Medicine and Surgery

Activity type

Funzioni biologiche integrate di organi, sistemi e apparati umani

SSD

BIO/09

Year

2nd year

Semester

2nd semester

CFU

7

Hours distribution

84 classroom hours

Lecturers

MANUELA MERLI
CRISTINA LIMATOLA
PAOLO PALANGE
FRANCESCA GRASSI

Activity type

Funzioni biologiche integrate di organi, sistemi e apparati umani

SSD

BIO/09

Year

3rd year

Semester

1st semester

CFU

3

Hours distribution

36 classroom hours

Lecturers

STEFANO FERRAINA

Activity type

Funzioni biologiche integrate di organi, sistemi e apparati umani

SSD

BIO/09

Year

2nd year

Semester

1st semester

CFU

8

Hours distribution

96 classroom hours

Lecturers

CRISTINA LIMATOLA
CARMINE SAVOIA
FRANCESCA GRASSI

Main teaching objectives:
At the end of the course, students must know the function of the organs in the human body; the dynamical integration of the various organs into systems; the general mechanisms of functional control under normal conditions; the normal values of the main functional parameters in healthy humans; the medical application of biophysical and biotechnological principles. They must also know some of the techniques used to measure physiological parameters.

By the end of the course, the student must be able to:
Understand Homeostasis: Explain the concept of homeostasis and the negative and positive feedback control mechanisms that regulate vital functions (e.g., body temperature, blood glucose, blood pH).
Cellular and General Physiology: Describe the fundamental properties of biological membranes, the mechanisms of transport (passive and active), and the basis of cellular excitability (resting membrane potentials and action potentials).
Systems Physiology:
Nervous System: Describe the general organization and functions of the central and peripheral nervous system, including synaptic transmission, sensory systems (vision, hearing, somatosensory), motor control, and higher cognitive functions (memory, learning).
Endocrine System: Explain the principles of hormonal regulation, the function of the main endocrine glands (hypothalamus, pituitary, thyroid, adrenal, pancreas), and their role in homeostasis.
Cardiovascular System: Describe cardiac excitability and contractility, the cardiac cycle, the laws of hemodynamics (flow, pressure, resistance), and the regulation of arterial blood pressure and cardiac output.
Respiratory System: Explain ventilatory mechanics, gas exchange at the pulmonary and tissue levels, gas transport in the blood, and the regulation of respiration.
Renal System: Describe the structure and function of the nephron, the mechanisms of filtration, reabsorption, and secretion, and the kidney's role in regulating fluid and electrolyte balance and acid-base equilibrium.
Digestive System: Explain the mechanisms of motility and secretion in different sections of the gastrointestinal tract and the role of the liver and pancreas in digestion and absorption of nutrients.
Muscle Physiology: Describe the contraction mechanisms of skeletal, smooth, and cardiac muscle.

Physiology studies how structures function and physiological phenomena have molecular and chemical roots. It is, therefore, essential that the student has a deep knowledge of the following disciplines:
Human Anatomy: Detailed knowledge of the macroscopic organization of organs, apparatuses, and systems (e.g., muscles, heart, lungs, kidneys, nervous system structures). Understanding spatial relationships and vascularization is crucial for comprehending blood flow or nerve reflexes.
Histology and Cytology: Understanding the microscopic structure of tissues (e.g., epithelial, muscle, nervous) and cellular morphology. This is vital for understanding how cellular structure (e.g., ion channels, neuromuscular junctions) is directly related to function (e.g., action potential, contraction).
Biochemistry: Knowledge of the major metabolic processes (glycolysis, Krebs cycle, electron transport chain), the structure of macromolecules (proteins, lipids, carbohydrates), and the role of enzymes. This is fundamental for the physiology of nutrition, muscle, and energy production.
Chemistry: Solid basics on the concepts of solutions, pH, buffers, and the mechanisms of chemical bonding. Essential for understanding acid-base balance and oxygen transport.

