W E S L E Y A N U N I V E R S I T Y - P H I L I P P I N E SMabini Extension, Cabanatuan CityPhilippines 3100

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES BACHELOR OF SCIENCE IN PHYSICAL THERAPY

2ND Semester, AY 2014 -2015

I. Course Code: Physiology

II. Course Title: Human Physiology

III. Course Description:

The purpose of this course is for physical therapy students to learn the fundamentals of human physiology. This will provide a foundation for subsequent courses in the physical therapy curriculum. Accordingly, the intent is for students to gain a basic understanding of physiology and pathophysiology of different organs systems. Lectures will provide an overview of the various physiological systems (e.g. respiratory, renal, etc.). In general, the lectures will follow the textbook chapters both in content and order of presentation. Please see the next page of the syllabus for a detailed list of lecture topics.

IV. Credit Units: 5 Units Laboratory (4 Units Lecture & 1 Unit LaboratoryV. Contact Hours: 4 Lecture Hours/Week and 3 Laboratory Hours/Week

VI. Pre-requisites: Chem 1, Integrated Human Anatomy and Physiology

TIMETABLESESSION TOPICS OBJECTIVES

WEEK 1Introduction/presentation/orientation of the course (that includes the syllabus,grading system, textbooks and references).

Cell Physiology1. Identify the prominent cellular organelles and state their functions in cells.

2. Identify the building blocks of the cellular cytoskeleton and state their contributions to cell structure and function.

3. Define the functional system of cells,processes of exocytosis and endocytosis, and describe the contribution of each to normal cell function.

4. Define proteins that contribute to membrane permeability and carrier-mediated transport.

5. Describe the specialized types of cell membrane transport, diffusion, osmosis and filtration across the capillary wall.

6. Discuss the genetic control of protein synthesis, cell function, and cell Reproduction

7. Define cellular homeostasis

WEEK 2Functional Organization of the Human Body 1. Identify the different fluid compartments in the human body.

2. Define moles, equivalents, and osmoles.

3. Define pH and buffering.

4. Understand electrolytes and define diffusion, osmosis, and tonicity.

5. Define and explain the resting membrane potential.

6. Understand in general terms the basic building blocks of the cell: nucleotides, amino acids, carbohydrates, and fatty acids.

7. Understand higher-order structures of the basic building blocks: DNA, RNA, proteins and lipids.

8. Understand the basic contributions of these building blocks to cell structure,function, and energy balance.

9. Understand the basic contributions of these building blocks to cell structure, function, and energy balance.

WEEK 3Nerve :Membrane Potential and Action Potential1. Identify the parts of a neuron and their functions.

2. Idenify the various types of glial cells and their functions.

3. Describe the chemical nature of myelin, and differentiate how unmyelinated and myelinated neurons conduct impulses

4. Define orthograde and retrograde axonal transport and the molecular motors involved

5. Describe the changes in ionic channels that underlie electrotonic potentials, theaction potential, and repolarization.

6. List the various nerve fiber types found in the mammalian nervous system.

Muscle Physiology1. Differentiate the major classes of muscle in the body and its functions.

2. Describe the molecular and electrical makeup of muscle cell excitationcontraction coupling.

3. Define thick and thick filaments and discuss the steps on how they slide to create contraction (Sliding Filament theory).

4. Differentiate the role of Ca2+ in skeletal, cardiac, and smooth muscle contraction.

WEEK 4Neurotransmitters &Neuromodulators1. List neurotransmitters and the principal sites in the nervous system at which they are released.

2. Describe the receptors for catecholamines, acetylcholine, 5-HT, amino acids, and opioids.

3. Summarize the steps involved in the biosynthesis, release, action, and removal from the synaptic cleft of the various synaptic transmitters.

4. Define opioid peptide, list the principal opioid peptides in the body, and name the precursor molecules from which they originate.

5. Explain the molecular biology of Ach formation and release

Neuromuscular Junction1. Describe the main morphologic features of synapses.

2. Distinguish between chemical and electrical transmission at synapses.

3. Define convergence and divergence in neural networks, and discuss their implications.

4. Describe fast and slow excitatory and inhibitory post-synaptic potentials, outline the ionic fluxes that underlie them, and explain how the potentials interact to generate action potentials.

5. Define and give examples of direct inhibition, indirect inhibition, presynaptic inhibition, and post-synaptic inhibition.

6. Describe the neuromuscular junction, and explain how action potentials in the motor neuron at the junction lead to contraction of the skeletal muscle.

7. Define and explain Myasthenia gravis and drugs that enhance or block transmission at the neuromuscular junction.

WEEK 5Immunology1. Understand the significance of immunity, particularly with respect to defending the body against microbial invaders.

