changes in the concentration of ions in the intercellular fluid and the resulting jump in transmembrane electrical potentials. The combined use of methods from various sciences makes it possible to construct physiological concepts and a model of processes occurring in the body. Based on physiological constructs, a diagnosis is established and a reasonable treatment path is outlined. All of the above gives grounds to assert that physiology has been and remains a fundamental science in relation to medicine. This found an adequate solution in the resolution of the scientific session of Bright's disease). Kazan, 1924.
18. Shakespeare W. Sonnets. M.: Chronicle, 1996.
19. Shakespeare W. Sonnets. St. Petersburg: Crystal, 2003.
20. Shakespeare W. 333 sonnets. Simferopol: Renome. LIRA, 2001.
21. Yudin S.S. Reflections of a surgeon. M.: Medicine, 1968.
22. Orloff J., Handler J. The similarity of effects of vasopressin, adenosine 3", 5"-phosphate (cyclic AMP) and theophylline on the toad bladder // J. Clin. Invest. 1962. V. 41. P. 702-709.
23. Natochin Yu. V. The mechanism of increasing the permeability of the bladder of the grass frog under the influence of pituitrin // Physiol. magazine USSR named after THEM. Sechenov. 1963. T. 49. pp. 526-531.
24. Natochin Yu.V., Parnova R.G., Shakhmatova E.I. et al. AVP-independent high osmotic water permeability of frog urinary bladder and autacoids // Eur. J. Physiol. 1996. V. 433. P. 136-145.
25. Komissarchik Y. Y., Snigirevskaya E. S., Shakhmatova E. I, Natochin Y. V. Ultrastructural correlates of the antidiuretic hormone-dependent and antidiuretic hormone-independent increase in osmotic water permeability in the frog urinary bladder epithelium // Cell Tissue Res. 1998. V. 293. P. 517-524.
The purpose of the journal is to promote the integration of theory, practice, methods and research in the field of human physiology. Articles are published on the functioning of the brain and the study of its disorders, including on the mechanisms of the nervous system responsible for perception, learning, remembering, experiencing emotions and speech, discussion materials on problems such as breathing, blood circulation, circulatory system, motor functions, digestion , as well as physiology of sports and physiology of work. Articles on ecological physiology are welcome, including the study of adaptation to extreme conditions (polar zone, desert) and new (space) external conditions. Every year, from one to three issues of the journal are devoted to the consideration of a selected problem.
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Human physiology is the science of the mechanical, physical, bioelectrical and biochemical functions of the human body with the good health of its organs and the cells of which these organs are composed. Physiology concentrates mainly at the level of organs and systems. Many aspects of human physiology are close to corresponding aspects of animal physiology, and animal experiments have provided a wealth of information for the development of science. Anatomy and physiology are two closely related scientific fields: anatomy is the study of form, and physiology is the study of function; they are interrelated and are studied together in a university course.
The concept of homeostasis in human physiology
The term "homeostasis" means the maintenance of general internal resistance in the body. Homeostasis stabilizes the body by regulating the internal environment. It is necessary for efficient work body. The process of homeostasis is vital to the survival of every cell, tissue and system in the body. Homeostasis in a general sense means stability, balance or equilibrium. Maintaining a stable internal environment requires constant monitoring, particularly through the brain and nervous system. The brain receives information from the body and responds to each request with a release various substances, such as neurotransmitters, catecholamines and hormones. Moreover, the physiology of each individual organ simplifies the maintenance of homeostasis of the entire organism. For example, regulation of blood pressure: the production of renin by the kidneys allows blood pressure to stabilize (renin-angiotensinogen-aldosterone system), and the brain helps regulate blood pressure through antidiuretic hormone (ADH), which is produced by the pituitary gland. Consequently, homeostasis is not only maintained within the entire organism, but also depends on each part of it.
Systems in physiology
Traditionally, academic physiology views the body as a set of interacting systems, each of which has its own functions and goals. Each system of the body contributes to the homeostasis of other systems and the whole organism. None of the body systems works alone, and the state of human health depends on the state of all interacting systems.
|
System |
Clinical area |
Physiology |
|
Nervous system consists of the central nervous system (which includes the brain and spinal cord) and the peripheral nervous system. The brain is the organ of thinking, emotion, and sensory processing, serving many aspects of communication and controlling other systems and functions. Special Feelings- these are vision, hearing, taste and smell. The eyes, ears, tongue and nose collect information about the environment in which the organism is located. |
Neurobiology, neurology (diseases), psychiatry (behavior), ophthalmology (vision), otolaryngology (hearing, taste, smell) |
Neurophysiology |
|
Musculoskeletal system consists of the human skeleton (which includes bones, ligaments, tendons and cartilage) and the muscles attached to it. It provides the body with basic structure and the ability to move. In addition to their structural role, large bones contain bone marrow, the site of blood cell production. Bones also contain large reserves of calcium and phosphate. |
Endocrinology |
The traditional division into systems is somewhat arbitrary. Many parts of the body are involved in more than one system; these systems may be organized according to function, embryological nature, or other characteristics. In particular, "neuroendocrine system" is a complex interaction between the neurological and endocrine systems, which together are responsible for regulating physiology. Moreover, many aspects of physiology are not always included in traditional organ system categories.
