FISIOLOGIA UMANA I M - Z

Knowledge of how the body works, from basic mechanisms at the molecular level to the functions of cells and organs up to the integration of organ functions in complex organisms.

Knowledge of all the topics listed in the attached program. Ability to analyze and subsequently summarize the topics,  to understand the mechanisms in detail and subsequently trace the purposes of the function. Ability to present the topics in an appropriate manner, both analytically and synthetically. Understanding of the importance of in-depth knowledge of the topics of Physiology for professions in the medical-health field.

At the end of the course, the student will have the knowledge necessary to understand the mechanisms underlying the functioning of the apparatuses and systems of the human body, also acquiring advanced notions of anatomical organization and physiopathology.

AUTONOMOUS NERVOUS SYSTEM

Anatomo-functional organization of the nervous system: functions and modes of action; Sympathetic and parasympathetic system, neurotransmitters of the autonomic nervous system, integrated functions and higher control mechanisms.

BLOOD AND LYMPH

Blood composition: corpuscular part and liquid part, hematocrit, plasma proteins and electrophoretic proteinogram, main laboratory tests, blood count.

Red blood cells: erythropoiesis and iron metabolism, hemocatheresis, hemolysis, respiratory functions of red blood cells, affinity of hemoglobin for respiratory gases, O2 intake and release by hemoglobin. Physio-pathological implications: anemia

Leukocytes: distribution and leukocyte formula, functions. Physio-pathological implications: infections.

Platelets: functions, hemostasis and coagulation. Physiopathological implications: anti-aggregating and anti-coagulant agents.

The lymphatic system: lymphatic stations, composition and function of lymph. The blood-tissue barrier.

CARDIOCIRCULATORY SYSTEM

Electrical function of the heart: excitability, cardiac automaticity and cardiac pacemaker, refractory periods, conduction.

Mechanical function of the heart: cardiac cycle, movements of the valves and variations in pressure in the atria and ventricles during the phases of the cardiac cycle, duration of the phases of the cardiac cycle, cardiac output, Starling's law of the heart, Laplace's law applied to the heart. Determination of cardiac output and most commonly used methods. Heart sounds: auscultation sites and characteristics of heart sounds. Physiopathological implications: valvular insufficiency and stenosis.

Properties of the heart: chronotropism, bathmotropism, dromotropism, inotropism. Notes on pharmacology: beta-blockers, calcium antagonists, digitalis.

Nervous control of the heart: ANS, bulbar and hypothalamic centers, reflex regulation of the cardiovascular system.

Work of the heart, cardiac metabolism and oxygen consumption.

Electrocardiography: Einthoven's triangle, leads, standard electrocardiographic conventions, analysis of the most common tracings, determination of the heart axis and its functional significance. Echocardiogram. Physiopathological implications: flutter, fibrillation, extrasystole, bundle branch block, infarction.

Systemic blood pressure: systolic, diastolic, differential, mean. Short- and long-term regulatory mechanisms of systemic arterial pressure (chemoreceptors and baroreceptors, renin-angiotensin system, aldosterone, bradykinin, catecholamines, dopamine, serotonin). Arterial pulse. Determination of systemic arterial pressure. Pathophysiological implications: arterial hypertension

Venous bed: distensibility of veins, posture and veins, venous return to the heart, phlebogram, venous pressure and its variations, jugular pulse. Pathophysiological implications: venous insufficiency

Special vascular circuits: district distribution of cardiac output, coronary, cerebral, cutaneous, muscular, hepatosplanchnic, pulmonary, renal, splenic, fetal circulation.

RESPIRATORY SYSTEM

Respiratory mechanics: General considerations. Functions of the upper airways. Generation of pressure gradients: eupneic inspiration and expiration. Role of the respiratory muscles and importance of the pleura. Elastic recoil of the lung. Resistance of the airways to flow. Effects of surface tension on breathing and role of surfactant. Definition of the concepts of compliance and lung elasticity and applications to clinical practice. Spirometry, lung volumes and capacities. Forced spirometry and lung function tests, notes on obstructive and restrictive conditions. Examples of physiopathology aimed at understanding physiological mechanisms.

