Unit HUMAN PHYSIOLOGY 2

HUMAN PHYSIOLOGY - MOD. 3

Code	A001244
Location	PERUGIA
CFU	2
Teacher	Alessandro Tozzi
Teachers	Alessandro Tozzi
Hours	25 ore - Alessandro Tozzi
Learning activities	Base
Area	Funzioni biologiche integrate di organi, sistemi e apparati umani
Academic discipline	BIO/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Teaching methods	Frontal lessons
Learning verification modality	Oral exam
Extended program	DIGESTIVE SYSTEM -Functions of the gastro intestinal tract and general structure of the mucosa. -Smooth muscle. Unitary and multi-unit smooth muscle. Function. Factors stimulating contraction. Smooth muscle action potential, hormonal, paracrine and stretch factors. Slow waves, myogenic tone. Pacemaker potentials. Electro-mechanical coupling. Transverse bridge cycle. Phasic and tonic contraction. Length-tension relationship, force-velocity curve. -Autonomic nervous system. Structure, similarities and differences of the sympathetic and parasympathetic sections, neurotransmitters and receptors. -Nervous control of gastro-intestinal function. Autonomic control. Parasympathetic and sympathetic innervation. Nerve control of the intestinal wall. Sensory afferent fibres. Gastro-intestinal reflexes. Hormonal control of the gastro-intestinal tract. -Motility of the gastro-intestinal tract. Motility of the oesophagus, upper and lower oesophageal sphincters, stomach motility, control of gastric motility, bowel motility, defecation. Blood flow in the gastro-intestinal tract. -Food intake. Mastication. Swallowing. The swallowing reflex. Function of the upper oesophageal sphincter. -Stomach functions. Gastric mucosa. Stomach pacemaker centre and slow waves. Gastric emptying. Enterogastric reflexes. Neuronal and hormonal control of gastric emptying. -Motility of the intestine. Peristalsis in the small intestine. Migrating motor complex (MMC). Functions of the ileo-cecal valve. Peristalsis in the large intestine. -Secretory functions in the intestinal tract. Basic mechanisms of secretion, activity of the ANS. Secretion of organic substances. Secretion of water and electrolytes. Mucus functions. -Salivary secretion. Nerve control and regulation of salivary secretion. -Esophageal and gastric secretions. Ossin glands, components of gastric secretion, mechanism of HCl production, gastric mucosal barrier, control of gastric secretion. Short and long reflexes in the stomach. -Secretion of the exocrine pancreas. Components of exocrine pancreatic secretion, bicarbonate production, control of bicarbonate secretion, control of enzyme secretion. -Biliary secretion. Components of bile, bile acids, bilirubin, control of bile secretion. -Intestinal secretions. -Digestion and absorption. Anatomical bases. Digestion and absorption of carbohydrates, lipids and proteins. Management of lipids, calcium, iron, vitamin B12. -Feed control. Mechanisms of hunger and satiety control, factors that alter physiological controls, long-term feeding control.

HUMAN PHYSIOLOGY - MOD. 4

Code	A001245
Location	PERUGIA
CFU	3
Teacher	Vito Enrico Pettorossi
Teachers	Vito Enrico Pettorossi
Hours	37.5 ore - Vito Enrico Pettorossi
Learning activities	Base
Area	Funzioni biologiche integrate di organi, sistemi e apparati umani
Academic discipline	BIO/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian

