Unit HUMAN PHYSIOLOGY 2

HUMAN PHYSIOLOGY - MOD. 3

Code	A001244
CFU	2
Teacher	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)

Cognomi A-L

CFU

2

Teacher

Alessandro Tozzi

Teachers

• Alessandro Tozzi

Hours

• 25 ore - Alessandro Tozzi

Language of instruction

Italian

Contents

Gastro-intestinal tract
-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. Pace-maker 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 sympathetic and parasympathetic sections, neurotransmitters and receptors.
-Nervous control of gastro intestinal function. Autonomic control. Parasympathetic and sympathetic innervation. Nervous control of the intestinal wall. Sensory afferent fibers. Gastro-intestinal reflexes. Hormonal control of the gastro-intestinal tract. -Movements of the gastro-intestinal tract. Motility of the esophagus, upper and lower esophageal sphincters, motility of the stomach, control of gastric motility, motility of the intestines, defecation. Blood flow in the gastro-intestinal tract.
-Food intake. Chewing. Swallowing. The swallowing reflex. Function of the upper esophageal sphincter.
-Functions of the stomach. Gastric mucosa. Stomach pacemaker center and slow waves. Gastric emptying. Entero-gastric 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 for secretion, Activities of the SNA. 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.
-Gut secretions.
-Digestion and absorption. Anatomical bases. Digestion and absorption of carbohydrates, lipids and proteins. Management of lipids, calcium, iron, vitamin B12.
-Feeding control. Mechanisms of hunger and satiety control, factors that alter physiological controls, long-term feeding control.

Reference texts

Conti "Fisiologia Medica", Vol. 2, Ed. Edi-ERMES
Guyton and Hall "Fisiologia Medica", Ed. Edra

Educational objectives

Knowledge of the physiology of the gastro-intestinal system.

Prerequisites

Compliance with the propaedeuticities specified in the course regulations.

Teaching methods

Lectures. Distribution of teaching materials on Unistudium platform.

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. Pace-maker 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 sympathetic and parasympathetic sections, neurotransmitters and receptors.
-Nervous control of gastro intestinal function. Autonomic control. Parasympathetic and sympathetic innervation. Nervous control of the intestinal wall. Sensory afferent fibers. Gastro-intestinal reflexes. Hormonal control of the gastro-intestinal tract. -Movements of the gastro-intestinal tract. Motility of the esophagus, upper and lower esophageal sphincters, motility of the stomach, control of gastric motility, motility of the intestines, defecation. Blood flow in the gastro-intestinal tract.
-Food intake. Chewing. Swallowing. The swallowing reflex. Function of the upper esophageal sphincter.
-Functions of the stomach. Gastric mucosa. Stomach pacemaker center and slow waves. Gastric emptying. Entero-gastric 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 for secretion, Activities of the SNA. 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.
-Gut secretions.
-Digestion and absorption. Anatomical bases. Digestion and absorption of carbohydrates, lipids and proteins. Management of lipids, calcium, iron, vitamin B12.
-Feeding control. Mechanisms of hunger and satiety control, factors that alter physiological controls, long-term feeding control.

Cognomi M-Z

CFU

2

Teacher

Alessandro Tozzi

Teachers

• Alessandro Tozzi

Hours

• 25 ore - Alessandro Tozzi

Language of instruction

Italian

Contents

Gastro-intestinal tract
-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. Pace-maker 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 sympathetic and parasympathetic sections, neurotransmitters and receptors.
-Nervous control of gastro intestinal function. Autonomic control. Parasympathetic and sympathetic innervation. Nervous control of the intestinal wall. Sensory afferent fibers. Gastro-intestinal reflexes. Hormonal control of the gastro-intestinal tract. -Movements of the gastro-intestinal tract. Motility of the esophagus, upper and lower esophageal sphincters, motility of the stomach, control of gastric motility, motility of the intestines, defecation. Blood flow in the gastro-intestinal tract.
-Food intake. Chewing. Swallowing. The swallowing reflex. Function of the upper esophageal sphincter.
-Functions of the stomach. Gastric mucosa. Stomach pacemaker center and slow waves. Gastric emptying. Entero-gastric 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 for secretion, Activities of the SNA. 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.
-Gut secretions.
-Digestion and absorption. Anatomical bases. Digestion and absorption of carbohydrates, lipids and proteins. Management of lipids, calcium, iron, vitamin B12.
-Feeding control. Mechanisms of hunger and satiety control, factors that alter physiological controls, long-term feeding control.

