MODULE OF PHYSIOLOGY OF ORGANS, APPARATUS AND INTEGRATED PHYSIOLOGY (50 hours provided)
Physiology of the Cardiocirculatory System. Blood: blood and plasma volume, composition and functions; hemostasis and erythropoiesis. Cardiac tissues: common myocardium and specific myocardium. Electrical activity of fast-conducting cells (common myocardium and conduction system) and slow-conducting cells (cardiac pacemakers). ECG. Mechanical characteristics of the whole heart: the heart as a pump. The cardiac cycle; Ventricular compliance and intracavitary pressure gradients. Tension - length relationship, comparison with that of skeletal muscle; law of the heart of Maestrini-Frank-Starling. Relationship between radius / thickness isometric tension: Laplace law. The work and the performance of the heart. The vascular system: structure and function of the walls of arterial, capillary and venous vessels; Vascular compliance; viscoelastic behavior, elastic hysteresis, aortic windkessel, arterial pulse (sphygmic wave). Definition of hemodynamic pressure, arterial pressure, systolic, diastolic and mean pressure, transmural pressure and wall tension, pressure Hydrostatic. The laws of hydrostatics (Pascal Laws). Relationship between pressure, flow and resistance. Laws of hemodynamics: Bernoulli's theorem, Hagen-Poiseuille's law. Microcirculation and interstitial plasma-liquid exchanges. Cardiac output: definition, measurement. Venous return: average filling pressure and central venous pressure. Functional coupling between the heart and the vascular system: preload and afterload. Regulation of cardiac output and systemic blood pressure. District circulations: their regulation and self-regulation.
Physiology of the kidney and urinary tract
Compartments, volume, composition of body fluids. Water balance. The functions of the kidney in the homeostasis of the organism: regulation of the osmolarity and volume of body fluids; regulation of arterial pressure, renal regulation of acid-base balance. The endocrine functions of the kidney. The nephron as a functional anatomical unit. Renal circulation. Regulation of renal flow and glomerular filtration rate: self-regulation and regulation. Filtration pressure. Kidney processes: filtration, absorption, secretion and excretion. Tubular function: transport of water and solutes along the nephron. Mechanisms of concentration and dilution of urine. Clearance of free water and osmolar clearance. Actions of ADH on the kidney. Osmotic and hemodynamic control of ADH secretion. Mechanism of thirst. Control of extracellular fluid volume and regulation of renal excretion of NaCl. Signals that control renal excretion of water and NaCl: renal sympathetic nerves, renin-angiotensin-aldosterone system, atrial natriuretic peptide. Control of sodium excretion under normal VEC conditions under conditions of expansion and volume reduction. Renal clearances. The urinary tract and the bladder: a reflection of urination and control by the higher centers. Acid-base balance and its regulation. The chemical and physiological buffer systems. The Henderson-Hasselbach equation. Respiratory regulation and renal regulation of acid-base balance. Alkaline reserve: reabsorption and production of bicarbonate. Urine acidification. Acidosis and respiratory and metabolic alkalosis: compensation mechanisms. Volume and composition of urine.
Physiology of the gastrointestinal system
General principles of gastrointestinal function. Blood circulation. Mechanisms of nervous regulation of gastrointestinal functions: Autonomic Nervous System and Enteric Nervous System. Hormonal regulation mechanisms. Control by the higher centers. Types of motility in various segments of the intestine. Sphincter function. Digestive secretions: salivary secretion, gastric secretion, pancreatic secretion, secretions of the small and large intestine. Liver functions. Secretion and function of bile. Digestion and absorption of nutritive principles. Mechanisms and control of intestinal absorption / secretion of water and salts. Stool formation. Basal metabolism. Regulation of energy supply: hunger and satiety. Respiratory quotient.
Respiratory System Physiology Module (25 hours delivered). General information on the functions of the respiratory system. Action of the respiratory muscles. The respiratory cycle. Pleural pressure. Modifications of pleural, alveolar and air flow during a respiratory cycle. Dynamic pulmonary mechanics: flow and resistance in the airways, maximal expiratory flows; flow-volume diagrams. Static pulmonary mechanics: pressure-volume curves of the lung, chest and thorax-lung system, compliance, Laplace's law applied to the lung, contribution of surface tension to pulmonary elasticity, surfactant factor and its physiological significance. Respiratory work. Composition of atmospheric, inspired, exhaled and alveolar air. Oxygen waterfall. Laws of gases and their application in respiratory exchanges. Mechanisms of pulmonary gaseous exchange. Definition of ventilation: pulmonary ventilation and alveolar ventilation. Pressure and pressure gradients in the respiratory tree. Alveolar gas equation. Alveolus-capillary barrier. Measurement of pulmonary diffusion capacity. Measurement of anatomical and physiological dead space. Volumes and lung capacity. Pulmonary circulation: peculiarities and values. Pulmonary shunts. Ventilation-perfusion ratio: regional lung differences in the ventilation-perfusion ratio; excess ventilation compared to perfusion; excess of perfusion compared to ventilation. Central and peripheral ventilation regulation: function of peripheral and central chemoreceptors. Ventilatory responses to changes in the partial pressure of oxygen, carbon dioxide and the hydrogenionic concentration in the arterial blood. Hypoxia and hypercapnia. Voluntary and reflexive respiration: cortical and truncatedphalic control. Bulbar and pontine respiratory centers. Lung receptors and respiratory reflexes. Breath of Hering Breuer. Factors that modulate the apnea times. Periodic breathing. Effect of vagal action on breathing. Forms of oxygen transport in the blood. Factors that influence the link between oxygen and hemoglobin. Quantitative aspects of oxygen transport in the blood. Transport forms of carbon dioxide in the blood. Quantitative aspects of the transport of carbon dioxide in the blood. Interaction between oxygen transport and carbon dioxide. Tissue respiration. Respiratory quotient.