Pathophysiology is the study of changes in physiology in diseases.
History of the study of human physiology
The study of human physiology dates back to at least 420 BC, the time of Hippocrates, the father of medicine. Critical thinking Aristotle and his emphasis on the relationship between structure and function marked the beginning of physiology in Ancient Greece, and Claudius Galen (126-199 AD), known as Galen, was the first to use experiments to study the functions of the body. Galen became the founder of experimental physiology. The medical community only moved away from Galenism with the advent of Andreas Vesalius and William Harvey.
In the Middle Ages, the medical traditions of Ancient Greece and India were continued by Muslim doctors. A significant role was played by the works of Avicenna (980-1073), author "Canon of Medicine", and Ibn Al-Nafis (1213-1288).
After the Middle Ages, the Renaissance ushered in an increase in physiological research in the Western world, sparking modern research in anatomy and physiology. Andreas Vesalius was the author of one of the most influential books on human anatomy, "De humani corporis fabrica". Vesalius is often cited as the founder of modern human anatomy. Anatomist William Harvey described the operation of the circulatory system in the 17th century, demonstrating the fruitful combination of close observation and careful analysis in the study of bodily functions, a major step in the development of experimental physiology. Hermann Bergave is often called the father of physiology, thanks to his outstanding lectures in Leiden and his book "Institutiones medicae"(1708).
In the 19th century, knowledge of physiology began to accumulate very quickly, especially in 1838, after the emergence of the Cell Theory of Matthias Schleiden and Theodor Schwann. They stated that all organisms are made up of tiny particles called cells. Further discoveries of Claude Bernard (1813-1878) led him to the development of the concept "milieu interieur"(internal environment), which was then picked up, refined and presented as “homeostasis” by the American physiologist Walter Cannon (1871-1945).
In the 20th century, biologists also became interested in how organisms other than humans function, which eventually led to the development of comparative physiology and ecophysiology. Significant figures in these areas are Knut Schmidt-Nelsen and George Bartholomew. Later, evolutionary physiology became a separate discipline.
The biological basis for the study of physiology - integration - refers to the intersection of many functions of the human body systems and their associated forms. This is achieved through communication, which occurs in numerous ways, both electrical and chemical.
In the human body, endocrine and nervous system play a large role in transmitting and receiving signals, which are the basis of functioning. Homeostasis is the main aspect of the interaction of systems within the body, including the human body.
- when you sneeze, all body functions stop, even the heart
- our nose and ears never stop growing
- children grow faster in spring
- fair-haired people have more hair than dark-haired people
- Babies are born without kneecaps. They appear at 2-6 years of age
- in the brain ordinary person there are about 100 billion nerve cells
- nerve impulses move to the brain and back at a speed of 274 km per hour
- You can’t sneeze with your eyes open
- 15 million blood cells are destroyed in the human body every second
- human femurs are stronger than concrete
– every two weeks the stomach needs a new layer of mucus or it will digest itself
- in order to speak you need the interaction of 72 muscles
- relative to size, the strongest muscle in the body is the tongue
- right-handers live 9 years longer than left-handers
- women blink almost 2 times more than men
- if you go blind in one eye, you lose only 1/5 of your vision, but all the sensations of depth
- our eyes always remain the same size from birth
- finger length indicates how quickly the fingernail grows
- the skull is made up of 29 different bones
- after death, the body begins to dry out, creating the illusion that hair and nails are still growing after death
- average intestinal length 200 m
- Every year about 98% of the atoms in the body are replaced
- a person breathes about 23,040 times during the day
- blood travels 96,540 km every day
- the human heart creates sufficient pressure to raise blood to a height of 9 m
— length of the rectum 1.9 meters
— The length of hair on the head grown by the average person during a lifetime is 725 kilometers.
— Blondes grow a beard faster than brunettes.
— When a person smiles, 17 muscles “work.”
— The surface of the lungs is about 100 square meters.
— Human DNA contains about 80,000 genes.
- Men are considered dwarfs if their height is below 130 cm, women - below 120 cm.
— Leukocytes in the human body live 2-4 days, and erythrocytes - 3-4 months.
— Each human finger bends approximately 25 million times during a lifetime.
— The size of a person’s heart is approximately equal to the size of his fist. The weight of an adult human heart is 220-260 g.
— The human body contains only 4 minerals: apatite, aragonite, calcite and cristobalite.
— The human brain generates more electrical impulses per day than all the phones in the world combined.
— The total weight of bacteria living in the human body is 2 kilograms.
— In the human brain, 100,000 chemical reactions occur in one second.
— Children are born without kneecaps. They appear only at the age of 2-6 years.
— The surface area of human lungs is approximately equal to the area of a tennis court.