Reference texts

Conti "Fisiologia Medica", Vol. 2, Ed. Edi-ERMES
Guyton and Hall "Fisiologia Medica", Ed. Edra

Educational objectives

Knowledge of the physiology of the gastro-intestinal system.

Prerequisites

Compliance with the propaedeuticities specified in the course regulations.

Teaching methods

Lectures. Distribution of teaching materials on Unistudium platform.

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. Pace-maker 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 sympathetic and parasympathetic sections, neurotransmitters and receptors.
-Nervous control of gastro intestinal function. Autonomic control. Parasympathetic and sympathetic innervation. Nervous control of the intestinal wall. Sensory afferent fibers. Gastro-intestinal reflexes. Hormonal control of the gastro-intestinal tract. -Movements of the gastro-intestinal tract. Motility of the esophagus, upper and lower esophageal sphincters, motility of the stomach, control of gastric motility, motility of the intestines, defecation. Blood flow in the gastro-intestinal tract.
-Food intake. Chewing. Swallowing. The swallowing reflex. Function of the upper esophageal sphincter.
-Functions of the stomach. Gastric mucosa. Stomach pacemaker center and slow waves. Gastric emptying. Entero-gastric 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 for secretion, Activities of the SNA. 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.
-Gut secretions.
-Digestion and absorption. Anatomical bases. Digestion and absorption of carbohydrates, lipids and proteins. Management of lipids, calcium, iron, vitamin B12.
-Feeding control. Mechanisms of hunger and satiety control, factors that alter physiological controls, long-term feeding control.

HUMAN PHYSIOLOGY - MOD. 4

Code	A001245
CFU	3
Learning activities	Base
Area	Funzioni biologiche integrate di organi, sistemi e apparati umani
Academic discipline	BIO/09
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

3

Teacher

Alessandro Tozzi

Teachers

• Alessandro Tozzi

Hours

• 37.5 ore - Alessandro Tozzi

Language of instruction

Italian

Contents

CIRCULATORY SYSTEM
Principles of haemodynamics. Physiology of the heart: functional characteristics of the contractile myocardium, nodal tissue and conduction tissue. Electrophysiology and cardiac mechanics.
Circulation. The microcirculation and the lymphatic system. Local control of blood flow.
Nerve regulation of circulation. Mechanisms of blood pressure regulation.
Long-term regulation of blood pressure.
Venous return and cardiac output. District circulations.
Cardiocirculatory adaptations in exercise.

Reference texts

Fisiologia medica - F. Conti, Vol. 2, Edi Ermes

Fisiologia medica - Guyton & Hall.
di John E. Hall, Michael E. Hall

Educational objectives

Knowledge of the functioning of the cardiovascular system and homeostatic regulatory mechanisms.

Prerequisites

The student in order to understand the content covered in the teaching of Human Physiology and achieve the intended learning objectives must possess the fundamental knowledge derived from the previous teachings and in particular of:
Physics
Chemistry
Biochemistry
Human Anatomy.

Teaching methods

Frontal lessons; theoretical-practical lessons; distribution of teaching material on the Unistudium institutional website.

Other information

Learning verification modality

The level of learning achieved will be assessed by final oral examination consisting of two tests, which the student may take at different times. One test is designed to ascertain the level of knowledge attained on the theoretical contents indicated in the syllabus related to Organ Physiology (cardio-circulatory, respiratory, urinary and digestive systems) and the other on the contents related to the Physiology of the Nervous, muscular, and Endocrine Systems. In each test the student will be asked two questions by two different lecturers of the course. The test is considered passed if the student achieves a passing grade in both questions. The sequence of the tests is the student's choice. The oral examination will also test the student's ability to communicate with properties of language and organization of exposition on the topics under discussion and his or her ability to reason.
The final grade will result from the average of the marks obtained in the 4 questions.