External and internal breathing: Ventilation-perfusion coupling. V/Q ratio and regulatory mechanisms. Alveolar compartment, role of membrane thickness and surface in respiratory exchanges. Partial pressures of gases, solubility and physical laws applied to respiratory physiology. Role of red blood cells and hemoglobin. Recall of hemoglobin function, oxygen dissociation curve, oxygen saturation and clinical implications. Definition of hypoxia. Types of hypoxia and clinical implications.

Regulation of breathing: Definition of the nervous structures fundamental to the generation of the respiratory pattern: pneumotactic and apneustic centers, dorsal and ventral respiratory groups. Generation of the nervous signal and mechanical transduction: frequency and depth of breathing. Central and peripheral chemoreceptors. Other regulatory mechanisms: stretch receptors, irritants, juxtacapillary receptors, muscle proprioceptors. Voluntary control of breathing.

URINARY SYSTEM

Functions of the Kidney. General. Notes on functional anatomy. The functional unit of the kidney: the nephron. Differences between cortical nephrons and juxtamedullary nephrons. The renal vascular bed.

Functions of the glomerulus. Mechanisms that determine glomerular filtration. Effective filtration pressure, characteristics of the ultrafiltrate, resistances opposed to the flow of the ultrafiltrate liquid or tubular liquid. Glomerular filtration rate. Inulin clearance and creatinine clearance. Mechanisms capable of modifying the volume of the ultrafiltrate. Concept of filtered load and its functional significance.

Functions of the tubules. Reabsorption processes at the level of the proximal tubule. Active and passive transport. The concept of renal threshold and that of maximum tubular transport. Glucose reabsorption and the appearance of glycosuria. Facultative reabsorption at the level of the distal tubule. Action of aldosterone. Concentration of urine. Loop of Henle and countercurrent multiplication mechanism. Vasa recta and countercurrent exchange mechanism. Action of vasopressin. Tubular secretion (hydrogen ions, potassium and ammonium ion). Acidification of urine.

Renal circulation, extrinsic control of renal circulation. Renal self-regulation of blood flow in relation to systemic arterial pressure (myogenic mechanism and tubuloglomerular feedback).

Systemic functions of the kidney. Control of systemic arterial pressure. Control of osmolarity. Regulation of the composition and volume of organic fluids. Production of erythropoietin. Endocrine functions of the kidney.

GASTROENTERIC SYSTEM, METABOLISM AND NUTRITION

Digestive processes: Digestive tract. Chewing. Salivary secretion. Composition and function of saliva. Conditioned reflexes. Swallowing. Gastric filling. Movements of the stomach. Gastric secretion. Nervous and humoral regulation of gastric secretion. Pancreatic secretion. Secretin and pancreozymin. Pancreatic juice. Secretion of the small intestine and colon. Movements of the small intestine. Gastrointestinal hormones.

Gastrointestinal nervous system: Intrinsic and extrinsic innervation. Endoluminal pressure regimes. Movements of the villi. Types of intestinal movements. Esophageal, gastric and intestinal motility. Myogenic and neurogenic mechanisms of intestinal movements. Visceral reflexes. Motility of the colon. Defecation.

Liver: The functional unit of the liver. Hepatic arterial and portal circulation. Overview of the main functions of the liver. Hepatic metabolism, protein synthesis and reserve function. Biotransformation of drugs and toxins. Liver involvement in hematopoiesis and blood coagulation. Bile synthesis and excretion. Hepatic bile and cystic bile. Entero-hepatobiliary circulation. Hemoglobin degradation process: jaundice and its various forms.

Metabolism: Recall of the general chemical characteristics of carbohydrates, lipids and proteins. Carbohydrate metabolism: carbohydrates in foods, processes of digestion, absorption and metabolic fate. Lipid metabolism: processes of digestion, absorption and metabolic fate. Protein metabolism: carbohydrates in foods, processes of digestion, absorption and metabolic fate.

Nutrition: Principles of dietetics. Energy requirements. Composition of the normal diet. Mechanisms of hunger and satiety.

Carbone, Aicardi, Maggi - FISIOLOGIA  EdiSES 

Silverthorn - FISIOLOGIA  Pearson Italia

Stanfield - FISIOLOGIA  EdiSES 

Guyton & Hall - FISIOLOGIA MEDICA  EdiSES 

Fox- FISIOLOGIA UMANA Piccin