Physiology 310 principles of physiology syllabus Spring 2007 Instructor




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PHYSIOLOGY 310 - PRINCIPLES OF PHYSIOLOGY

Syllabus - Spring 2007
Instructor: Dr. David Wade, Room 16E, Lindegren Hall, 453-1542, e-mail: dwade@siumed.edu

Study questions web site: http://www.siumed.edu/~dwade/phys310/

Office Hours: Mon. 1-3 p.m., Wed 1-3 p.m., Thur. 1-3 p.m.
Textbooks:

Widmaier, Raff, & Strang. Vander’s Human Physiology. McGraw-Hill, 10th ed., 2006.



Youther. "Laboratory Exercises for PHSL 208 & PHSL 310". Kopies & More, 2006.
Schedule of classes:


Lecture

Start date

Topic

Chapter

1, 2

1/17

Homeostasis & biological rhythms

1

3

1/22

Protein ligand interaction

3

4, 5

1/24

Membrane transport

4

6, 7

1/29

Signal transduction

5

8-12

2/2

Neural mechanisms

6

13-15

2/14

Skeletal & smooth muscle

9

16

2/21

1st Hourly Test

1-9

17-23

2/23

Cardiovascular system

12

24, 25

3/19

Endocrine system

11

26-29

3/23

Respiration

13

30

4/2

2nd Hourly Test

11-13

31-34

4/4

Kidney

14

35-37

4/13

Gastrointestinal system

15

38-40

4/20

Metabolism & energy balance

16

41-44

4/27

Reproduction

17


3rd Hourly Test (Chaps 14-17), & Final Exam (All material) during Finals Week, Monday 7 May, 12:50-2:50 p.m.
Scoring system:
1st hourly test 18% (54 questions, 1/3 point each)

2nd hourly test 15% (45 questions, 1/3 point each)

3rd hourly test 17% (51 questions, 1/3 point each)

Final exam 20% (40 questions, 1/2 point each)

Discussion paper 15%

Laboratory discussions 8%

Laboratory reports 7%

Total 100%


Grades:
A: 90+% B: 80-89% C: 70-79% D: 60-69% F: below 60%
Laboratory

Attendance at the laboratory is compulsory. Absence from one lab session during the semester with the prior permission of your T.A. will not be penalized. Absences in excess of this, or unexcused absences will result in a 20% reduction in your lab grade per absence.

The laboratory discussion groups are designed to give you the opportunity to talk rather than listen. Bring your questions and your opinions and be prepared to express them. The most important value of this small group experience is to have you (the student) explain your understanding of physiological mechanism to other students. You will be graded on your participation (not on the accuracy of your explanations) which will count for 8 points toward your final grade..

Lab reports should be shown to your T.A. either at the end of the lab period or at the beginning of the next lab period. The quality and punctuality of your lab reports will count for 7 points toward your final grade.



Discussion Paper

Each student will write a 7-10 page discussion paper which will explore one of the following topics (or topic of your choice if your T.A. approves). See item 7 (below) for topic list. The purpose of this exercise is to give you a chance to study some aspect of physiology in greater depth, to develop your skills in writing understandable English, and to introduce you to the use of the physiology literature. Your paper will be graded according to the following criteria:

1. Content:

This is a physiology course and your paper should be written from a physiological point of view. Do not bite off more than you can chew. Choose a small aspect of your topic and write about it in depth.

2. Organization:

Group your information; put all the material about one topic together, rather than scattering it throughout the piece. It is perfectly acceptable to head each of your sections with a title.

3. References:

They should be appropriate to the point you are trying to make. Strictly speaking, every factual statement you make should have a citation. In practice, scientists do not quote references for things that they believe most people would agree to, but controversial statements or statements that you think your reader might like to know more about, should have references.

You should prepare your references using the style of Ann Intern Med. 1997;126:36-47. They should come at the end of your paper, should be listed alphabetically according to the last name of the first author and then numbered serially (one through whatever). When you cite a reference in the paper, you should put the appropriate reference number in parentheses at the proper place in your paper.

In the reference list at the end of your paper, you should list journal articles as follows: author's last name, title of article, abbreviated name of journal, volume, inclusive pages, and year.

Example: Dozios R.R., Kelly K.A. Effects of gastrin pentapeptide on canine emptying of liquids. Am J Physiol 1971;21:113-117.

For book references, list author(s), title of book, edition, publisher, year and pages (preceded by "p.").