Information on support services for students with disabilities and/or DSA visit http://www.unipg.it/disabilita-e-dsa

Extended program

CIRCULATORY SYSTEM
-General remarks. General considerations on the cardiovascular system: morphological organisation and fundamental principles of circulatory function. Physical characteristics of the circulation.
-Principles of haemodynamics. Equation of flow. Flow in the circulatory system, (cardiac output and venous return). Flow and kinetic energy. Simplified model of the creation of the pressure difference in the circulatory system. Distribution of blood volume in the different districts and filling pressure of the system in the absence of flow. Vascular compliance. Differences between arteries and veins. Vascular resistances. Pressures in the various districts in the presence of cardiac activity.
Hydrostatic pressure: effects on the circulation in the orthostatic position. Transmural pressure. Blood flow velocity and flow-velocity relationship. Pressure-velocity relationship (Bernoulli): influence on coronary circulation and stenosis. Laminar and turbulent motion, Reynold's number. Stenosis and turbulence.
Hagen-Poiseuille's law. Parameters determining vascular resistance. Pressure drop along the circulatory bed. Series and parallel resistances. Effects of pressure on vascular resistances, pressure-flow relationship in passive (pulmonary) and reactive (cerebral, renal) vessels. Viscosity. Effect of haematocrit on blood viscosity. Flow velocity and blood viscosity. Influence of plasma skimming and vessel calibre on blood viscosity. Blood viscosity in the microcirculation.
Summary of the most salient functional characteristics of the circulatory bed: blood volume distribution in the different portions of the circulatory bed, overall cross-sectional area in the different districts and flow velocities, resistance and pressures. Percentage distribution of flow in the different districts and principles governing distribution: spatial and temporal control.
-Heart. Functional characteristics of the contractile myocardium, nodal tissue and conduction tissue.
-Cardiac electrophysiology. Cardiac automatism (isolated heart) and its myogenic nature (Engelmann experiment in the embryonic chicken heart). Morphological basis of action potential conduction (gap junction, functional syncytium). Electrical behaviour of different cardiac tissues. Slow, lower amplitude action potentials and fast, higher amplitude potentials.
Action potentials in common myocytes. Ionic bases of depolarisation, plateau and repolarisation. Functional significance of plateau. Temporal relationship between electrical and contractile phenomena. Na, itO, Ca, iK, iK1 rectifying currents.
Cardiac pacemaker concept. Pacemaker hierarchy (Stannius ligatures). Physiology of nodal tissue. Sinus-atrial node. Ionic bases of the spontaneous genesis of the action potential in the sinoatrial node cells.Ionic currents: if sodium, calcium T, calcium L and Na, K. Inactivation of the K base current. Control of heart rate, action of the autonomic nervous system: parasympathetic and sympathetic. Direction of depolarisation.Atrio-ventricular node, mechanisms underlying atrio-ventricular delay: prenodal bundles. Conduction of the potential in the Hiss-Purkinje bundle.Identification of the temporal sequence of electrical activation of the various regions of the heart and the speed of conduction in the different parts of the conduction system.Extrasystole.Reentry phenomenon.
Electrocardiogram. Definition and characteristics.Relationship between electrical events of cardiac excitation and ECG waves.Physiological basis of the ECG.Concept of conducting volume, concept of equivalent dipole (potential jump) and instantaneous electric vector.Consideration of potentials recorded at the surface of a conducting volume. Electrocardiographic leads. Bipolar leads and Einthoven's triangle. Relationship between position of the exploring electrode and recorded potential. Goldberger and Wilson unipolar leads. Correlation between excitation progression in the heart and ECG tracing.Interpretation of the ECG for diagnostic purposes.The mid-ventricular electrical axis.ECG recording.
-Cardiac mechanics.Excitation-contraction coupling in the cardiac fibre, function of Ca2+ ions and transverse tubules.Ca2+ ejection mechanisms (Ca2+ pump, Ca2+/Na+ exchanger) Concept of contractility.Effect of noradrenaline and acetylcholine on contractility (inotropism) and muscle relaxation.Effect of cardiac gangliosides.
