生理大纲.docx

Preface Physiology is a branch of the biology. It is a science that studies the vital regularity in living organisms. It has long been regarded as one of the most basic and important courses in medicine. The teaching purpose of physiology is to make the students to master the basic knowledge of human physiology and establish a good basis for learning other courses. According to the necessity of medicine, the teaching contents must be the basic concept and knowledge, as well as fundamental skills. The teachers should pay special attention to training the students on scientific manner and the ability of scientific thinking. This outline is based on the new text book Medical Physiology (edited by Guyton and Hall) and the sixth edition of Physiology (Peoples Health Press. Edited by Tai Yao). According to the teaching plan for international student of bachelor medicine, the total teaching hours of physiology is 190, among which 130 for lectures and 60 for experiments. Chapter contents lecture hours 1 Introduction 4 2 Basic function of cell 20 3 Blood 4 4 Blood circulation 24 5 Respiration 12 6 Digestion and absorption 10 7 Energy metabolism and body temperature 2 8 Excretory function of the kidney 12 9 Sensory organs 8 10 Nervous system 24 11 Endocrine system 8 12 Reproduction 2 Chapter 1 Introduction Purpose and Requirement: 1.To master the concepts of physiology. 2. To understand the fundamental characteristics of life phenomena 3. To study the regulation of body function. 4. To master feedback control system Teaching Contents: 1. Physiology is a science that studies the vital regularity in living organisms. 2. Basic characteristics of life phenomena: metabolism, excitability and reproduction. 3. The concept of internal environment and homeostasis. 4. Regulation of body function and homeostasis: nervous regulation, hormonal regulation and autoregulation. 5. The concept of feedback regulation: negative feedback and positive feedback. 6. Two ways and 3 levels for study of physiology. Chapter 2 Fundamental Functions of the Cell Purpose and Requirement 1. To understand the basic structure of cell membrane. 2.To master the transport through cell membrane, bioelectrical activities and neuromuscular transmission. 3. To master the excitation -contraction coupling, and to understand the mechanism and mechanics of the skeletal muscle contraction. Teaching Contents Part 1. Transport through cell membrane 1. Structure of the cell membrane: the fluid mosaic model. 2.The transporting function of cell membrane: simple diffusion, channel mediated facilitated diffusion and carrier mediated facilitated diffusion, primary active transport, secondary active transport, endocytosis and exocytosis 3.Signal transmission across the membrane: receptor -channel, receptor -G protein - second messenger. Part 2. Membrane potentials of the cell 1. Bio-electrical phenomenon of the cell : membrane potential. 2. Resting potential: definition, property, and the ionic basis. 3. Action potential: definition, stages, properties, initiation or genesis, threshold, threshold potential, excitability 4.Local potential: definition, properties, role of the local potential 5. Signal transmission along nerve fiber: “Local current flow” theory Part 3. Contraction of Skeletal Muscle 1. Molecular Characteristics of Contractile Filaments 2. Molecular Mechanism of Muscle Contraction: “Sliding theory”, steps of each cross bridge cycle. 3.Mechanics of skeletal muscle contraction: the effects of preload, afterload and contractility on muscle contraction. 4.Transmission of action potential across the neuromuscular junction: steps, properties, and 5. Excitation contraction coupling Chapter 3 Blood Purpose and Requirement 1. To master the distribution pattern of body fluid and the role of blood in internal environment. 2. To master the mechanisms of physiological hemostasis 3. To understand physical and chemical properties of blood 4. To understand blood groups and principles of blood transfusion Teaching contents Part 1 General statement 1. Distribution of body fluid. 2. Function of blood. Part 2 Plasma The concept of plasma and its physical and chemical properties. Part 3 Blood cell Hematocrit value, suspension stability, erythrocyte sedimentation rate (ESR) Part 4 Physiological hemostasis 1. The concept and basic process of physiological hemostasis. 