Moreover, since Physiology is, to a large extent, the application of physical principles to a biological system, students are requested to understand the basic concepts of:
Electricity: Fundamentals of electrical potentials and the movement of charges (necessary for membrane and action potentials).
Fluid Dynamics: Laws governing flow, pressure, and resistance (critical for cardiovascular and respiratory physiology).
Thermodynamics: Principles of energy and heat exchange (necessary for thermoregulation and metabolism).
Diffusion and Osmosis: Mechanisms of transport across membranes (fundamental for renal physiology and cellular exchanges).

Module: Human Physiology I
Grassi: The kidney and the body fluids. Body fluid compartments; water and salt equilibrium. Urine formation: glomerular filtration, tubular transport of the electrolytes, tubular water reabsorption and the regulation of fluid osmolarity. Micturition. Renal mechanisms for the control of blood and extracellular fluid volume. Regulation of the concentration of the principal electrolytes (sodium, potassium, calcium, magnesium, phosphate).
Grassi: Respiration: structure of the lungs. Pulmonary pressure and ventilation; Pulmonary volumes. Mechanical properties of the lungs. Pulmonary circulation. Gas exchange. Respiratory gas transport. Control of breathing.
Grassi: Acid-base balance: Body buffer systems for extracellular pH: plasma proteins, bicarbonate, phosphate. Renal regulation of the acid-base balance. Respiratory regulation of the acid-base balance. Disturbances of the acid-base balance.
Grassi: Gastrointestinal physiology: motility, nervous control and blood circulation in the gastrointestinal tract. Food progression and mixing in the digestive tract. Gastrointestinal secretion: salivary, gastric, pancreatic, biliary, intestinal secretions. Food digestion. Absorption of water, nutrients and electrolytes in the small intestine. Absorption in the large intestine. Main metabolic functions of the liver.
Merli: Gastrointestinal function from a clinical perspective
Limatola: Endocrinology: hormone structure and action. Measurement of hormone levels. Pituitary hormones and hypothalamic control mechanisms. Thyroid hormones. Adrenocortical steroid hormones. Endocrine pancreas: insulin and diabetes. Parathyroid hormone and calcitonin: calcium and phosphate metabolism. Male and female sex steroid hormones. Reproduction and pregnancy.



Module: Human Physiology II
Contents:
The somatosensory system. Somatic sensitivity. Cortical areas involved in somatic sensitivity. Psychophysics of pain. Peripheral and central nervous mechanisms of pain. Analgesia.
The Retina visual system. The visual field. Visual pathways. Parvo and magno cells. Primary visual cortex and the extrastriate areas. The stereopsis. The perception of colors. The "where" and "what" pathways in vision. Visual psychophysics.
The Cochlea hearing system. Central acoustic pathways. Auditory areas of the cerebral cortex. Perception and localization of sounds.
Taste receptors, central structures. Olfactory receptors, central structures.
General organization of motor systems. Muscles and motor units. Voluntary movements and reflexes. Motor control and internal models. Spinal reflexes. Muscle tone. The vestibular system and vestibular reflexes. Otolith organs. Vestibular-ocular reflex. Vestibulospinal reflexes. Posture control. Postural tone. Control of the orientation of the head, of the body and maintenance of balance.
The cortical control of voluntary movement. Premotor and motor areas of the cerebral cortex. Motor descending pathways. The posterior parietal cortex. Basal ganglia. The cerebellum. The cerebellum and motor learning. Locomotion. Biomechanics of locomotion. Neural control of locomotion.
Eye movements. Saccadic eye movements, vergence movements, slow pursuit movements. Vestibulo-ocular reflex, opto-kinetic reflex, nystagmus.
The associative areas of the cerebral cortex. Prefrontal, temporal and parietal areas.
Sleep-wake cycle. The neurophysiological and neurochemical mechanisms underlying the sleep-wake cycle. The electroencephalogram. Consciousness and its states.
Hemispheric dominance. Language and other higher functions. Memory and learning.
Elements of the history of neurophysiology.