Isometric and isotonic contraction, length-tension relationship in the cardiac fibre.Concept of preload and afterload.Pressure-volume curves and changes in preload, afterload and contractility. Laplace's law applied to the heart.
Cardiac cycle, atrial, ventricular and arterial pressures in the various phases.Cardiac events over time (Wiggers).Differences between left and right ventricle.Valve physiology and cardiac tones (Echo-Doppler).Cardiac work: static (pressure) and dynamic (volume) work.Oxygen consumption and output.Cardiac output and cardiac index. Methods of measuring Cardiac Output, Fick's Principle, Dilution, Echodoppler, electromagnetic flowmetry. Control mechanisms of cardiac output. Heart rate control, role of the parasympathetic and sympathetic nervous systems.Bambridge reflex.Control of Systolic Output: Frank-Starling's law and role of heterometric control in maintaining constant output during preload and afterload increases. Contractility control, effects of sympathetic stimulation and homeometric control.Assessment of cardiac contractility.
-Circulation.Physiology of the arterial system.Vascular compliance, delayed compliance. Determinants of arterial pressure.Mean arterial pressure.Pulse blood pressure.Blood pressure measurement. Sphygmic wave.Arterial pulse changes along the arterial tree and flow velocity.Flowmetry.
-Microcirculation and the lymphatic system.Physiology of the microcirculation.Functional properties of capillaries.Blood-liquid interstitial exchanges: diffusion (Fick's law).Filtration and Starling equilibrium. Alterations of the hydrostatic-osmotic balance.Lymph formation.Role of the lymphatic system in controlling protein concentration, volume and pressure of the interstitial fluid. Lymph flow and interstitial pressure. Edema and determinants. -Local control of blood flow.Metabolic regulation, vasodilator substances.Endothelium-mediated regulation, endothelial release factors (role of nitric oxide).Self-regulation, Byliss: myogenic regulation.Humoral regulation of the circulation.Vasoconstricting agents (Catecholamines, Angiotensin, ADH). Vasodilating agents (Histamine, Bradykinin, Prostglandins).
-Nervous regulation of the circulation: Sympathetic nervous system and innervation of the vessels.Vasomotor centre: vasoconstrictor and vasodilator centre.Basal and resting tone of the vessel musculature, different role in the various circulatory districts.Sympathetic vasodilator system.Vasovagal syncope.Parasympathetic vasodilator system.
-Mechanisms of blood pressure regulation. an overview of short-, medium- and long-term mechanisms.Over-driving controls in the defence reaction and exercise.Role of the nervous system in the rapid control of blood pressure, reflex mechanisms in the maintenance of blood pressure. Baroreceptor control system.The function of the baroreceptors during changes in body position.Adaptation of the baroreceptors.Control of blood pressure by the chemoreceptors.Atrial reflexes in the regulation of blood pressure.Ischaemic response of the central nervous system.Cushing's reaction. -Long-term regulation of blood pressure.Role of the kidney: the kidney-body fluid system.Renal elimination curve.Fluid and salt intake.Equilibrium point and blood pressure.Shifts in the elimination and intake curve as determinants of long-term pressure change.The importance of sodium chloride in the kidney-body fluid ratio. The renin-angiotensin system, role in blood pressure control and hypertension.Renal function curve under sodium load.Summary of the integrated multifactorial system for blood pressure regulation.
-Venous return.Mean filling pressure and effect on venous return.Influences of lower limb valves, muscle pump, abdominal, intrathoracic and suction pressures during the cardiac cycle. The venous return curve.Effect of changes in volaemia and sympathetic tone on mean filling pressure and effect on the venous return curve.Venous return resistance, effect on the venous return curve.
-Venous return and cardiac output.Combined evaluation of cardiac output and venous return curves.Significance of right atrial pressure.Auxiliary factors influencing venous system and cardiac output (gravity, circulatory effects of respiratory activity).Compensation mechanisms in orthostatism. District circulations:Coronary circulation, pulmonary circulation, skin circulation, skeletal muscle circulation, cerebral circulation.
Cardiocirculatory adaptations in exercise.