Example: Fox, S.I. Human Physiology. 5th ed. Wm.C.Brown; 1996. p. 208-209.

4. Original papers:

In general, there are three levels at which scientists spread the word about the research they have done: the original paper, the review article, and the textbook. By writing this paper, you are in effect writing at the review level. To ensure that you have an opportunity to experience original articles, you are also required to choose 2 such articles related to your discussion paper topic and to write an abstract of each article in 100 of your own words which summarizes the main findings of the paper. Include these abstracts with your discussion paper when you turn it in.

5. English:

Please be gentle with the English language. I expect your paper to be grammatical and correctly spelt.

6. Topic outline:

You must turn in an outline of your chosen topic to your T.A. by Monday March 26. This outline could be a short paragraph or even a list of paragraph headings and must include a main reference source (e.g. a review article or book chapter).

7. Topics:

Because the deadline for turning in your outline is 26 March, I have limited this topic list to material which we shall cover in lecture through the Respiratory chapter.

a. Would I, or my grandmother, be better off pumping iron or exercising aerobically?

b. Calcium channel blockers (e.g. nifedipine) are useful drugs for treating hypertension. Describe the mechanisms by which such drugs action the heart and the peripheral vasculature to lower blood pressure.

c. Catecholamines, the neurotransmitters and neurohormones for the sympathetic nervous system, bind to adrenergic receptors on the cell surface. Describe the variable responses that binding to these receptors ( & ) has on the cell.

d. Cyclic 3’5’ AMP is a second messenger for a large variety of hormonal and neurotransmitter systems. Describe the mechanisms by which cyclic 3’5’ AMP mediates the action of hormones and neurotransmitters on cardiac function, and cardiac metabolism of glycogen and triglyceride.

e. Asthma is an obstructive lung disease triggered by a variety of external and internal stimuli. What are the mechanisms of action of the various drugs used to treat asthma?

f. Describe how the blood flow to various organs changes during exercise and the physiological mechanisms which regulate those changes.

g. Any topic mutually acceptable to you and your T.A.

8. Completed paper:

The completed paper should be handed to your T.A. by Monday April 23. Get it in on time; your T.A. has final exams to take as well! If you are going to use a computer, back up the disk; electronic accidents (the new age version of “the dog ate my homework”) are not acceptable excuses for late papers.

9. Plagiarism.

In the past, the occasional student has copied his/her paper from some source rather than writing an original. When that has been discovered, I have had the dreary task of punishing that student. This exercise is designed to help you develop your writing skills and explore in depth a topic that interests you. Because students bring such different skills to the course, the paper is graded leniently by the T.A., and is meant to be a teaching device rather than a testing vehicle. Please don't cheat yourself.



PRINCIPLES OF PHYSIOLOGY

PHSL 310 Objectives

Based on: Widmaier, Raff, & Strang. Vander’s Human Physiology. McGraw-Hill, 10th ed., 2006

Note: objectives in italics will not be covered in lecture.

Chapter 1: Homeostasis, a framework

1. Be aware of the terminology used for the various levels of cellular organization: cell, tissue, organ, organ system.

2. Define the following body fluid spaces: extracellular, intracellular, interstitial, plasma.

3. Define the components of a negative feedback system including the stimulus, receptor, afferent pathway, integrating center, efferent pathway, effector and response in your description.

4. Explain in graphical form how a homeostatic system functions, defining steady state (contrasting it with equilibrium), operating point, negative feedback, and error signal. (Note: “error signal” is not explained in your text).

5. Apply these principles of negative feedback to the regulation of body temperature.

6. Define the terms hormone, neurotransmitter, paracrine and autocrine.

7. Explain how biological rhythms are maintained, describing the concepts of free-running rhythms, environmental entrainment, and phase-shifts.

8. Define "circadian" rhythm, and describe the location of the biological clock.

9. Define the terms balance, stable balance, negative balance, and positive balance.



Chapter 2: Chemical composition

1. Define the terms carbohydrate, pentose, hexose, monosaccharide, disaccharide, polysaccharide, and use these terms to categorize glucose, ribose, galactose, fructose, sucrose, lactose, maltose, starch, and glycogen.

2. Given a diagram of the structure of a lipid, identify it as a triacylglycerol (triglycerides), fatty acid (saturated or unsaturated), phospholipid or steroid.

3. Define the terms amino acid, peptide bond, polypeptide, and protein. Define the forces which contribute to the primary, secondary, tertiary and quaternary conformations of proteins.

