Medicine and Surgery

Core curriculum. This program will be carried out during the 2 year 1 semester of the CdS with schedule of the lessons published on the website of the CdS in the section dedicated to the timetable of the lessons. The topics are intended to be carried out in temporal succession as reported in the rest of the document. Cellular Physiology and Biophysics 3 CFU • What physiology studies. Concept of homeostasis. Body fluids. • Physiology of blood cells - The general functions of the blood. - The constituents of blood: plasma, erythrocytes, leukocytes, platelets. Hemostasis. • The cell as basic unit: electrical parameters of the cell membrane and equivalent circuits; resting potential; action potential. - Voltage-gated ion channels. - Biophysical methods for the study of membrane electrical events. • Neurotransmitters • Electrical synapses: structure and function. - • Chemical synapses. Spontaneous and evoked transmitter release. Synaptic potential; spatial and temporal summation. The neuromuscular junction. • Membrane receptors: Ionotropic receptor families: structural analogies and functional peculiarities. - Metabotropic receptor families: structural analogies and functional diversity. - Second messenger systems and signal transduction. Synaptic activity and cognitive and mnemonic processes. • Muscle physiology 1 CFU The muscle: structure and function of the various types of muscle. - The contraction of skeletal, smooth and cardiac muscle. • Ortho and parasympathetic autonomic nervous system. Respiratory and cardiocirculatory centers 2 CFU • Physiology of the heart and blood circulation Laws of fluid mechanics applied to blood circulation. Arterial pressure and peripheral resistance. The heart: physiological aspects of the myocardium; the cardiac cycle. Cardiac output and venous return. Excitation of the myocardium and impulse conduction; nerve control mechanisms. - The electrocardiogram. - Microcirculation and lymphatic system: Exchanges between blood and tissues. - Control of blood flow and arterial pressure. Methods of measuring blood pressure. • Physiology of respiration 2 CFU Respiration: functional structure of the lung. - Pulmonary pressures and ventilation; lung volumes - Mechanical properties of the lung. - The pulmonary circulation. - Gas exchanges - Transport of respiratory gases. - Breathing control.

Previous knowledge of anatomy is recommended but not a prerequisite.

For the examination of the exam, we suggest a theoretical deepening already from the beginning of the course attendance. For the purpose of consultation and in-depth study, the recommended books are: Guyton and Hall: Human Physiology. EdiSES, 2000 Berne and Levy: Physiology. Ambrosiana Publishing, 2000 Baldissera: Physiology and Medical Biophysics. Poletto Publisher E. Kandel: Principles of Neural Science. McGraw-Hill Companies, 2000 (for consultation in the library) E. Kandel: Principles of Neural Science. McGraw-Hill Companies, 2000 (for consultation in the library) Other teaching aids for Human Physiology I

The teacher delivers lectures with traditional methods with audiovisual aids and scheduling of lessons as reported on GOMP Aule/Orari system, published on the website of the CdS. The teacher provides teaching to small groups during the professionalizing activities (APP). The lessons of the Physiology I course are held in person and online mode on Tuesdays from 13.30 to 17.30 and on Thursdays from 9.00 to 13.00 at the Medicine and Surgery office of Corso Repubblica in Latina in the first semester. Link to the material of the lessons on elearning: https://elearning.uniroma1.it/course/view.php?id=2969 Link for lessons unless otherwise specified on elearning: https://uniroma1.zoom.us/j/7128261193

According the Regulations of the CdS, the student must attend the educational and professionalizing activities of the CdS. The frequency is checked by the teachers through signature lists provided by the academic office, as established by CCL. The certificate of mandatory attendance to the teaching course is required to the student to be admitted at the final test.

This course includes for the final evaluation a exam written, to pass the course of Physiology I the student must achieve a grade of not less than 18/30. The student must demonstrate that he has acquired a sufficient knowledge of the integrated physiology as developed in classes. To achieve a score of 30/30 cum laude, the student must instead demonstrate that he has acquired an excellent knowledge of all the topics covered during the course, being able to connect them in a logical and coherent way. Types of verification: written. The dates of the exams (eight sessions) are published on the CdS website in the relative section.