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Cognomi M-Z

CFU

3

Teacher

Alessandro Tozzi

Teachers

• Alessandro Tozzi

Hours

• 37.5 ore - Alessandro Tozzi

Language of instruction

Italian

Contents

CIRCULATORY SYSTEM
Principles of haemodynamics. Physiology of the heart: functional characteristics of the contractile myocardium, nodal tissue and conduction tissue. Electrophysiology and cardiac mechanics.
Circulation. The microcirculation and the lymphatic system. Local control of blood flow.
Nerve regulation of circulation. Mechanisms of blood pressure regulation.
Long-term regulation of blood pressure.
Venous return and cardiac output. District circulations.
Cardiocirculatory adaptations in exercise.

Reference texts

Fisiologia medica - F. Conti, Vol. 2, Edi Ermes

Fisiologia medica - Guyton & Hall.
di John E. Hall, Michael E. Hall

Educational objectives

Knowledge of the functioning of the cardiovascular system and homeostatic regulatory mechanisms.

Prerequisites

The student in order to understand the content covered in the teaching of Human Physiology and achieve the intended learning objectives must possess the fundamental knowledge derived from the previous teachings and in particular of:
Physics
Chemistry
Biochemistry
Human Anatomy.

Teaching methods

Frontal lessons; theoretical-practical lessons; distribution of teaching material on the Unistudium institutional website.

Other information

Learning verification modality

The level of learning achieved will be assessed by final oral examination consisting of two tests, which the student may take at different times. One test is designed to ascertain the level of knowledge attained on the theoretical contents indicated in the syllabus related to Organ Physiology (cardio-circulatory, respiratory, urinary and digestive systems) and the other on the contents related to the Physiology of the Nervous, muscular, and Endocrine Systems. In each test the student will be asked two questions by two different lecturers of the course. The test is considered passed if the student achieves a passing grade in both questions. The sequence of the tests is the student's choice. The oral examination will also test the student's ability to communicate with properties of language and organization of exposition on the topics under discussion and his or her ability to reason.
The final grade will result from the average of the marks obtained in the 4 questions.

Information on support services for students with disabilities and/or DSA visit http://www.unipg.it/disabilita-e-dsa

