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Table of Contents:

AWPF Fundamentals of Biomedical Engineering

Lecturer: Dr. rer. nat. Reiner Schnettler

 

Medical technology:
    - What is medical technology?
    - Meaning of MT based on the development of medical technology?
    - Differentiation between: "biological technology and biologically conditioned technology"  Def. technology.
    - Development phases of MT.
    - Medical technology in the field of tension between technology and medicine.
    - Sciences with the prefix bio:
        ◦ Biology
        ◦ Biotechnology
        ◦ Biophysics
        ◦ Biomedical engineering or biomedical engineering sciences.

Medical technology and life extension State of the art research:
    - Artificial organs
    - Importance of model systems in biology and medicine.
    - The importance of the axolotl in regenerative medicine
    - Automated production of bone, cartilage and skin substitutes
    - Organs from the 3D printer
    - Necessary scaffolds for cell culture of organ tissues
    - The importance of electrospinning technology
    - Ghost organs
    - Problems of organ cultivation
    - 5 basic tissues (elementary tissues) are to be mastered
    - Stem cells, adult or embryonic?
    - Importance of immune defense
    - Technical (bionic organ substitutes)

Hemodialysis as an example of a bionic organ replacement:
    - What does the original
    - the smallest functional subunit of the kidney
    - Requirements for a bionic solution
    - Possible solutions to

Medical technology in space:
    - Electrically induced cell fusion (biomembranes under µ x g - conditions).
    - The principle of operation: dielectrophoresis, the biological membrane as a capacitor, reversible and irreversible electrical breakdown
    - The influence of homogeneous and inhomogeneous electric fields
    - The effect of alternating voltage and direct voltage
    - Experimental setup for electrically induced cell fusion
    - The steps of electrically induced cell fusion
    - The voltage-time diagram of electrofusion
    - Possible applications

Importance of measurement in medical technology:
    - Importance of measurement in medical technology
    - Measurement error, systematic and random measurement error, examples
    - Closed loop measurement systems
    - The concept of measurand
    - Combinations of different measuring methods, sense and purpose
    - Tasks of measurement technology in medical technology

Evaluation of reliability of medical examinations:
    - Table of true negative, true positive, false negative and false positive results
    - diagnostic specificity
    - diagnostic non-specificity
    - diagnostic sensitivity
    - diagnostic non-sensitivity

biosignals:
    - biosignals
    - electrical biosignals
    - The special characteristics of electrical biosignals
    - Overview of human biosignals
    - Classification of biosignals according to their physical qualities
    - Biosensors for the detection of biosignals

Proteins and enzymes as the basis of biosensors:

    - What are proteins?
    - Properties of proteins
    - Building blocks of proteins
    - The hydrochloric acid pepsin experiment
    - Biogenic amino acids
    - The importance of the spatial structure of proteins
    - Primary, random coil, secondary, tertiary and quaternary structure of proteins
    - Enzyme proteins

Enzymes and enzyme kinetics:

    - The enzyme as a biocatalyst
    - Classification of enzymes, 6 main classes
    - Applications for enzymes, in the cell, in medicine, in biotechnology
    - Temperature and pH optimum for enzymes
    - Terminology of enzymes
    - Reaction kinetics of enzymes as a simple way to characterize enzymes
    - General chemical reaction equation for enzymes
    - Dissociation constant of the enzyme-substrate complex
    - Michaelis-Menten equation
    - Michelis constant
    - Lineweaver-Burk equation
    - V-[S] diagram of an enzyme catalyzed reaction
    - Micheleis-Menten kinetics of an enzyme-catalyzed reaction
    - substrate analogues
    - competitive inhibition
    - non-competitive inhibition
    - allosteric inhibition, and how to distinguish between them
    - Enzymes and the position of chemical equilibrium
    - Methods for the determination of the Michaelis constant

The origin of electrical biosignals:
    - Organigram of the eukaryote cell
    - Fluid mosaic model of the cell membrane
    - Components of the biolg. Membrane
    - Thought experiment Origin of electrical biosignals
    - What is needed? What are the initial conditions?
    - The meaning of Stavermann's reflection coefficient
    - Experiment to build up a membrane potential without Na+-K+-ATPase
    - Calculation of the membrane potential approximately
    - Calculation of the membrane potential more exactly
    - Initial conditions, final conditions
    - Experimental setup without Na+-K+-ATPase
    - Calculation of the resting membrane potential
    - Which ion determines the resting membrane potential to a first approximation?
    - Nernst equation, Nernst factor, Goldmann equation, constant field equation
    - How good is the Nernst equation, compared to the Goldmann equation?
    - The electronic equivalent circuit of the biological membrane for the resting potential
    - Assignment of the physiology to the components of the electronic equivalent circuit
    - Calculation and simulation of the equivalent circuit
    - Mathematical relationship between electrolytic permeability and membrane conductivity