2. Blood coagulation: coagulation factors 3. Process of coagulation: activation of factor X, activation of factor II, activation of factor I 4. Intrinsic pathway, extrinsic pathway. 5. Anti-coagulation and fibrinolysis. 6. Function of platelet in physiological hemostasis. Chapter 4 The Blood Circulation Purpose and requirement 1. To understand the function of heart and concepts of basic mechanics of cardiac muscle. 2. To understand the functional characteristics of various vessels, mechanics of blood flow, venous return, local circulation. 3. To master the function of heart as a blood peripheral pump, regulation of cardiac output, factors affecting cardiac output, electrical phenomena of cardiac muscle cell, physiological of cardiac muscle. 4. To master principle of formation of blood pressure, factors affecting blood pressure, microcirculation, and formation of interstitial fluid. 5. To master the neuronal innervation of heart and blood vessels; baroreceptor reflex; the effect of epinephrine, norepinephrine, nitric oxide, angiotensin on cardiovascular system. Teaching contents Part 1 Function of the heart 1. The cardiac cycle: atrium systole, ventricular systole, ventriular diastole 2. Cardiac output, ejection fraction, cardiac work, cardiac index. 3. Regulation of cardiac output: heterometric regulation. homometric regulation, effect of afterload, heart rate on output Part 2 Cardiac electrical phenomena and physiological property of cardiac muscle 1. Cardiac electrical phenomena of working cell: resting potential, action potential 2. Membrane potential of autorhythmic cell 3. Electrophysiological properties of cardiac muscle: excitability. refractory period and its relation with mechanical contraction; automaticity, conductivity and spreading of excitation in heart Part 3 Physiology of blood vessels 1. Function of different vessels 2. Blood flow in blood vessels: blood flow resistance, blood flow resistance, blood pressure 3. Arterial blood pressure: concept of blood pressure, formation of arterial blood pressure, normal value of arterial blood pressure. 4. Factors affecting the arterial blood pressure: stroke volume. heart rate. peripheral resistance, ration between the circulatory blood flow and the total vessel volume, windkessel effect of large arterial vessels. 5. Factors affecting venous return, concept of central venous pressure and its clinical significance 6. Microcirculation: concept of microcirculation, formation of interstitial fluid effective filtration pressure Part 4 Regulation of cardiovascular activity 1. Nervous regulation: innervation of heart and vessles, cardiovascular center 2. Cardiovascular reflex: baroreceptor reflex, chemoreceptor reflex 3. Hormoral regulation: renin -angiotensin system, epinephrine and norepinephrine, endothelium-derived relaxing factor (EDRF) and endothelium-derived vasoconstrictor factor (EDSF), vasopressin, atrial natriuretic peptide. Chapter 5 Respiration 1. To understand the respiratory significance and basic processes of respiration 2. To master the principles of pulmonary ventilation and gas exchange in lung and tissue 3. The master the transport of O2 and carbon dioxide in the blood 3. To master the regulation of respiration Teaching contents Part 1 Pulmonary ventilation 1. Respiration: external respiration - pulmonary ventilation and gas exchange; Transport of gas in the blood; internal respiration. 2. Alveoli and respiratory membrane 3. Surface tension of the alveoli and the surfactant 4. Recoil force of the lung and the intrapleual pressure. Pneumothorax 5. Mechanics of ventilation: respiratory muscle phrenic muscle and intercostals; intrapulmonay pressure 6. Pulmonary compliance, airway resistance 7. Pulmonary volume: tidal volume, inspiratory reserve volume, expiratory volume, residual volume and pulmonary capacity, inspiratory capacity, functional residual capacity, vital capacity, forced vital capacity, total lung capacity 8. Minute ventilation volume, maximal respiratory volume, alveolar ventilation and anatomicaldead space, alveolar dead space, physiological dead space; alveolar ventilaion. Part 2 Gas exchange 1. Mechanism of diffusion: partial pressure of mixed gas 2. Factors affecting diffusion across respiratory membrane: area and thickness of the respiratory membrane, ventilation/ perfusion ratio 4. Pulmonary diffusing capacity part 3 Gas transport in blood 1. Oxygen transport: physical solution and combination with hemoglobin; oxyhemoglobin dissociation curve, factors that shift the oxygen hemoglobin dissociation curve: pH and PCO2 (Bohr effect), temperature, DPG, CO, fetal hemoglobin. 