Extended program

CIRCULATORY SYSTEM
-General remarks. General considerations on the cardiovascular system: morphological organisation and fundamental principles of circulatory function. Physical characteristics of the circulation.
-Principles of haemodynamics. Equation of flow. Flow in the circulatory system, (cardiac output and venous return). Flow and kinetic energy. Simplified model of the creation of the pressure difference in the circulatory system. Distribution of blood volume in the different districts and filling pressure of the system in the absence of flow. Vascular compliance. Differences between arteries and veins. Vascular resistances. Pressures in the various districts in the presence of cardiac activity.
Hydrostatic pressure: effects on the circulation in the orthostatic position. Transmural pressure. Blood flow velocity and flow-velocity relationship. Pressure-velocity relationship (Bernoulli): influence on coronary circulation and stenosis. Laminar and turbulent motion, Reynold's number. Stenosis and turbulence.
Hagen-Poiseuille's law. Parameters determining vascular resistance. Pressure drop along the circulatory bed. Series and parallel resistances. Effects of pressure on vascular resistances, pressure-flow relationship in passive (pulmonary) and reactive (cerebral, renal) vessels. Viscosity. Effect of haematocrit on blood viscosity. Flow velocity and blood viscosity. Influence of plasma skimming and vessel calibre on blood viscosity. Blood viscosity in the microcirculation.
Summary of the most salient functional characteristics of the circulatory bed: blood volume distribution in the different portions of the circulatory bed, overall cross-sectional area in the different districts and flow velocities, resistance and pressures. Percentage distribution of flow in the different districts and principles governing distribution: spatial and temporal control.
-Heart. Functional characteristics of the contractile myocardium, nodal tissue and conduction tissue.
-Cardiac electrophysiology. Cardiac automatism (isolated heart) and its myogenic nature (Engelmann experiment in the embryonic chicken heart). Morphological basis of action potential conduction (gap junction, functional syncytium). Electrical behaviour of different cardiac tissues. Slow, lower amplitude action potentials and fast, higher amplitude potentials.
Action potentials in common myocytes. Ionic bases of depolarisation, plateau and repolarisation. Functional significance of plateau. Temporal relationship between electrical and contractile phenomena. Na, itO, Ca, iK, iK1 rectifying currents.
Cardiac pacemaker concept. Pacemaker hierarchy (Stannius ligatures). Physiology of nodal tissue. Sinus-atrial node. Ionic bases of the spontaneous genesis of the action potential in the sinoatrial node cells.Ionic currents: if sodium, calcium T, calcium L and Na, K. Inactivation of the K base current. Control of heart rate, action of the autonomic nervous system: parasympathetic and sympathetic. Direction of depolarisation.Atrio-ventricular node, mechanisms underlying atrio-ventricular delay: prenodal bundles. Conduction of the potential in the Hiss-Purkinje bundle.Identification of the temporal sequence of electrical activation of the various regions of the heart and the speed of conduction in the different parts of the conduction system.Extrasystole.Reentry phenomenon.
Electrocardiogram. Definition and characteristics.Relationship between electrical events of cardiac excitation and ECG waves.Physiological basis of the ECG.Concept of conducting volume, concept of equivalent dipole (potential jump) and instantaneous electric vector.Consideration of potentials recorded at the surface of a conducting volume. Electrocardiographic leads. Bipolar leads and Einthoven's triangle. Relationship between position of the exploring electrode and recorded potential. Goldberger and Wilson unipolar leads. Correlation between excitation progression in the heart and ECG tracing.Interpretation of the ECG for diagnostic purposes.The mid-ventricular electrical axis.ECG recording.
-Cardiac mechanics.Excitation-contraction coupling in the cardiac fibre, function of Ca2+ ions and transverse tubules.Ca2+ ejection mechanisms (Ca2+ pump, Ca2+/Na+ exchanger) Concept of contractility.Effect of noradrenaline and acetylcholine on contractility (inotropism) and muscle relaxation.Effect of cardiac gangliosides.
Isometric and isotonic contraction, length-tension relationship in the cardiac fibre.Concept of preload and afterload.Pressure-volume curves and changes in preload, afterload and contractility. Laplace's law applied to the heart.
Cardiac cycle, atrial, ventricular and arterial pressures in the various phases.Cardiac events over time (Wiggers).Differences between left and right ventricle.Valve physiology and cardiac tones (Echo-Doppler).Cardiac work: static (pressure) and dynamic (volume) work.Oxygen consumption and output.Cardiac output and cardiac index. Methods of measuring Cardiac Output, Fick's Principle, Dilution, Echodoppler, electromagnetic flowmetry. Control mechanisms of cardiac output. Heart rate control, role of the parasympathetic and sympathetic nervous systems.Bambridge reflex.Control of Systolic Output: Frank-Starling's law and role of heterometric control in maintaining constant output during preload and afterload increases. Contractility control, effects of sympathetic stimulation and homeometric control.Assessment of cardiac contractility.
-Circulation.Physiology of the arterial system.Vascular compliance, delayed compliance. Determinants of arterial pressure.Mean arterial pressure.Pulse blood pressure.Blood pressure measurement. Sphygmic wave.Arterial pulse changes along the arterial tree and flow velocity.Flowmetry.
-Microcirculation and the lymphatic system.Physiology of the microcirculation.Functional properties of capillaries.Blood-liquid interstitial exchanges: diffusion (Fick's law).Filtration and Starling equilibrium. Alterations of the hydrostatic-osmotic balance.Lymph formation.Role of the lymphatic system in controlling protein concentration, volume and pressure of the interstitial fluid. Lymph flow and interstitial pressure. Edema and determinants. -Local control of blood flow.Metabolic regulation, vasodilator substances.Endothelium-mediated regulation, endothelial release factors (role of nitric oxide).Self-regulation, Byliss: myogenic regulation.Humoral regulation of the circulation.Vasoconstricting agents (Catecholamines, Angiotensin, ADH). Vasodilating agents (Histamine, Bradykinin, Prostglandins).
-Nervous regulation of the circulation: Sympathetic nervous system and innervation of the vessels.Vasomotor centre: vasoconstrictor and vasodilator centre.Basal and resting tone of the vessel musculature, different role in the various circulatory districts.Sympathetic vasodilator system.Vasovagal syncope.Parasympathetic vasodilator system.
-Mechanisms of blood pressure regulation. an overview of short-, medium- and long-term mechanisms.Over-driving controls in the defence reaction and exercise.Role of the nervous system in the rapid control of blood pressure, reflex mechanisms in the maintenance of blood pressure. Baroreceptor control system.The function of the baroreceptors during changes in body position.Adaptation of the baroreceptors.Control of blood pressure by the chemoreceptors.Atrial reflexes in the regulation of blood pressure.Ischaemic response of the central nervous system.Cushing's reaction. -Long-term regulation of blood pressure.Role of the kidney: the kidney-body fluid system.Renal elimination curve.Fluid and salt intake.Equilibrium point and blood pressure.Shifts in the elimination and intake curve as determinants of long-term pressure change.The importance of sodium chloride in the kidney-body fluid ratio. The renin-angiotensin system, role in blood pressure control and hypertension.Renal function curve under sodium load.Summary of the integrated multifactorial system for blood pressure regulation.
-Venous return.Mean filling pressure and effect on venous return.Influences of lower limb valves, muscle pump, abdominal, intrathoracic and suction pressures during the cardiac cycle. The venous return curve.Effect of changes in volaemia and sympathetic tone on mean filling pressure and effect on the venous return curve.Venous return resistance, effect on the venous return curve.
-Venous return and cardiac output.Combined evaluation of cardiac output and venous return curves.Significance of right atrial pressure.Auxiliary factors influencing venous system and cardiac output (gravity, circulatory effects of respiratory activity).Compensation mechanisms in orthostatism. District circulations:Coronary circulation, pulmonary circulation, skin circulation, skeletal muscle circulation, cerebral circulation.
Cardiocirculatory adaptations in exercise.

