HUMAN PHYSIOLOGY 2

Degree course: 
Corso di Long single cycle degree (6 years) in MEDICINE AND SURGERY
Academic year when starting the degree: 
2019/2020
Year: 
2
Academic year in which the course will be held: 
2020/2021
Course type: 
Basic compulsory subjects
Credits: 
6
Period: 
Second semester
Standard lectures hours: 
60
Detail of lecture’s hours: 
Lesson (50 hours), Seminar (10 hours)
Requirements: 

To be admitted to the final exam of Human Physiology 2 it is necessary to possess a positive evaluation of the exams of Human Anatomy and of Biochemistry

Final Examination: 
Orale

The learning verification covers all the topics of the program and is divided into two phases:
a) a test for access to the oral exam, performed by computer support (PC) and comprising 20 multiple choice or true / false questions. The score attributed to each answer is 1.65 for correct answers and -0.5 for each wrong answer or not given. If the total score is greater than or equal to 18/30, the test is considered passed and allows access to the oral test. The score obtained in this first test is not considered in the final exam evaluation.
b) The oral exam consists of two questions on different topics of the course with discussion of the topic and further more specific questions for further study of the topic. For each of the two questions, the knowledge of the topic, the ability to describe the physiological mechanisms covered, the ability to analyze the physiological mechanisms from a biophysical point of view and to discuss them quantitatively using appropriate analytical tools (graphs, equations, units of measurement) will be assessed. ), the ability to describe the functioning of a single tissue / apparatus within the general economy of the organism, the appropriateness of scientific language.

The final assessment of the Human Physiology 2 exam, expressed in thirtieths, will be averaged with that of the Human Physiology 1 exam and will appear in the student's curriculum as a global assessment of the Human Physiology exam.
In the event that, due to the COVID health emergency, it is not possible to carry out the face-to-face examination, this will be carried out remotely by means of an electronic meeting with the Teams platform and use of the University Moodle platform

Assessment: 
Voto Finale

Educational objectives
The course aims to offer students a biophysical-quantitative view of the functioning mechanisms of cells, tissues and systems of the human body. In this way, the course intends to provide the skills necessary to understand in detail the complexity of vital functions in normal conditions and to make available to students the indispensable prerequisites for facing subsequent courses aimed at studying the pathological alterations of tissues and organs and their treatment. clinical and surgical. Therefore, teaching proves to be a fundamental pivot in building the professional profile of the student of Medicine and Surgery.

Expected Learning Outcomes
At the end of the course, the student will be able to:
1. describe the fundamental functional parameters that characterize the physiological conditions of cells, tissues and organs;
2. explain how cells and tissues work
3. use biophysical-quantitative tools (equations, graphs) to describe and analyze the physiological processes involved;
4. describe the correlations between structure, biophysical behavior and function of organs and systems.
5. describe the mechanisms underlying the coordinated and interactive functioning of several organs and systems
6. analyze the phenomena that lead to possible modifications of the quantitative and functional parameters as the organic conditions vary
7. discuss the topics dealt with clearly and using the appropriate technical language.
8. explain how the changes in functional balance found in physiological conditions lead to the onset of pathophysiological conditions of clinical interest for cells, tissues and organs.
The teaching is preparatory to that of General Pathology; therefore, the student is required to gain knowledge of the physiological mechanisms introduced in this course such as to enable him / her to easily and profitably attend the next course.

The Course will deal with the biophysical mechanisms that guarantees the normal functions and omeostatic control in the following systems:
Skeletal muscle and locomotion.
Cardiac muscle.
Vascular systemic circulation and lymphatic system.
Pulmonary and coronary circulation. Control of cardiovascular function.
Respiratory system, gas exchanges and transport.
Nervous and chemical control of respiratory function.
Renal system and regulation of volume and osmoticity in extracellular body fluids.
Acid-base equilibrium.
Metabolism.
Thermoregulation.
Digestive system.
Endocrine system.