2. Carbon dioxide transport: physical solution, bicarbonate and carbominohemoglobin; carbon dioxide dissociation curve and Haldane effect. Part 4 Regulation of respiratory movement 1. Respiratory center and generation of respiratory rhythm 2. Respiratory reflex (l) Pulmonary stretch reflex (2) Respiratory chemoreflex: peripheral chemoreceptor, central chemoreceptor (3) Effect of PCO2, PO2 and pH on ventilation Chapter 6 Digestion and Absorption Purpose and Requirement 1. To understand the basic process of food digestion and absorption in digestive tract 2. To master the neural and hormonal regulation of secretory functions and motility of digestive tract. Teaching contents 1. Introduction: master concept of digestion and absorption, electrical activity of gastreintestinal smooth muscle, innervations of the gut and its actions, physiological actions of gut hormones, brain gut peptides. understand the general characteristics of smooth muscle, secretory functions of digestive glands, endocrine cells in gastrointestinal tract, chemistry and transportation of these hormones. 2. Digestion in Oral Cavity: understand secretion and function saliva. regulation of salivary secretion. mastication and swallowing . 3. Digestion in Stomach: master gastric secretion: composition and actions of gastric juice, such as HCL, pepsin, mucus and intrinsic factor; endogenous substances stimulating gastric secretion: acetlcholine, gastrin and histamine; regulation of gastric secretion including cephalic, gastric and intestinal phases. inhibitory regulation of gastric secretion. understand gastric motility, gastric receptive relaxation, gastric peristalsis, gastric emptying, regulation of gastric emptying 4. Digestion in Small Intestine: master pancreatic and bile secretion: composition and actions of pancreatic juice and bile, regulation of pancreatic and bile secretion. understand composition, functions and regulation of small intestinal secretion; motility of small intestine: tonic contraction, segmentation contraction, peristalsis and regulation; composition and function of the bile, gallbladder emptying and the regulation 5. Digestion in Large Intestine: master the types of colon movement and the defecation, haustrations-mixing movement, peristalsis and mass movement, defecation. Chapter 7 Energy Metabolism and Body Temperature Purpose and requirement 1. To understand the processes of energy metabolism, the principles of measurement of energy metabolism. 2. To master the concept of basic metabolic rate and factors affecting metabolic rate 3. To master normal changes in body temperature and measurement of body temperature, and the mechanisms of thermoregulation. Teaching contents Part I Energy metabolism 1. The source of energy and its transfer 2. Principle of measurement of energy metabolism: direct calorimetry, indirect calorimetry. 3. Factors affecting energy metabolism: muscle contraction, environment temperature, food specific dynamic effect 5. Basal metabolism rate: concept and clinical significance Part 2 Body temperature 1. Concept of body temperature: shell temperature and core temperature; normal value of body temperature, normal variation of body temperature 2. Heat generation and dissipation of the body. 1 ) Generation: organs.muscles, shivering. 2 ) disspiation: irradiation, conduction and convection; evaporation and its significance; sweating. 3. Regulation of body temperature: voluntary and autonomic thermoregulation. 4. Autonomic thermoregulation: peripheral and central temperature receptor, thermotaxic center: its position and the set -point hypothesis. Chapter 8 Excretory function of the kidney Purpose and requirement 1. To understand the important of the kidney in maintaining homeostasis of the body and excretion function of the kidney. 