PHYSIOLOGY MODULE OF THE PHYSICAL EXERCISE (25 hours provided)
Cardiocirculatory and respiratory metabolic adaptations to physical exercise. Aerobic and anaerobic capacity and training effects. Muscular fatigue. Aerobic and anaerobic oxygen debt. Physiological consequences of training. Energy costs of exercise. Measurement of muscle strength and strength and power training; structural and functional changes induced by force training. Determination of body composition. Body weight control. Hunger and appetite. Adjustment of thirst during physical exercise Thermoregulation: adaptation to heat and cold, physical and physiological mechanisms of thermoregulation. Hypobaric environment: Adaptations of man to altitude, space flight and in the absence of gravity. Hyperbaric environment: adaptation to sea and swimming physiology.
MODULE OF PHYSIOLOGY OF THE ENDOCRINE SYSTEM (25 hours provided)
General principles of the endocrine system. Background and concept of homeostasis. Nervous, hormonal, paracrine and autocrine communication. Hormones: classification, biosynthesis, secretion. Blood transport and protein binding, free quota. Mechanism of action, hormone-receptor binding: binding studies, membrane receptors and signal transduction pathways, intracellular receptors. Receptorial desensitization (homologous, heterologous). Regulation of hormonal secretion, feedback control mechanisms, circadian rhythms and hormonal secretion. Overview of the methods for the determination of the plasma concentration of hormones (biological dosage, radioimmunoassay and enzyme immunoassay).Hypothalamus-hypophysis axis
Role of the hypothalamus in the control of hormone secretion. Hypothalamic neuroendocrine cells. Functional aspects of the hypophyseal portal circle. Neurohypophysis hormones: oxytocin and vasopressin. Adenohypophysis. Endocrine growth regulation (GH). Secretion of secretion and circadian rhythm. Variations with age. Factors that stimulate and inhibit Somatomedine or IGF secretion. Feedback control. Actions of GH. Prolactin. Hypothalamic-pituitary-thyroid axis: TSH, thyroid hormones T3 and T4. Synthesis, deposit, circulation and blood transport. Factors that regulate secretion and feedback control mechanisms. Thyroid hormone actions. Effects on the SNA and on the physiological parameters of the organism. Effects on growth (bone and cartilage) and on CNS development. Effects on heat production. Enhancement of the effects of others hormones. Hypothalamus - pituitary - adrenal axis: ACTH, cortisol, aldosteone, dehydroepiandrosterone (DHEA). Glycocorticoids (Cortisol): Secretion rhythms. Circadian rhythms. Factors that regulate secretion and feedback control mechanisms. Actions on target organs: actions on metabolism, anti-insulin effects, actions on muscle, bone, connective tissue, actions on the cardiovascular system, renal actions, neurological actions, anti-inflammatory and immunosuppressive action. Mineralocorticoids (aldosterone): see renal physiology. Endocrine control of sexual function and reproduction. Pituitary gonadotropins: stimulating and luteinizing follicle hormone. Secretion rhythms. Circadian rhythm. Variations with age. Gonadal hormones: estrogens and androgens. Control of the ovarian and menstrual cycle. Endocrine control during pregnancy, childbirth and lactation. Male gonadal hormones: interaction between the cells of Sertoli, Leydig, peritubular and germ cells. Male gametogenesis. Endocrine regulation of calcium and phosphorus metabolism Physiological role of calcium and phosphorus.Consequences of hyper and hypocalcemia. Distribution of calcium in the body .. Plasma calcium: ionized, complexed with low molecular weight anions and bound to proteins. Consequences of acidosis and alkalosis. Body muscle homeostasis: absorption, renal excretion, deposition and reabsorption of bone tissue. Endocrine regulation: Vitamin D, parathormone and calcitonin of the blood levels of calcium and phosphorus. Endocrine regulation of energy metabolism Regulation of energy deposits by leptin. Absorption and post-absorption states. Pancreatic islet hormones: insulin, glucagon, pancreatic polypeptide. Secretion mode. Effects on glucose, lipid and protein metabolism. Actions on muscle, adipose and hepatic tissue. Mutual and complementary interactions of pancreatic hormones. The adrenal medulla Adrenaline and noradrenaline. Adrenergic receptors. Biological effects. Control of secretion by the orthosympathetic. Coordinated nervous response, endocrine (catecholamines and cortisol) and behavioral stress.