Obiettivi Agenda 2030 per lo sviluppo sostenibile

HUMAN PHYSIOLOGY - MOD. 5

Code	A001246
CFU	3
Teacher	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)

Cognomi A-L

CFU

3

Teacher

Roberto Panichi

Teachers

• Roberto Panichi

Hours

• 37.5 ore - Roberto Panichi

Language of instruction

Italian

Contents

Respiratory system:
Respiratory mechanic. Pulmonary circulation. Gaseous Exchange. Gas Transport in the blood. Peripheral gas exchange. 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

F. Conti "Fisiologia Medica", Vol. 2, Ed. Edi-ERMES.
Guyton and Hall "Fisiologia Medica", Ed. Edra.
Berne & Levy "Fisiologia" Ed. Casa Editrice Ambrosiana.
JB West, AM Luks “West - Fisiologia della Respirazione", Ed. Piccin.
MG Levitzky “Pulmonary Physiology” Ed. McGraw-Hill.
DC Eaton, JP Pooler “ Vander’s - Renal Physiology” Ed. McGraw-Hill.
Academic content made available on the Unistudium-Perugia online platform.

Educational objectives

Knowledge of the respiratory and urinary systems' functioning and the integrated homeostatic regulatory mechanisms.

Prerequisites

The student is required to have basic knowledge of Physics, Chemistry, Biochemistry and Human Anatomy.

Teaching methods

Teaching is organized through:
32 hours of face-to-face lessons on all subjects of the program with discussion in the classroom and
1 Practical training on spirometry. The students will be divided into groups (25-30 students for a group), and with a tutor, they will perform spirometric examinations followed by an analysis of results and discussion.
The teaching of the module integrates with that of the others planned for the Human Physiology course.

Other information

For information on support services for students with disabilities or DSA, visit http://www.unipg.it/disabilita-e-dsa.

Learning verification modality

Learning is assessed through two oral tests the student can take at different times. Each test, lasting approximately twenty-five minutes, is divided into two questions, which are asked to the student by different course teachers. One test focuses on discussing problems relating to the contents of the program developed in Cardiovascular, Respiratory, Urinary, and Digestive Physiology. In contrast, the other focuses on discussing contents developed in the Physiology of the nervous, muscular, and endocrine systems. The student decides which tests to take in what order. A test is passed when the student reaches a sufficient grade on both questions. The final grade for the Human Physiology course is the arithmetic average of the grades obtained in the individual questions.