2. To master the processes of urine formation and factors influencing urine formation, regulation of urine formation. Teaching contents 1. Introduction: master concept and way of excretion, importance of renal excretion, structural characteristics of kidney: nephron and collection ducts, cortical nephron and juxtamedullary nephron, characteristics of renal blood circulation. -understand general functions of kidney including urine formation and production of some biological active substance, juxtaglomerular apparatus. 2. Function of Glomerular Filtration: master glomerular membrane and its permeability, the effective filtration pressure, factors effecting glomerular filtration, glomerular filtration rate and filtration fraction. 3. Functions of Renal Tubules and Collecting Duct: master reabsorption of renal tubules and collecting ducts: active reabsorption of various substances (Na+, Cl- , H2O- ,HCO3-, NH4+, K+, glucose), secretory and excretory function of renal tubules and collecting ducts (H+, Na+, K+). 4. Urinary Concentration and Dilution: understand mechanisms for creating osmotic gradient in the medullary interstitial fluid, formation of concentrated and diluted urine, role of the vasa recta for maintaining the high solute concentration in the medullary intersitial fluid. 5. Regulation of Urine Formation in the Kidney: master renal autoregulation: osmotic diuresis and glomerulotubular blance; actions of ADH; regulation of ADH secretion: osmolality of extracellular fluid and blood volume of circulation and other factors;the effects of aldosterone and regulation of aldosterone secretion: the rennin-angiotensin aldosterone system, Na + , K + concentration of plasma. hormone and cardionatrin. The effect of atrial natriuretic peptide (ANP) 6. Plasma Clearance: understand concept of plasma clearance. physiological significance of plasma clearance test. 7. Micturition: understand innervation of uninary bladder and ureters. master reflex of micturition Chapter 9 Sense Organs Purpose and requirement 1. To understand the functions of various sense organs. 2. To master the general characteristics of sensory receptors, vision and hearing. Teaching contents 1. Basic concepts : understand concept and classification of sensory receptors and sense organs. master general characteristics of sensory receptors: sensory threshold and adequate stimulus, transducer function of sensory receptors, coding of sensory information, adaptation. 2. Visual sense organs: understand anatomical basis of eye, optical principle relative to formation of an image in eye, reduced eye, structure of retina,chemistry of rhodopsin, space vision and binocular vision. master visual acuity, accommodation reflex, near point of vision, papillary light reflex,cone system and rod system, transduction of light energy by rod, cones and color vision. trichromatic theory of vision, dark and light adaptation, visual field. 3. Auditory sense organs: understand structure of ear, collecting sound of auricle, resonance of auditory canal, function of Eustachian tube pharyntotympanic tube), basic structure of cochlea, action potential in auditory nerve, auditory thresholds and audible area. master pathways transmitting sound wave from external environment to inner ear, increasing sound pressure by auditory ossicles and tympanic membrane, vibrations of basilar membrane and traveling wave theory,. bioelectrical phenomenon of the cochlea. Chapter 10 the Nervous System Purpose and Requirement 1. To understand the basic function of nerve cells and central nervous system. Sensory functions and higher function of nervous system 2. To master synaptic transmission, motor functions, central control of visceral functions. Teaching contents 1. General Action Rules of Neuron: Neuron and nerve fibers: -master characteristics of nerve conduction: physiologically intact, nature, insulated propagation,double propagation and indefatigability; conduction velocity of verve fibers;axoplasmic transport. understand mechanisms of nerve conduction and classification of nerve fibers; elementary interactions between neurons. -master concept of synapse, gap junction. understand no synaptic chemical transmission, local circuit neurons,local neuronal circuit. Neurotransmitters: master peripheral neurotransmitters: Ach, NE, peptides, cholinergic receptors, adrenergic receptors understand central neurotransmitters, concept of transmitter and modulator; synthesis, release and inactivity of transmitter; presynaptic receptors of transmitter in central nervou