2. Define the circulating and tissue cell types that contribute to immune and inflammatory

3. Define the circulating and tissue cell types that contribute to immune and inflammatory responses.

4. Describe how phagocytes are able to kill internalized bacteria.

5. Identify the functions of hematopoietic growth factors, cytokines, and chemokines.

6. Delineate the roles and mechanisms of innate, acquired, humoral, and cellular immunity.

PRELIM EXAMINATION

WEEK 7Cardiovascular Physiology : The Heart1. Describe how the sequential pattern of contraction and relaxation of the cardiac muscles in the heart results in a normal pattern of blood flow.

2. Explain the physiology of the cardiac muscles, heart valves and the cardiac cycle.

3. Describe the relationship of heart sounds to heart pumping and cardiac cycle.

4. Understand the pressure, volume, and flow changes that occur during the cardiac cycle.

5. Explain the basis of the arterial pulse, heart sounds, and murmurs.

6. Explain the regulation of heart function - intrinsic and extrinsic

7. Expain Frank-Starling's Law and its signification in cardiac function

8. Delineate the ways by which cardiac output can be up-regulated in the setting of specific physiologic demands for increased oxygen supply to the tissues, such as exercise.

9. Describe how the pumping action of the heart can be compromised in the presence of disease states.

WEEK 8Cardiovascular Physiology : The Rhythmical Excitation of the Heart1. Describe the structure and function of the conduction system of the heart and compare the action potentials in each part.

2. Explain the mechanism behind cardiac muscle automaticity and rhythmicity including the control of excitation and conduction in the heart .

3. Explain the methods for recording the electrocardiograms (ECG), the normal ECG, placement of ECG leads and the relationship of the ECG to the electrical axis of the heart.

4. Discuss the common cardiac arrhythmias and describe the processes that produce them.

5. List the principal early and late ECG manifestations of myocardial infarction and explain the early changes in terms of the underlying ionic events that produce them.

6. Describe the ECG changes and the changes in cardiac function produced by alterations in the ionic composition of the body fluids.

WEEK 9Cardiovascular Physiology: The Circulation (Fluid and Hemodynamics)1. Discuss the functional parts of the circulation including the pressures and volume of blood at different parts of the circulation

2. Understand the basis of methods used to measure blood flow and blood pressure in various vascular segments of the human body.

3. Discuss the interrelationships of pressure, flow and resistance

4. Describe how physical principles dictate the flow of blood and lymph around the human body

5. Discuss the neural mechanisms that control arterial blood pressure and heart rate,including the receptors, afferent and efferent pathways, central integrating pathways,and effector mechanisms involved

6. Describe the direct effects of CO2 and hypoxia on the vasomotor areas in themedulla oblongata

7. Describe how the process of autoregulation contributes to control of vascular caliber.

8. Identify the paracrine factors and hormones that regulate vascular tone, theirsources, and their mechanisms of action.

9. Discuss how the oxygen needs of the contracting myocardium are met by the coronary arteries and the consequences of their occlusion.

10. Define the special features of the circulation in the brain, coronary vessels, skin, and fetus, and how these are regulated.

11. Understand how the fetus is supplied with oxygen and nutrients in utero, and the circulatory events required for a transition to independent life after birth.

WEEK 10Blood cells, blood typing and blood coagulation1. Describe the components of blood and lymph, their origins, and the role of hemoglobin in transporting oxygen in red blood cells.

2. Understand the molecular basis of blood groups and the reasons for transfusion reactions.

3. Explain the process of hemostasis that restricts blood loss when vessels are damaged, and the adverse consequences of intravascular thrombosis.

5. Identify the types of blood and lymphatic vessels that make up the circulatory system and the regulation and function of their primary constituent cell types.

Circulatory Shock1. Discuss the physiologic causes of shock and the 3 major stages of shock

2. Understand the different types of shock including:

2a. Hypovolemic Shock

2b. Neurogenic Shock

2.c Anaphylactic Shock

2.d Septic Shock

3. Explain the treatment protocols for circulatory shock and the effects of circulatory arrest on the brain.

MIDTERM EXAMINATION

WEEK 11Respiratory Physiology1. Define partial pressure and calculate the partial pressure of each of the important gases in the atmosphere at sea level including the mechanics of pulmonary ventilation.

2. Discuss passageways through which air passes from the exterior to the alveoli, and describe the cells that line each of them. Differentiate the Conducting Zone and Respiratory Zone.