HUMAN PHYSIOLOGY - MOD. 5

Code	A001246
Location	PERUGIA
CFU	3
Teacher	Roberto Panichi
Teachers	Roberto Panichi
Hours	37.5 ore - Roberto Panichi
Learning activities	Base
Area	Funzioni biologiche integrate di organi, sistemi e apparati umani
Academic discipline	BIO/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Respiratory system: Respiratory mechanic. Pulmonary circulation. Gaseous Exchange. Gas Transport in the blood. Respiration neurogenesis and control. Urinary system: Physiology of nephron: filtration, tubular reabsorption and secretion. Renal mechanisms for controlling water-electrolyte balance. Regulation of Acid-Base balance.
Reference texts	CONTI "Fisiologia Medica", Vol. 2, Ed. Edi-ERMES GAYTON-HALL "Fisiologia Medica", Ed. Edises BERNE-LEVY "Fisiologia" Ed. Ambrosiana WEST " Le Basi fisiologiche della pratica medica", Ed. Piccin. West's "Respiratory Physiology- The Essentials" Ed. Wolters Kluwer.
Educational objectives	knowledge of functional and regulatory mechanisms of respiratory and urinary system.
Prerequisites
Teaching methods	Teaching is organized through: 32 hours of face-to-face lessons on all subjects of the program with discussion in room and 1 Practical training on spirometry. The students will be divided in groups (25-30 students for group) and with a tutor they will perform spirometric examinations followed by analysis of results and discussion.
Other information	For information on support services for students with disabilities or DSA visit the page http://www.unipg.it/disabilita-e-dsa
Learning verification modality	Oral exam
Extended program	RESPIRATORY SYSTEM Respiratory mechanic: Mechanisms of pulmonary ventilation, air movement and the pressures that cause it. Thorax and lung coupling. Pleural pressure. Thorax and lung elastic retraction. Surface tension and surfactant.Laplace's law in the alveoli. Interdependence between alveoli. Changes in lung volume, alveolar pressure, pleural pressure and air flow during normal breathing. The volume-pressure relation in static condition, relaxing curves and compliance. Compliance changes during restrictive pathologies. Airway resistances and the regulating mechanisms. Dynamic airway compression. Dynamic compliance and volume-pressure diagram during breathing, contribution of elastic and viscous resistances. The work of breathing. Changes of work graphical representation during constricted lung diseases and airway obstruction. The pulmonary volumes and capacities and their measurements. Recording changes in pulmonary volume. Spirometry. Methods for measuring the functional residual capacity. Residual volume and total lung capacity. The anatomical and physiologic dead space and their measurement. The minute respiratory volume, pulmonary ventilation, alveolar ventilation and dead space ventilation. The forced expiratory vital capacity and forced expiratory volume in the normal conditions and during diseases (airway obstruction and constricted lungs). Effect of gravity on alveolar ventilation. Pulmonary and bronchial circulations. Pulmonary hemodynamics. Flow, pressure and resistance in the pulmonary circulation system. Passive and active regulation of blood flow in the lungs. Blood flow distribution through the lung and gravity effects. The West's zones. Capillary exchange of fluid in the lungs, role of lymphatics, pulmonary edema. Measurement of anatomical and physiologic shunts. Gaseous exchange: Composition and partial pressures in the atmospheric, inspirated and alveolar air. Diffusion of gases. Diffusion law and factors influencing diffusion rate. Diffusion and perfusion limited gas transfer. Measurement of diffusing capacity. The ventilation-perfusion ratio and its distribution in different parts of the lungs. Gaseous exchange and partial pressure with normal and abnormal ventilation-perfusion rate Compensation of ventilation-perfusion abnormalities. Gas Transport in the blood: Transport of oxygen. The oxygen-hemoglobin dissociation curve, curve analysis and its physiological significance. Factors influencing the oxygen-hemoglobin dissociation curve. The Bohr effect and its physiological significance. Transport of carbon dioxide. The carbon dioxide dissociation curve. The Haldane effect and its physiological significance. Metabolic use of oxygen by the cells. The respiratory exchange ratio. Diffusion of oxygen to the cells and oxygen utilization in different tissues. Effects of ischemia, hypoxia and anemia on the oxygen transport to the tissues.. Respiration neurogenesis: Organization and function of respiratory centers, the respiratory center in the medulla oblungata, apneustic and pneumotaxic centers. The bases of respiration rhythm. Chemical and not chemical controls of respiration. Control of ventilation by central and peripheral chemoreceptors. Respiratory effects of altitude. Role of pulmonary, bronchial and thoracic receptors in regulating respiratory activity and redistributing blood flow and ventilation. Abnormal breathing and breathing during sleep. URINARY SYSTEM Glomerular filtration, tubular reabsorption and secretion. Plasma clearance. Formation of urine: glomerular filtration. Composition of glomerular filtrate, the glomerular membrane. Factors determining glomerular filtration. Glomerular filtration rate (GFR) and inulin clearance, creatinine clearance. Factors determining the renal blood flow, PAH clearance and renal plasmatic flow, filtration fraction. Regulation of glomerular filtration rate and renal blood flow. Autoregulation of the GFR and renal blood flow. Tubuloglomerular feedback. Formation of urine: tubular reabsorption, secretion and escretion. Clearance and measurement of tubular reabsorption and secretion, tubular load, escreted load and reabsorbed or secreted load. Active and passive absorption, Maximum tubular transport. Reabsorption and secretion in different segment of nephron. Tubular reabsorption regulation. Processing of the main plasma constituents in the kidney. Glucose: Glucosereabsorption, threshold for glucose, loss of glucose in the urine. Balance of Urea, Sodium, Potassium, Calcium, Phosphate and Magnesium. Renal mechanisms for controlling water-electrolyte balance: Body fluids and renal function, intake versus output of water. Measurement of body fluid volumes. Effect of adding iso-hyper and hypotonic solutions. Transport of water and solutes in different nephron segments. The mechanisms for excreting a concentrated or dilute urine. The countercurrent mechanism. Osmolar clearance and free water clearance. Role of ADH. Osmotic and hemodynamic control of ADH release. Thirst mechanism. Control of extracellular fluid volume and regulation of NaCl excretion. Renin-Angiotensin system, Aldosterone, Atrial natriuretic peptide. Control of sodium excretion with normal ECV, during volume increase or decrease. The micturition reflex. Control of micturition by the brain Regulation of Acid-Base balance: Defense against pH changes, the acid-base buffers. The Henderson-Hasselbalch Equation. Titration curve for the bicarbonate buffer system. Respiratory regulation of acid-base balance. Renal control of acid-base balance. Kidney capability to excrete acidic urine: bicarbonato reabsorption, titolable acidity, Excretion of ammonium ion. Respiratory and metabolic acidosis and alkalosis and compensation mechanisms.