Excitable membranes:
    - Threshold potential, electrically gated ion channels.
    - Structure of a motor neuron,
    - Soma, dendrites, axon hillock, axon, terminal knob, synapse, Ranvier's lacing rings, Schwann's cells,
    - Functions of dendrites,
    - Functions of the axon,
    - Experimental setup for measuring action potentials,
    - Um-time diagram, Gm-time diagram,
    - Conclusion for the modification of the electronic equivalent circuit of the resting potential.
    - Origin of the AP at the neuron,
    - locomotion of the action potential,
    - Chain ladder model, where and when valid,
    - Longitudinal or length constant,
    - Relationship with axon diameter,
    - anelectrotonus, and cathelectrotonus
    - continuous and saltatory excitation conduction (excitation propagation),
    - all-or-nothing law
    - rheobase and chronaxy,
    - refractory period, absolute and relative refractory period
    - Receptors,
    - pain and pressure receptors,
    - torsion balance,
    - frequency modulation of stimulus intensity,
    - sensory nerve pathways, somatosensory cortical field of cerebral cortex,
    - motor nerve pathways,
    - somatomotor cortical field of cerebral cortex,
    - Morphology of neurons,
    - fine structure of synapses,
    - Consideration of subsynaptic membrane and subsnyptic cleft,
    - Postsynaptic membrane areas,
    - Current valve function
    - The influence of axon hills
The influence of axon hillock near and axon hillock far synapses,- relationship between morphines and endorphins

Chain ladder,

electrotonus,- Structure of the nervous system:

Electric and ligand-gated synapses,How does the AP cross the synaptic cleft,    Transmitter vesicles,      Transmitter firing, what events precede,       receptor-gated ion channels      excitatory, inhibitory receptor-gated ion channels      Postsynaptic potentials, excitatory, inhibitory       Relationship between transmitter firing and triggered AP number      What prevents sustained excitation of ligand-gated synapses       acetycholine, dopamine      pharmacological significance of transmitter analogues      atropine, curarerelationship between morphines and endorphins      Structure of the nervous system:
- Central nervous system consisting of brain and spinal cord
    - peripheral NS, and vegetative NS
    - autonomic NS, voluntary NS

Muscle (The muscle as a chemo- thermo- mechanical

energy converter):

    - Cell types

    - Characterization of muscle cell types
    - Action potentials of muscle cells especially cardiac muscle cells
    - Extracellular potential measurement versus transmembrane potential measurement
    - Electronic equivalent circuit of the cardiac muscle cell
    - Tetanus, tetanisability, complete incomplete
    - Motor end plate
    - Structure and function of striated muscle
    - Actin, myosin, myosin head, troponin, tropomyosin, myosin binding site, myosin filament, The role of calcium and magnesium, ATPase activity and myosin.
    - Sarcomeres
    - Contractile unit
    - Molecular mechanism of muscle contraction
    - Sliding - filament - mechanism
    - The role of ATP
    - Longitudinal tubules
    - Transverse tubules
    - Sarcoplasmic Reticulum
    - Sarcolemma
    - Types of contraction of the muscle

Fine structure of the myofibril:
- The tubular system (transverse and longitudinal tubules, Ca2+-storage)
- The sarcomere (structure of the smallest contractile subunit of the
skeletal muscle)

The molecular mechanism of muscle contraction (sliding filament hypothesis):
    - Sliding filament mechanism
    - The actin-myosin complex
    - The role of ATP as energy supplier and softener (rigor mortis)

The muscular action potential:
    - In smooth muscle
    - Cardiac muscle
    - In skeletal muscle
    - Modified electronic equivalent circuit of the working myocardium

The motor endplate:
    - Endplate potentials

The mechanical equivalent circuit of the muscle:
    - Working diagram of the muscle
    - Resting strain curve
    - Isometric contractions
    - Isotonic contractions
    - auxotonic contractions (positive-, negative-)
    - Tetanus (incomplete-,complete-)

The importance of pharmacologically active substances in neuro- and muscle physiology:

Cardiovascular system:
    - Structure (two pumps)
    - Relationship to the lungs and the body
    - after birth
    - Lungs in shunt
    - Lungs in the main circuit
    - Small circuit
    - systemic circulation
    - Arteries
    - Veins
    - Position of the heart in the body
    - The pericardium
    - Sliding fluid
    - The heart as a hollow muscle
    - Heart valves
    - Aorta
    - Valves and leaflets
    - The working cycles of the heart
    - The importance of the sympathetic and vagus nerves
    - Resting ECG
    - Assumptions underlying the ECG derivation according to Einthoven
    - ECG lead forms: Einthoven, Wilson, Goldberger, Nehb
    - Unipolar and bipolar lead forms
    - Extremity lead
    - Differential electrodes and indifferent electrodes
    - Planes, which can be developed by the ECG
    - frontal plane,-horicinal plane, saggital plane
    - What information does the resting ECG provide?
    - waves and stretches of the ECG recording
    - Non-invasive determination of the anatomical cardiac axis
    - The heart as a dipole
    - Summation vector of the heart (summation vector)
    - Cabrera circle
    - Vector cardiography
    - Electronic equivalent circuit for deriving biopotentials from the body surface
    - Rythmus disturbances without alteration of the basic rhythm
    - Rythmusst disturbances with change of the basic rhythm
    - Extrsystoles
    - Compensatory pause
    - Estrasystoles in the area of the ventricles
    - Interposed extrasystoles
    - Five-point accupressure cardiac explosion technique zwinkernd

Ergospirometry as an example of a non-invasive procedure to determine the performance capacity and limitations of an organism:
    - Assessment of performance capacity (cardiovascular, pulmonary function, and metabolism).
    - Differential diagnosis of exercise intolerance
    - Evaluation of therapeutic interventions
    - Basis for training recommendations
    - Basis for the evaluation of pension applications
    - Components and basics of ergospirometry
    - Performance of ergospirometry examinations
    - Evaluation of ergospirometry examinations (9 field evaluation according to Wassermann)