Physiology

I SEMESTER. CELLULAR PHYSIOLOGY
This unit addresses the organization and biophysical properties of cells and tissues. Basic concepts in cell and membrane physiology are synthesized through exploring the function of epithelial, neuronal and muscle cells. The following topics will be covered:
1. INTRODUCTION
What is physiology? Main characteristics of a living being. Cells, tissues, organs, organ systems, organism. Liquid compartments composition in the body. Homeostasis.
2. BIOLOGICAL MEMBRANES AND TRANSPORT PHENOMENA
Structure and function of biological membranes. Transport through biological membranes: Simple diffusion and Fick's law. Facilitated diffusion and Michaelis-Menten equation. Ionic channels, Transporters and pumps. Primary active transport: ATPases. Secondary active transport, property and function. Transport mediated by vesicles. Osmosis: osmotic pressure. Complex biological barriers: epithelia
3. MEMBRANE POTENTIAL
Resting membrane potential. Equilibrium potentials. Nernst's law. Goldman-Hodgkin-Katz equation. Electrical analogue of a membrane. Extracellular and intracellular recording techniques.
4. CELL COMMUNICATION I: HORMONAL SIGNALS.
Hormone chemistry, synthesis and secretion. Regulatory mechanisms and mechanisms of action of hormones. Endocrine disruptors
5. CELL COMMUNICATION II: NERVOUS SIGNALS
Neurons and glial cells. The graduate potential and action potential. Generation and propagation of the action potential: ionic and molecular bases. Relative and absolute refractory period. Myelin and saltatory conduction Action potentials in excitable cells.
Synaptic transmission. Electrical and chemical synapses. Neurotransmitters, ionotropic and metabotropic receptors, vesicular and membrane transporters. Excitatory and inhibitory postsynaptic potentials and synaptic integration.
6. PHYSIOLOGY OF THE MUSCLE CELL.
Skeletal muscle: electrical and mechanical phenomena. Neuromuscular junction. Excitation-contraction coupling. Molecular mechanism of contraction. Regulation of muscle contraction. Classification of muscle fibers. Motor unity.
Cardiac musculature. Electrical activity of individual cardiac cells and regulation. Heartbeat origin and excitement propagation. Contractile activity. Heart rate regulation. Smooth muscle. Excitation-contraction coupling in smooth muscle. Mechanism of muscle contraction at the molecular level, differences with the striated muscle. Smooth muscle classification
7. CIRCULATING LIQUIDS
The blood. Plasma: ionic components, protein and non-protein components.
Blood Cells: erythrocytes, leukocytes and platelets. The red blood cell: characteristics, composition, membrane properties and Hamburger phenomenon. Hemoglobin and the transport of O2. The lymph and lymph nodes.