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, the 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, and dead space ventilation. The forced expiratory vital capacity and forced expiratory volume in 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 fluid exchange in the lungs, role of lymphatics, pulmonary edema. Measurement of anatomical and physiologic shunts.
Gaseous exchange: Composition and partial pressures in the atmospheric, inspired, 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 oblongata, 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. Pulmonary, bronchial and thoracic receptors regulate respiratory activity and redistribute 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, renal plasmatic flow, and 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 excretion. Clearance and measurement of tubular reabsorption and secretion, tubular load, excreted load, and reabsorbed or secreted load. Active and passive absorption, Maximum tubular transport.
Reabsorption and secretion in different segments of the nephron. Tubular reabsorption regulation. Processing of the main plasma constituents in the kidney. Glucose: Glucose reabsorption, glucose threshold, and glucose loss 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 water output. 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 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: bicarbonate reabsorption, tileable acidity, excretion of ammonium ion. Respiratory and metabolic acidosis and alkalosis and compensation mechanisms.

Cognomi M-Z

CFU

3

Teacher

Roberto Panichi

Teachers

• Roberto Panichi

Hours

• 37.5 ore - Roberto Panichi

Language of instruction

Italian

Contents

Respiratory system:
Respiratory mechanic. Pulmonary circulation. Gaseous Exchange. Gas Transport in the blood. Peripheral gas exchange. 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

F. Conti "Fisiologia Medica", Vol. 2, Ed. Edi-ERMES.
Guyton and Hall "Fisiologia Medica", Ed. Edra.
Berne & Levy "Fisiologia" Ed. Casa Editrice Ambrosiana.
JB West, AM Luks “West - Fisiologia della Respirazione", Ed. Piccin.
MG Levitzky “Pulmonary Physiology” Ed. McGraw-Hill.
DC Eaton, JP Pooler “ Vander’s - Renal Physiology” Ed. McGraw-Hill.
Academic content made available on the Unistudium-Perugia online platform.

Educational objectives

Knowledge of the respiratory and urinary systems' functioning and the integrated homeostatic regulatory mechanisms.

Prerequisites

The student is required to have basic knowledge of Physics, Chemistry, Biochemistry and Human Anatomy.

Teaching methods

Teaching is organized through:
32 hours of face-to-face lessons on all subjects of the program with discussion in the classroom and
1 Practical training on spirometry. The students will be divided into groups (25-30 students for a group), and with a tutor, they will perform spirometric examinations followed by an analysis of results and discussion.
The teaching of the module integrates with that of the others planned for the Human Physiology course.

Other information

For information on support services for students with disabilities or DSA, visit http://www.unipg.it/disabilita-e-dsa.

Learning verification modality

Learning is assessed through two oral tests the student can take at different times. Each test, lasting approximately twenty-five minutes, is divided into two questions, which are asked to the student by different course teachers. One test focuses on discussing problems relating to the contents of the program developed in Cardiovascular, Respiratory, Urinary, and Digestive Physiology. In contrast, the other focuses on discussing contents developed in the Physiology of the nervous, muscular, and endocrine systems. The student decides which tests to take in what order. A test is passed when the student reaches a sufficient grade on both questions. The final grade for the Human Physiology course is the arithmetic average of the grades obtained in the individual questions.

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, the 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, and dead space ventilation. The forced expiratory vital capacity and forced expiratory volume in 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 fluid exchange in the lungs, role of lymphatics, pulmonary edema. Measurement of anatomical and physiologic shunts.
Gaseous exchange: Composition and partial pressures in the atmospheric, inspired, 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 oblongata, 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. Pulmonary, bronchial and thoracic receptors regulate respiratory activity and redistribute 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, renal plasmatic flow, and 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 excretion. Clearance and measurement of tubular reabsorption and secretion, tubular load, excreted load, and reabsorbed or secreted load. Active and passive absorption, Maximum tubular transport.
Reabsorption and secretion in different segments of the nephron. Tubular reabsorption regulation. Processing of the main plasma constituents in the kidney. Glucose: Glucose reabsorption, glucose threshold, and glucose loss 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 water output. 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 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: bicarbonate reabsorption, tileable acidity, excretion of ammonium ion. Respiratory and metabolic acidosis and alkalosis and compensation mechanisms.