3. List the major muscles involved in respiration, and state the role of each.

4. Define the basic measures of lung volume and capacities, and give approximate values for each in a normal adult.

5. Define compliance, and give examples of diseases in which it is abnormal.

6. Describe the chemical composition and function of surfactant.

7. List the factors that determine alveolar ventilation.

8. Define diffusion capacity, and compare the diffusion of O2 with that of CO2 in the lungs.

9. Compare and contrast between the pulmonary and systemic circulations.

10. Describe the reactions of O2 with hemoglobin and the oxygenhemoglobin dissociation curve.

11. Discuss the important factors affecting the affinity of hemoglobin for O2 and the physiologic significance of each.

12. the reactions that increase the amount of CO2 in the blood, and draw the CO2 dissociation curve for arterial and venous blood.

13. Define alkalosis and acidosis and outline respiratory and renal compensatorymechanisms in response to alkalosis and acidosis.

14. Define hypoxia and describe its four principal forms

15. Describe the effects of hypercapnia and hypocapnia

16. Identify the structures that regulate respiration including pre-Btzinger complex and describe its role in producing spontaneousrespiration; the dorsal and ventral groups of respiratoryneurons, the pneumotaxic center, and the apneustic center in the brain stem and probable functions.

17. Understand the specific respiratory functions of the vagus nerves and the respiratory receptors in the carotid body, the aortic body, and the ventral surface of the medulla oblongata

WEEK 12Endocrinology1. Describe the structures of the endocrine glands and how it relates to its function.

2. Define the structure of the pituitary gland and cell types present in the anterior pituitary and understand how their hormones are controlled in response to physiologic demands.

3. Define the effects of the growth hormone in growth and metabolic function, and how insulin-like growth factor I may mediate some of its actions in the periphery.

4. List the stimuli that regulate growth hormone secretion and define their underlying mechanisms.

5. Understand the basis of conditions where pituitary function and growth hormone secretion and function are abnormal, and how they can be treated. Understand the basis of conditions where pituitary function and growth hormone secretion and function are abnormal, and how they can be treated.

6. Describe the structure of the thyroid gland and how it relates to its function.

7. Define the chemical nature of the thyroid hormones (TSH, T3, T4) and how they are synthesized.

8. Identify the role of the hypothalamus and pituitary in regulating thyroid function.

9. Define the effects of the thyroid hormones in homeostasis, growth and development.

10. Understand the basis of conditions where thyroid function is abnormal and how they can be treated

11. Understand the importance of maintaining homeostasis of bodily calcium and phosphate concentrations, and how this is accomplished.

12. Describe the bodily pools of calcium, their rates of turnover, and the organs that play central roles in regulating movement of calcium between stores.

13. Delineate the mechanisms of calcium and phosphate absorption and excretion.

14. Identify the major hormones and other factors that regulate calcium and phosphate homeostasis and their sites of synthesis as well as targets of their action.

15. Define the basic anatomy of bone.

16. Outline how bone cells and their functions in bone formation and resorption.

17. Name the three catecholamines secreted by the adrenal medulla and summarize their biosynthesis, metabolism, and function

18. List the stimuli that increase adrenal medullary secretion.

19. Outline the steps involved in steroid biosynthesis in the adrenal cortex.

20. Name the plasma proteins that bind adrenocortical steroids and discuss their physiologic role.

21. Name the major site of adrenocortical hormone metabolism and the principal metabolites produced from glucocorticoids, adrenal androgens, and aldosterone.

22. Describe the mechanisms by which glucocorticoids and aldosterone produce changes in cellular function.

23. List and briefly describe the physiologic and pharmacologic effects of glucocorticoids

24. Contrast the physiologic and pathologic effects of adrenal androgens

25. Describe the mechanisms that regulate secretion of glucocorticoids and adrenal sex hormones.

26. List the actions of aldosterone and describe the mechanisms that regulate aldosterone secretion.

27. Describe the main features of the diseases caused by excess or deficiency of each of the hormones of the adrenal gland.

28. Describe the structure of the pancreatic islets and name the hormones secreted by each of the cell types in the islets.

29. List the hormones that affect the plasma glucose concentration and briefly describe the action of each.

30. Describe insulin receptors, the way they mediate the effects of insulin, and the way they are regulated

31. List the major factors that affect the secretion of insulin.

32. Describe the structure of glucagon and other physiologically active peptides produced from its precursor

33. Outline the mechanisms by which thyroid hormones, adrenal glucocorticoids, catecholamines, and growth hormone affect carbohydrate metabolism.

34. Understand the major differences between type 1 and type 2 diabetes

WEEK 12Renal Physiology1. Describe the morphology of a typical nephron and its blood supply.