4. Compare the structures of DNA and RNA in terms of their base composition, sugar and chain number.

Chapter 3: Cell structure & protein function

1. Describe the arrangement of phospholipid, cholesterol, integral and peripheral proteins, and glycoprotein within the cell membrane, and explain why it is known as the fluid mosaic model.

2. Relate the structures of the desmosome, tight junction, and gap junction to their functions.



3. Describe the structure and function of the nucleus, nucleolus, granular (rough) and agranular (smooth) endoplasmic reticulum, ribosome, Golgi apparatus, mitochondrion, lysosome, and cytoplasmic filaments (microfilaments, intermediate filaments, muscle thick filaments, microtubules).

4. Describe the general characteristics of the interaction between proteins and ligands including specificity, affinity, saturation, and competition.

5. Explain how allosteric regulation and covalent modification can affect protein/ligand interaction, and therefore enzyme activity and transport rates.

6. For intermediary metabolism, define the terms glycogenolysis, glycogenesis, lipolysis, lipogenesis, gluconeogenesis, ketogenesis, and urea synthesis, and describe their interrelationships. Which of these processes occur only in the liver?

7. Outline the path of glucose metabolism via anaerobic or aerobic glycolysis and the Krebs cycle. Include only the following intermediates in your description: glucose, glucose 6 phosphate, pyruvate, lactate, acetyl CoA, oxaloacetate, citrate. Indicate which processes are cytoplasmic and which are mitochondrial.

8. Outline the pathways which link triglyceride and amino acids to the Krebs cycle. Include only the following intermediates in your descriptions: triglyceride, glycerol, fatty acid, fatty acyl CoA, amino acids, ketoacids, urea.

9. Describe the central role of ATP in cellular energy transfer. What is the yield of ATP from aerobic oxidation of glucose, anaerobic metabolism of glucose, and aerobic oxidation of a 16-C fatty acid.

10. Compare the energy yields when carbohydrate, fat and protein are oxidized (table 3-11). Why then does the body store energy as triglyceride?



Chapter 4: Membrane Transport

1. Compare the intra- and extracellular concentrations of Na+, K+, Cl-, phosphate and protein (table 4-1).

2. For each of the following types of membrane transport:


  • diffusion through the lipid bilayer

  • diffusion through protein channels (including ligand-, voltage-, mechanical gating, and gating by

covalent modification)

  • facilitated diffusion

  • primary active transport (including Na+/K+ ATPase in ion distribution)

  • secondary active transport (cotransport or countertransport)

Compare and contrast their properties according to the following criteria: equilibrium position (intracellular concentration vs. time); involvement of a protein carrier, saturation, specificity and affinity (transport rate vs. transported substance concentration); energy requirement; examples of substance transported.

3. Describe the mechanism of water transport across cell membranes through aquaporin channels.

4. Given solutions having solutes which may or may not dissociate and/or cross cell membranes:

a. calculate their osmolalities

b. predict the behavior of red blood cells when placed in the solutions

c. distinguish between osmolality and tonicity

5. Describe the processes of endocytosis and exocytosis including the roles of the lysosome and Golgi apparatus, respectively.

6. Describe how different membrane transport mechanisms interact to move Na+, water, and glucose across epithelial cell layers.



Chapter 5: Control of cells by chemical messengers

1. Define the following terms as they apply to the properties of receptors: specificity, saturation, affinity, competition, agonist, antagonist, down-regulation, up-regulation and supersensitivity.

2. Binding of a chemical messenger to a membrane receptor causes changes in cellular processes by a variety of mechanisms, a process described as “signal transduction”. Describe the mechanisms for each of the following systems.

A. Intracellular receptors (steroid & thyroid hormones)

B. Plasma membrane receptors (catecholamine & peptide hormones, and neurotransmitters)

I. receptors which function as ion selective channels.

II. receptors which have enzyme (generally tyrosine kinase) activity.

III. receptors which act via G proteins to affect plasma membrane proteins:

a. adenylate cyclase (include Gs protein, Gi protein, adenylate cyclase, cyclic AMP, cyclic AMP dependent protein kinase, phosphorylated protein, and cyclic nucleotide phosphodiesterase in your description)

b. phopholipase C (include Gq protein, phosphatidyl inositol bisphosphate, diacylglyceride, inositol trisphosphate, and protein kinase A in your description)

b. G protein regulation of ion selective channels

3. Describe the various roles of Ca++ as a second messenger. Include processes by which cytosolic Ca++ is regulated (via membrane channels and release from endoplasmic reticulum) and mechanisms of Ca++ action (direct and via calmodulin).