II SEMESTER. HUMAN PHYSIOLOGY.
This unit addresses the organization and functioning of organs and systems of normal human body. The regulatory mechanisms and the contributions of each system to the body homeostasis will be emphasized. The functioning of the following systems will be covered:
8. THE NERVOUS SYSTEM
Organization of the central and peripheral nervous system (in brief)
Sensory function. Sensory signals. Transduction and coding of sensory information in sense organs and receptors. Somatosensory perception. The nociception and control of painful stimuli.
View: elements of optics, pupillary reflexes, the retina, photoreceptors and phototransduction, analysis of visual information in cortical circuits.
Hearing: structure of the ear, elements of acoustics, the cochlea, ciliated cells and mechanotransduction, analysis of acustic information in cortical circuits.
Motor function. The simple reflexes. Voluntary movements. Central control of motor activity. Role of the nuclei of the base and cerebellum. Mirror neurons.
Complex functions: learning and memory, molecular mechanisms of learning and memory, sleep and wake, language, emotions.
Integrated Physiology Control of body temperature
9. ENDOCRINE SYSTEM
Hypothalamic-pituitary relationships, hypothalamic hormones, neurohypophysis and anterior pituitary.
The endocrine "axes".
Thyroid hormones: synthesis, secretion, regulation and action
Hormonal control of glucose metabolism: insulin and glucagon.
Hormonal control of Ca2+, K+ and PO4- homeostasis: vitamin D, parathyroid hormone and calcitonin.
Adrenal hormones and stress response
Steroid sex hormones, sexual determination and differentiation.
10. HEART AND CIRCULATION
Cardiac muscle structure. Electrical cycle: origin of the heartbeat and propagation of excitement. Cardiac Mechanical cycle: cardiac pressures and volumes in the different phases of the cardiac cycle. Frank and Starling's law. Systolic and cardiac output. Cardiac output control. The role of the autonomic nervous system. Electrocardiogram.
Blood circulation: arteries, capillaries and venous. Hydrodynamics of blood circulation. Laplace's law, Bernoulli's law and Darcy's law. Blood pressure. Peripheral resistance: central and local control. Microcirculation and osmotic/oncotic pressure. Edema and lymphatic system.
Integrated Physiology Integrated blood pressure control.
11. BREATHING AND TRANSPORT OF RESPIRATORY GASES
Gas properties. Ventilation. Breathing Mechanics. Respiratory muscles. Surfactant. Spirometry and lung volumes. Ventilation and gas exchange.
Oxygen transport: hemoglobin, oxyhemoglobin dissociation curve. CO2 transport. Tissue breathing.
Integrated Physiology: Control of respiration.
12. KIDNEY FUNCTION
Kidney. Nephron. Kidney circulation. Glomerular filtration (FG). Factors influencing FG. Measurement of FG flow. Tubular function. Reabsorption mechanisms. Titration curve for glucose. Tubular secretion. Henle loop. Collector duct. Clearance concept.
13. HYDRO-SALINE INTEGRATION and ACID-BASE BALANCE
Countercurrent multiplication. Hormones action on kidney function. The antidiuretic hormone. Renin-angiotensin-aldosterone system.
Integrated Physiology Integrated control of Na+, K+ concentration.
Integrated Physiology Integrated control of plasma volume and blood pressure
Integrated Physiology Mechanisms of pH control. Buffer systems. Effects of breathing on the acid-base balance. Kidney regulation. Alterations of the acid-base balance: alkalosis and acidosis.
14. GASTROINTESTINAL FUNCTION (in brief)
The digestive system nervous system. Motility of the digestive system: swallowing, peristalsis and segmentation. Salivary, gastric, pancreatic secretions. Liver and bile.
Basis of nutrient digestion and absorption. Water and electrolyte absorption processes.
Integrated Physiology Food behavior.

PRACTICAL COURSE
Osmolarity and tonicity, Action potential and synaptic integration.
Principles and techniques of manual blood pressure measurement
Heart function: electrocardiogram
First Aid Guide and Emergency Treatment Instructions - Body Life Support and Defibrillation (fBLSD)

PART I: CELL PHYSIOLOGY
The biological membranes
- Transports across the biological membranes
- Osmosis and osmotic pressure, oncotic pressure
- Diffusion
- Facilitated diffusion
- Active transports
The physiological buffer system
- Henderson-Hasselbach equation and the isohydric principle
- Chemical (bicarbonate, phosphate) and protein buffers
- Involvement of lung and kidneys in the pH regulation
The blood
- The body fluids
- The blood and its components.
- The corpuscular elements of the blood
- Red blood cells and hemoglobin
- Platelets and blood coagulation
- The white blood cells and the immune system
- The blood groups and Rh factors
Conduction of nerve signals
- Cells of the nervous system: neurons and glia
- membrane potentials and action potentials
- Nernst and Goldman-Hodgkin-Katz equations
- Transmission of the nerve impulse
- Synaptic transmission.
- Neurotransmitters and their membrane receptors
- Postreceptor signal pathways
- Role of calcium in the synaptic transmission
- Excitatory and inhibitory postsynaptic potentials
Physiology of the Muscle cell
- Classification of muscles: skeletal muscle, cardiac muscle, smooth muscle
- Structure of the skeletal muscle: the sarcomere
- The neuromuscular plate and muscle contraction
- Mechanisms involved in the contraction (cross-bridge cycling)
- Role of the ATP and calcium
- Types of muscle contraction: the cardiac and smooth muscle
- Biophysics of the muscle contraction