2. Define glomerular filtration rate, describe how it can be measured, and list the major factors affecting it.

3. Discuss tubular handling of Na+ and water

4. Discuss tubular reabsorption and secretion of glucose and K

5. Describe how the tonicity (osmolality) of the extracellular fluid is maintained by alterations in water intake and vasopressin secretion

6. Discuss the effects of vasopressin, the receptors on which it acts, and how its secretion is regulated

7. Describe how the volume of the extracellular fluid is maintained by alterations in renin and aldosterone secretion.

8. Outline the cascade of reactions that lead to the formation of angiotensin II and its metabolites in the circulation.

9. Understand the functions of angiotensin II and the receptors on which it acts to carry out these functions.

10. Describe the site and mechanism of action of erythropoietin, and the feedback regulation of its secretion.

11. Understand the processes involved in the secretion of H+ into the tubules and discuss the significance of these processes in the regulation of acidbase balance.

12. Define acidosis and alkalosis, and give (in mEq/L and pH) the normal mean and the range of H+ concentrations in blood that are compatible with health

WEEK 14Gastrointestinal Physiology1. Understand the functional significance of the gastrointestinal system, and in particular, its roles in nutrient assimilation, excretion, and immunity.

2. Understand how nutrients are delivered to the body and the chemical processes needed to convert them to a form suitable for absorption.

3. Understand basic principles of energy metabolism and nutrition.

4. Describe the major functions of the liver with respect to metabolism, detoxification, and excretion of hydrophobic substances.

5. Understand the functional anatomy of the liver and the relative arrangements of hepatocytes, cholangiocytes, endothelial cells, and Kupffer cells.

6. Describe the formation of bile, its constituents, and its role in the excretion of cholesterol and bilirubin

7. Discuss the mechanisms by which the liver contributes to whole body ammonia homeostasis and the consequences of the failure of these mechanisms, particularly for brain function.

8. Identify the mechanisms that permit normal functioning of the gallbladder and the basis of gallstone disease.

WEEK 15Development& Function of theReproductive System1. Explain the general structure of the male and female reproductive system.

2.Discuss the nature of testosterone, and describe its biosynthesis, transport, metabolism, and actions.

3. Outline the steps involved in spermatogenesis and the mechanisms that produce erection and ejaculation.

4. Name the key hormones secreted by Leydig cells and Sertoli cells of the testes and by graafian follicles and corpora lutea of the ovaries.

5. Describe the processes involved in regulation of testosterone secretion.

6. Describe the physiologic changes that occur in the female reproductive organs during the menstrual cycle.

7. Outline the role of chromosomes, hormones, and related factors in sex determination and development.

8. Summarize the hormonal changes that occur at puberty in males and females.

9. Outline the hormonal changes and their physiologic effects during perimenopause and menopause.

10. Know the general structures of 17 estradiol biosynthesis, transport, metabolism, and actions.

11. Describe the roles of the pituitary and the hypothalamus in the regulation of ovarian function, and the role of feedback loops in this process.

12. Describe the hormonal changes that accompany pregnancy and parturition.

13. List the physiologic stimuli and the drugs that affect prolactin secretion.

14. Outline the processes involved in lactation.

FINAL EXAMINATION

TEACHING METHODS & STRATEGIES:1. Lecture2. Interactive Discussion3. Problem-based learning approach4. Case Analysis5. Clinical Immersion and patient evaluation (ACTUAL PATIENT and SIMULATION) Observation & Feedback Demonstration (Modeling) Reflection and Integration

EVALUATION: Recitation Quizzes Research work Periodical Examinations

Textbook & References:Hall, John E. Guyton and Hall Textbook of Medical Physiology 12th Edition. Saunders (Elsevier) 2011Ganong, William Francis. Review of Medical Physiology. Mc-Graw Hill. New YorkVanders Human Physiology: The Mechanisms of Body Function. 8th Edition. Publisher: McGraw Hill

GRADING CRITERIA:Class Standing (CS)=100%

Breakdown:Attendance= 10%Behavior = 5%Recitation=10%Quizzes=40%Laboratory Exercises=25%Unit Tests=10%

Class Standing Total-100%Computation

Examination Grade = (Raw Score/ Total exam items) X 100) (100 X 60 + 40)

Class Standing (CS) Grade = (CS raw Score / 100) X 60+40Term Grade=Class Standing Grade X 2 + Examination Grade 3 (Prelim/Midterm/Finals)

Final Grade=Prelim Grade + Midterm Grade + Raw Final Grade 3

PREPARED BY:REVIEWED AND APPROVED BY:

Jacinto Jose P. Gapud, PTRPWilfredo C. Ramos, Ed.D, RNPT CoordinatorDean, CONAMS