The topics covered during the course can be downloaded from the e-learning platform at the site: https://elearning.uniroma1.it/course/view.php?id=174

The teacher delivers lectures with traditional methods with audiovisual aids and scheduling of lessons as reported on GOMP Aule/Orari system, published on the website of the CdS. The teacher provides teaching to small groups during the professionalizing activities (APP). The lessons of the Physiology I course are held in person on Tuesdays from 13.30 to 17.30 and on Thursdays from 9.00 to 13.00 at the Medicine and Surgery office of Corso Repubblica in Latina in the first semester. Link to the material of the lessons on elearning: https://elearning.uniroma1.it/course/view.php?id=2969 Link for lessons unless otherwise specified on elearning: https://uniroma1.zoom.us/j/7128261193

Cellular Physiology and Biophysics: What physiology studies. Concept of homeostasis. Body fluids. Blood Cell Physiology: The general functions of the blood. - The constituents of blood: plasma, erythrocytes, leukocytes, platelets. Hemostasis. The cell as a basic unit: electrical parameters of the cell membrane and equivalent circuits; resting potential; action potential. - Voltage-gated ion channels. - Biophysical methods for the study of membrane electrical events. Neurotransmitters Electrical synapses: structure and function. Chemical synapses: Spontaneous and evoked transmitter release. Synaptic potential; spatial and temporal summation. The neuromuscular junction. Membrane receptors: Ionotropic receptor families: structural analogies and functional peculiarities. - Metabotropic receptor families: structural analogies and functional diversity. - Second messenger systems and signal transduction. Synaptic activity and cognitive and mnemonic processes. Muscle physiology: The muscle: structure and function of the various types of muscle. - The contraction of skeletal, smooth and cardiac muscle. Ortho and parasympathetic autonomic nervous system. Respiratory and cardiocirculatory centers. Physiology of the heart and blood circulation: Laws of fluid mechanics applied to blood circulation. Arterial pressure and peripheral resistance. The heart: physiological aspects of the myocardium; the cardiac cycle. Cardiac output and venous return. Excitation of the myocardium and impulse conduction; nerve control mechanisms. - The electrocardiogram. - Microcirculation and lymphatic system: Exchanges between blood and tissues. - Control of blood flow and arterial pressure. Methods of measuring blood pressure. Breathing physiology: Respiration: functional structure of the lung. - Pulmonary pressures and ventilation; lung volumes - Mechanical properties of the lung. - The pulmonary circulation. - Gas exchanges - Transport of respiratory gases. - Breathing control.

No previous knowledge are necessary.

Guyton e Hall. Fisiologia medica (edizioni Edra – Masson more recent than the 2006 edition) Grassi, Negrini e Porro. Fisiologia umana (Poletto Editore, 2015) Cindy Stanfield, Fisiologia (Edises, 2017) Bruce Koeppen and Bruce Stanton. Berne & Lewy Fisiologia (Casa Editrice Ambrosiana, 2019) Other resources: slides with the lessons and exercises for the preparation of the exam (electronic archive indicated by the lecturer).

Attendance to the course is mandatory.

The evaluation methods of the Teaching are characterized by exam sessions set in the scheduled sessions (2 for each session, plus some extraordinary appeals). The exam consists of a written task with both multiple-choice and open-ended questions on the topics of the Teaching, followed by a clarification on the evaluation criteria at the request of the student or student. The exam aims to certify the student's knowledge of the physiological mechanisms of functioning and homeostatic control of the human body, with references to the cellular and molecular mechanisms underlying the action of drugs. The topics presented must be treated with proper language. The elements examined for evaluation purposes are listed below: (1) the knowledge of the subject in all the areas included in the teaching program; (2) the use of a proper language; (3) the ability to reasoning; (4) the logical articulation of the wording; and (5) the integration of skills demonstrated in the response to exam questions. The written nature of the task will allow correcting the individual evaluation of the student’s elaborate according to "item analysis" techniques. This procedure will allow not to penalize areas of the answer that will be insufficient in most of the students involved a certain exam appeal. Furthermore, the evaluation of the single student will be conducted comparatively, to guarantee equanimity and recognize the individual merits in the allocation of grades. To pass the exam with the smallest grade (18/30), a knowledge of the homeostatic objectives and the basic physiological-regulatory mechanisms of the organs and apparatus being evaluated is required. To achieve a score of 24/30, 27/30 and 30/30 cum laude, the student must prove that he/she has got, respectively, a good, particularly good, and excellent integrated knowledge of the various systems of physiological regulation with negative feedback and / or feed-forward of the nervous systems and the organ / apparatus subject to the examination evaluation. In the evaluation process, we will also consider (1) the ability of the student to manage the time agreed to supply the answers in a concise but exhaustive manner and (2) link the key concepts in a logical and coherent way from the behavioral and cellular level to the molecular one.