Learning objectives
At the end of the course the student has the knowledge and capacity of understanding the mechanisms underlying the cellular homeostasis e the electrical properties of membranes, the mechanisms underlying the activity of the muscle tissue, the functional features of the cardiovascular and respiratory systems as well as their integration for pressure and hydro-electrolyte homeostasis. In addition the course will enable students to acquire novel and critical knowledge on the electrocardiographic technique,ì and on its diagnostic and prognostic values.
The student will be able to describe these phenomena and to use afterwards this information for the physiopathological interpretation of signs and symptoms.
Prerequisites
Students must possess basic and fundamental notions of Anatomy, cell and tissue biology and biochemistry of the organs and systems which are the topic of this part of the course.
Course unit content
This first part of the course of Physiology focuses on arguments of general physiology, muscle physiology, cellular neurophysiology, physiology of the dcarduivascular and respiratory systems and of electrocardiography.
Full programme
GENERAL PHYSIOLOGY (Giuseppe Luppino)
Cell membrane. Mechanisms of passive permeability. Selective permeability. Simple diffusion. Facilitated diffusion. Active transport. Osmosis. Filtration.
Electrical properties of the biological membranes. Electrochemical gradient. Nerst equation. Properties of cell channels. Action potential. Properties and mechanisms of gating of cell channels. Voltage-gated channels. Slow potential. Propagation of the slow potentials and of the action potentials. Synaptic transmission. Neurotransmitters. Membrane receptors. Reflexes. Flexion and stretch reflexes.
MUSCULAR PHYSIOLOGY (Giuseppe Luppino)
Functional properties of nerve fibers. Basic anatomy and functional properties of skeletal and smooth muscles. Synaptic transmission. Neurotransmitters. Membrane receptors.
CARDIOVASCULAR APPARATUS. (Stefano Rozzi)
Physical principles of hemodynamics. Physical properties of blood. Myocardial properties: rhythm, conduction, excitability, contraction. Heart electrophysiology. Ionic theories of resting and action potentials. Electrocardiogram. Heart mechanics and the cardiac cycle. Cardiac output. Intrinsic and extrinsic regulation of heart activity. The vascular system. Passive mechanical properties. Vascular smooth muscles. Nervous and endocrine regulation of blood vessels. Blood pressure; systolic, diastolic, mean and pulsatory. Measuring blood pressure. Venous pressure and blood circulation. Arterial and venous pulse. Coronary circulation and heart metabolism. Local circulation: muscle, skin, kidney, splanchnic. Brain circulation: chemical, metabolic and nervous regulation.
RESPIRATORY APPARATUS
(Stefano Rozzi)
Physical laws of gases. Chest and respiration muscles. Alveolar and pulmonary ventilation. Lung volumes and capacities. Anatomic and functional dead space. Mechanics of breathing. Intra-pulmonary and intra-pleural pressures. Compliance. Pressure-volume curves. Airway resistance. Work of breathing. Inspirated air, alveolar air, and expirated air. Blood-tissue gas exchange in the lung: relationships between ventilation and alveolar pressures of gases. Distribution of ventilation. Gas exchange between alveoli and capillaries. Blood transport of oxygen and carbon dioxide. Pulmonary circulation. Ventilation-perfusion relationships. Respiratory centers: Genesis of the rhythm of respiration. Ventilation responses to variation in alveolar pressures of oxygen and carbon dioxide. Chemical and central regulation of respiration. Hypoxia. Respiratory mechanisms controlling the acid-base status.
ECG (prof. Rozzi, dott. Lazzeroni)
-ECG: its history and the basic principles of heart electrophysiology;
- P wave (electrogenesis; relation to the heart cycle, morphology, notion
of its diagnostic features in relation to atrial heart pathology;
- PR interval (electrogenesis, relation to the heart cycle, morphology,
notion of its diagnostic features in relation to heart pathology of
conduction tissue;
- QRS (electrogenesis; relation to the heart cycle, morphology, notion of
its diagnostic features in relation to the diagnosis of heart hypertrophy
and infarct;
- ST (electrogenesis; relation to the heart cycle, morphology, notion of its
diagnostic features in relation to the diagnosis of ischemia;
- T (electrogenesis; relation to the heart cycle, morphology, notion of its
diagnostic features in relation to the diagnosis of heart overload;
- U wave;
- QTc (absolute and relative refractory periods);
- ECG as prognostic tool (short excursus on the prognostic meaning of
“traditional waves”, followed by the introduction of
“alternative/innovative” measures applied to the ECG: waves dispersion
in the spatial and temporal domains, post-potentials, etc.);
- ECG applied to the study of the autonomic nervous system;
- HRV (temporal and spectral domains, notions of “complexity”): analysis
methodology and its implications;
- The heart-brain relationship;
- The Polyvagal Theory of Porges.
Bibliography
Fisiologia medica a cura di Fiorenzo Conti, Ed. Edi-Ermes
Berne-Levy Fisiologia casa ed. Ambrosiana
Basi fisiologiche della pratica medica di West, Ed. Piccin
Dale Dubin, Interpretazione dell’ECG. Monduzzi, 2008
Teaching methods
Oral lessons with Powerpoint presentation
Assessment methods and criteria
The content of this course will be object of the final exam planned at the end of the second course of physiology (II semester)
Other information
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