Module: Human Physiology III
Cell Physiology and Biophysics
- What physiology studies. Concept of homeostasis. Body fluids.
- The cell as a basic unit: electrical parameters of the cell membrane and equivalent circuits; resting potential; action potential. - Voltage-dependent ion channels. - Biophysical methods for studying 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: Families of ionotropic receptors: structural similarities and functional peculiarities. - Metabotropic receptor families: structural similarities 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.
- Blood cell physiology
The general functions of blood. - The constituents of blood: plasma, erythrocytes, leukocytes, platelets. Hemostasis.
- Ortho- and parasympathetic autonomic nervous system.
Respiratory and cardiovascular centers
- Physiology of the heart and blood circulation
Laws of fluid mechanics applied to blood circulation. Blood pressure and peripheral resistance. The heart: physiological aspects of the myocardium; the cardiac cycle. Cardiac output and venous return. Myocardial excitation and impulse conduction; mechanisms of nerve control. - The electrocardiogram. - Microcirculation and lymphatic system: Exchanges between blood and tissues. - Control of blood flow and blood pressure. Methods of blood pressure measurement.

Module: Human Physiology I
Suggested textbooks: One of the following, according to student's preference
WF Boron, EL Boulpaep: Medical Physiology. Elsevier 2017. ISBN: 978-0323427968 OR
BM Koeppen, BA Stanton: Berne & Levy Physiology. Mosby Elsevier 2010. ISBN: 978-0-323-07362-2 OR
JH Hall: Guyton and Hall Medical Physiology. Saunders Elsevier. ISBN: 978-1-4160-44574-8 OR
DU Silverthorn: Human Physiology. 6th edition. Benjamin Cummings. ISBN: 978-0321750006



Module: Human Physiology II
There isn’t one prescribed textbook for this course as the lecture content will not follow or match any particular textbook.
As a reference:
Kandel et al: Principles of Neural Science. McGraw Hill Education. ISBN-13: 978-0071390118.
Bear et al.: Neuroscience: Exploring the Brain. Wolters Kluwer. ISBN-13: 978-0781778176
Selected published papers for more details are available to specific request or sometime suggested during classes.


Module: Human Physiology III
Medical Physiology Guyton and Hall
Medical Physiology Boron and Boulpalep
Medical Physiology Berne and Levy

Module: Human Physiology I
N/D
Module: Human Physiology II
N/D
Module: Human Physiology III
N/D

In person teaching activities organized in 3 semesters

Mandatory

Oral exam

Cardiac and striated muscle function; Action potential; Membrane exchange; Ion channels; Control of cardiac output; Control of blood pressure; Role of the kidney in controlling systemic pH; Regulation of gastric emptying

Module: Human Physiology I

• Respiratory Physiology (12 hours)
  • Books: v. Testi


• Renal Physiology (10 hours)
  • Books: v. Testi


• Physiology of the digestive system (12 hours)
  • Books: v. Testi


• Endocrine Physiolkogy (12 hours)
  • Books: v. Testi


• Integrative Physiology (8 ore)
  • Books: v. Testi

• General introduction. Methods used to study brain activity and functions


• Somatic nervous system


• Nociception and pain perception


• The visual system part 1 (retina, LGN)


• The visual system part 2 (V1, motion – V5)


• Color, size, and distance perception


• Objects and face perception (Inferior Temporal Lobe)


• Cortical motor control (Primary motor cortex, Premotor areas)


• Cerebellum and basal ganglia


• Posture and muscle tone control. Walking


• Eye movements control


• Sleep-awake cycle


• Prefrontal cortex functions


• Memory

• What
  is
  physiology?
  –homeostasis 


• Body
  fluids and their regulation


• Cell membranes
  and transport mechanisms 


• Physiology of ion channels 


• Membrane potential and action potential in excitable cells


• Synaptic transmission


•  Skeletal Muscle physiology


• Smooth muscle physiology


• Cardiac Muscle: functional properties


• Blood functions 


• Mechanic of cardiac muscle 


• Autonomic nervous system 


• Heart electric activity 


• Electrocardiography 


• Alterations of the electrocardiogram (Prof. Carmine Savoia)


• Cardiac Output 


• Arterial system 


• Circulation: physical laws


• Local circulation: the heart (Prof. Carmine Savoia)


• Venous system and venous return. Guyton's diagrams


• Arterial pressure and its regulation


• Microcirculation


• Lymphatic system