PART II: GENERAL PHYSIOLOGY
- Physiology of normal skin
- The sensory perception
- Sensory receptors and signal transmission
- Progression of the sensory signals
- Special sensory organs: olfactive, gustative, auditory, vestibular and visual perception.
- Somatosensory and somatomotory connection
- Sensory cortex and motor cortex
- Autonomous nervous system and the control of the activity of the inner organs
- Central control of the motor activity (the example of Parkinson's disease)
- Spinal reflex and the local control of the motor activity
- Advanced levels of integration of the movements and posture: role of the inner ear, the basal ganglia, the reticular formation, the cerebellum and the cerebral cortex
- Higher functions of the cerebral cortex: learning and memory
- Elaboration of the thought, words and images
- The sleep; sleep-waking rhythms and sleep disturbance
- The limbic system, the behaviors and the relationships
PIS - Control of body temperature
PIS - Nociception and the control of the painful stimuli

Cardiovascular system
- Heart and cardiac cycle
- Structure of the cardiac muscle
- Conduction system and the contraction in the heart.
- Variation of intracardiac pressures along the various phases of the cardiac cycle
- Frank-Starling law of the heart
- The electrocardiogram (ECG)
- Cardiac output and blood flow
- The relationship among flow, pressure and resistance.
- Laplace's law; the Bernoulli and Darcy law.
- Blood circulation: arteries, capillary and venous systems.
- Osmotic/oncotic pressure and edema
- Special districts of the blood circulation: muscles, coronary arteries, cerebrospinal fluid and lymphatic system
- Control of the circulation and of the arterial blood pressure
- Local control of the circulation. Central control and vasomotor centers.

The respiratory system
- Mechanical respiratory and pulmonary volumes
- Alveolar pulmonary gas exchange
- Transport of respiratory gases in the blood
- Role of red blood cells and of hemoglobin
- Dissociation curve of oxyhemoglobin and carboxyhemoglobin
- The chloride shift
- CO2 elimination
- Local and central control of the respiratory activity: role of the pH, CO2 and oxygen
- The bulbar respiratory centers

Renal function
- Glomerular filtration.
- Evaluation of the glomerular filtration pressure: role of the plasma proteins and of the arterial and Bowman's capsule pressure.
- The plasma clearance. Determination of the clearance of a substance and analysis of the renal function.
- Determination of the glomerular filtration rate, of the plasmatic flow and of the renal blood flow.
- Exchanges of substances along several tracts of renal tubule.
- The proximal renal tubule.
- The Henle's loop, the vasa recta, the counter current multiplier and the counter current exchanger
- The distal renal tubule and the urea cycle.
- Reabsorption of water and electrolytes: role of ADH and aldosterone.
- The urine acidification of urines.
- The control of the renal activity.
- The renin-angiotensin system and the long-term control of the arterial pressure.
PIS - Nervous and hormonal control of the drinking behavior

The digestive system
- Mechanical and nervous control of the activity of the digestive system
- Physiological aspects of swallowing
- Introduction to digestive processes of carbohydrates, fats, and proteins
- Introduction to the absorption of the alimentary nutrients, water and ions
- Introduction of the liver and gallbladder functions

The Endocrine System
- Neuroendocrinology: the hypotalamo-pituitary relationship, hypothalamic hormones, hormones of the neurohypophisis and of the anterior pituitary
- The "endocrine axes": hypotalamo-pituitary-thyroid, hypotalamo-pituitary -adrenal, hypotalamo-pituitary-gonadal axes
- Fertilization and pregnancy, sex determination and sexual differentiation, delivery and breast-feeding.
- Control of the body growth: the growth hormone of the growth factors
- Hormonal control of the glucose metabolism: insulin and glucagone.
- Hormonal control of the calcium and phosphate homeostasis: vitamin D, parathyroid hormone and calcitonin.
Nervous and hormonal control of the sexual and reproductive behavior