— From the moment of birth, there are already 14 billion cells in the human brain, and this number does not increase until death. On the contrary, after 25 years it decreases by 100 thousand per day. In the minute you spend reading a page, about 70 cells die. After 40 years, brain degradation accelerates sharply, and after 50, neurons (nerve cells) dry out and brain volume decreases.
— The human small intestine during life is about 2.5 meters long. After his death, when the muscles of the intestinal wall relax, its length reaches 6 meters.
— A person has approximately 2 million sweat glands. The average adult loses 540 calories with every liter of sweat. Men sweat about 40% more than women.
— The right lung of a person holds more air than the left.
— An adult takes approximately 23,000 breaths (and exhalations) per day.
— Over the course of a lifetime, a woman’s body reproduces 7 million eggs.
— The human eye is capable of distinguishing 10,000,000 shades of color.
— There are about 40,000 bacteria in the human mouth.
- It is impossible to sneeze with your eyes open.
— There are 33 or 34 vertebrae in the human spine.
— Women blink about 2 times more often than men.
— The smallest cells in a man’s body are sperm cells.
— The strongest muscle in the human body is the tongue.
— There are about 2000 taste buds in the human body.
— At birth, there are about 300 bones in a child’s body, but in adulthood there are only 206.
— The human body contains the same amount of fat as it takes to make 7 bars of soap.
— Nerve impulses in the human body move at a speed of approximately 90 meters per second.
— Human hair is about 5000 times thicker than soap film.
- 36,800,000 - the number of heartbeats in a person in one year.
— Human gastric juice contains 0.4% hydrochloric acid (HCl).
— Almost half of all human bones are in the wrists and feet.
— People with blue eyes are more sensitive to pain than everyone else.
— Fingernails grow about 4 times faster than toenails.
— During a lifetime, a person’s skin changes approximately 1000 times.
— There are more than 100 different viruses that cause a runny nose.
— There are about 75 kilometers (!) of nerves in the body of an adult.
— Human bones are 50% water.
— The influenza epidemic of 1918-1919 killed more than 20 million people in the United States and Europe.
— A person who smokes a pack of cigarettes a day drinks half a cup of tar a year.
— Man is the only representative of the animal world capable of drawing straight lines.
— The names of the fingers of the French are: pous, index, major, anulaire, oriculaire.
— The phenomenon in which a person loses the ability to see due to strong light is called “snow blindness.”
— In psychiatry, a syndrome accompanied by depersonalization, impaired perception of time and space, one’s own body and the environment, is officially (!) called “Alice in Wonderland.”
— Papaphobia is the fear of the Pope!
— In Mesopotamia, the doctor who treated him was executed for the death of a patient, and blinded for blindness.
— Men are about 10 times more likely than women to suffer from color blindness.
— Medieval doctors, when in doubt about the diagnosis, diagnosed “syphilis.”
— You can lose 150 calories per hour by hitting your head against a wall.
— Bulimia is an indomitable appetite.
— Parthenophobia is the fear of virgins.
— The scientific name for the navel is umbilicus.
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Physiology is the study of the processes occurring in cells, organs and their systems. Regardless of structural and functional diversity, the activity of individual cells, organs and systems is complex for building a harmonious functional and structural whole, that is, a living organism.
Changes in the biological environment affect the course of life processes. Social conditions also matter for a person - work, social environment, living conditions, etc.
The physiology course for doctors studies vital phenomena in the human body using experimental data from animals. This is possible because the basic principles of activity and regulation in the animal body retain their importance in human physiology, thanks to common basis existence, but analogy rather than complete similarity should be taken into account.
The body exists as a stable self-regulating system with perfect regulatory mechanisms. It is determined by living conditions and guarantees the existence of the organism.
In case of disharmony of the regulatory system, the division of functions is compromised and a new (diseased) state may arise. With very great disharmony, it is possible that serious disturbances in body functions may occur, leading to death.
Physicians must have in-depth knowledge of the physiological processes occurring in secreting cells, subclinical structures and the body as a whole. A complete understanding of the body is required, knowledge of the complex relationships between organs and systems, as well as between the body and environment- physical and social. Modern physiological practice requires a more in-depth study of physiological mechanisms, which is also a prerequisite for a better understanding of normal abnormalities and their more effective removal. Physiology helps a medical specialist prevent a number of diseases, that is, it is an integral part of preventive medicine. Therefore, human physiology is the main medical science, necessary for the practice of propagating patterns in a living organism.
There are many examples illustrating the use of physiological advances in medical practice. For example, insulin (a pancreatic hormone) is used in the treatment of diabetes, elucidation of transport processes along the nephron is the basis for modern diuretics, and the accumulation of new data on the mechanisms of pain perception underlies the creation of new painkillers. In addition, physiology serves a healthy person in organizing his work.
The main methods in physiology are observations and experiments. Observation allows you to objectively assess the nature and course of certain processes and phenomena in the body, that is, the collection of data for physiological processes. To understand their essence, the results of an experiment are also necessary, which allows us to study the mechanisms of regulation in a living organism. In this way, data were obtained on the nature of the excitatory impulse in nerve and muscle cells, for transport through cell membranes, etc.