Muscle and locomotion. Isometric, isotonic and iso-velocity contraction. Force-length, force-velocity and dynamic force-velocity diagrams.
Heart. Cardiac pace-maker. Electrocardiogram. Control of cardiac function. Cardiac mechanics. Valves function. Ventricular pressure and volume during cardiac cycle. Cardiac stroke and cardiac output. Work output, cardiac efficiency and metabolism.
Distribution of blood volume. Velocity, cross section and pressure in the circulatory districts. Mechanical features of blood vessels. Laplace and Bernoully laws. Poiseuille law. Laminar and turbulent flow. Arterial and venous pulse pressure. Pressure distribution in the systemic and pulmonary circulation. Fluid and solute exchanges between microvasculature and interstitial space. Diffusion and convection. Control of interstitial volume and lymph formation. Oedema. Control of cardiovascualr function. Pulmonary and coronary circulation.
Respiratory system. Air composition and respiratory gasses. Spirometry, static lung volumes. Pulmonary and alveolar volume and flow. Static. Lung, chest and respiratory system pressure-volume curves. Intrapleural pressure and pneumothorax. Dynamics Mechanical work of respiration. Respiratory gas exchanges. O2 consumption and CO2. production. Respiratory ratio. Alveolar gas equation. Alveolo-capillary respiratory gas diffusion. O2 and CO2 transport in blood transport in blood. Ventilation-perfusion ratio. Artero-venous shunt, hypoxia. Nervous and chemical control of respiratory function.
Renal system. Glomerular filtration: composition of glomerular filtrate. Renal blood flow and filtration fraction. Glomerular auto regulation. Renal clearance. Proximal tubule Absorption of water, Na+, Cl-, bicarbonates, aminoacids, urea. Secretion of H+ and organic substances. Henle loop. Counter current mechanism. Osmolarity in tubular and extracellular fluid. Vasa recta. Distal convolute and collecting tubules. Absorption of water and Na+; excretion of H+, K+. Aldosterone and vasopressine. Regulation of volume and osmoticity in extracellular body fluids. Urine volume, pH and composition.
Acid-base equilibrium. Physiological buffer solutions. H+ production and its buffering. Respiratory and metabolic acidosis and alkalosis. Control of pH by renal and respiratory correction.
Metabolism. Energetic fuel: anaerobic and aerobic pathways. Energy available in food. Oxygen debt. Basal, rest ad exercise metabolism. O2 consumption.
Thermoregulation. Thermal equilibrium. Physiological mechanisms of heat production and dispersion. Nervous and endocrine control of heat production and dispersion.
Digestive system. General features of the digestive tube. Peristaltic movements. Salivary and gastric secretion and their nervous control. Bile secretion and functions. Composition and functions of pancreatic and intestinal secretion. Endocrine control of secretions. Digestion and absorption of carbohydrates, proteins, lipids, ions (Fe++, Ca++, etc.), vitamins, drugs and water.
Endocrine system. Mechanisms of hormone release and action. Pituitary gland. Anterior lobe. Hypotalamic neurosecretion and portal blood vessels. Releasing (RH) and inhibiting hormones (IH). Somatotropin, thyreotropin, corticotropin, gonadotropin, prolactine. Intermediate lobe: melatonine. Posterior lobe: oxytocine and ADH. Adrenal glands. Medulla: catecholamines. Cortical: glucocorticoids, mineralcorticoids, their function and regulation. Thyroid Function and secretion of thyroid hormones. Paratyroids. Metabolisms and function of calcium and fosphate ions. Vitamin D. Endocrine pancreas. Effect of insulin and glucagone on glucose metabolism. Gonads. Endocrine aspects of male and female sexual organs. Gastrointestinal hormones.

One of the following texts:
AA.VV. – FISIOLOGIA UMANA – a cura di F.Grassi, D.Negrini, C.A. Porro - Poletto Editore, Milano
AA.VV. – FISIOLOGIA MEDICA - a cura di F. Conti - Casa Editrice Edi-Ermes, Milano
Guyton & Hall – FISIOLOGIA MEDICA – Elsevier-Masson
J.B.West – Respiratory Physiology

Teaching will be given in the second semester through frontal lessons. The student will be driven to the comprehension of the different but integrated physiological processes with the aid of images, schemas, graphs and biophysical analysis of the functioning mechanisms of cells, tissues and organs.

The teacher is available for the the students by appointment taken at the e-mail address:
daniela.negrini@uninsubria.it

Professors

NEGRINI DANIELA