Chapter 6: Neural Control Mechanisms

1. Define the following terms which apply to the neuron: cell body, dendrites, axon, axon collateral, axon terminals, myelin sheath, node of Ranvier, synapse, neurotransmitter, presynaptic neuron, postsynaptic neuron, glial cell.

2. Compare the properties of afferent neurons, efferent neurons and interneurons (table 6-1).

3. Compare the intracellular and extracellular concentrations of Na+, K+, and Cl-, and explain the differences (table 6-2).

4. Describe the mechanism for the development of the resting membrane potential. Compare that potential with the equilibrium potential for K+ and Na+. Describe the changes in resting membrane potential which would occur if the extracellular or intracellular Na+ or K+ were changed, if the permeabilities of the cell membrane to Na+ or K+ were changed, or if the Na+/K+ pump were inhibited by ouabain. Describe the fluxes of Na+ and K+ at steady state.

5. Describe the general properties of graded potentials.

6. Describe the changes in membrane potential which occur during passage of an action potential. Include the time base of these changes, and relate the potential to the membrane permeabilities for Na+ and K+.

7. Describe how the action potential is conducted along the unmyelinated and myelinated axon. What determines the rate of conduction?

8. Compare graded potentials with action potentials. Outline the different molecular events involved, and include amplitude, summation, threshold, refractory period, decremental conduction, polarity and initiating event in your comparison (table 6-4).

9. Define the following terms associated with the chemical synapse: excitatory/inhibitory synapse, convergence, divergence, presynaptic cell/axon/membrane, postsynaptic cell, subsynaptic membrane, synaptic vesicle, synaptic cleft, excitatory postsynaptic potential and inhibitory postsynaptic potential.

10. Describe the sequence of events which occur between passage of an action potential along a presynaptic axon, and generation of a post synaptic potential.

11. Describe how spatial and temporal summation occur, and how the initial segment (axon hillock) is involved in generation of an action potential. Describe the process of “synaptic integration”.

12. Describe the overall organization of the nervous system.

13. Given a diagram of the brain identify:

cerebrum, diencephalon (thalamus, hypothalamus), cerebellum, brainstem (mid brain, pons, medulla oblongata), and spinal cord.

frontal parietal occipital and temporal lobes

primary motor cortex, basal ganglia and corpus callosum.

visual, auditory, taste, olfactory and somatosensory cortices.

14. Briefly outline the functions of the:

cerebral hemispheres

thalamus

hypothalamus

limbic system

cerebellum

brainstem

15. Given a diagram of a cross section of the spinal cord identify gray matter, dorsal horn, ventral horn, white matter, spinal nerve, dorsal root, dorsal root ganglion and ventral root. Describe the components of the dorsal and ventral root, and dorsal root ganglion.

16. Describe the anatomical components and functions of the limbic system and reticular activating system.

17. Compare the properties of the afferent and efferent divisions of the peripheral nervous system.

18. Compare the structure and function of the somatic and autonomic nervous systems.

19. Compare the structural features and neurotransmitters of the sympathetic and parasympathetic nervous systems.

20. Compare the actions of the sympathetic and parasympathetic nervous systems on the heart, vasculature, lungs, gastrointestinal system, metabolism, urinary bladder, reproductive system, and sweat.

Chapters 7, & 8: omitted

Chapter 9: Muscle

1. Briefly compare the structures of skeletal, cardiac & smooth muscle

2. Define the following terms as they apply to skeletal muscle: striations, myoblast, muscle fiber, myofibril, sarcomere, thick filament, thin filament, Z-line (but not other letters), and cross bridges.

3. Describe the arrangement of thick and thin filaments in cross section.

Note: the events of objectives 4-8 are described in reverse order in your text. The lecture will cover them in the sequence that they actually occur.

4. Describe the structure of the neuromuscular junction, and detail the events whereby an action potential in a somatic motor nerve generates an action potential in the skeletal muscle cell.

5. Describe the structure of the sarcoplasmic reticulum (lateral sacs, transverse tubule) and its function to regulate cytosolic Ca++ concentration.

6. Describe the molecular structure of the thin filament and the role of Ca++ in exposing the cross-bridge binding site.

7. Describe the sliding filament mechanism of muscle contraction. Include a description of the molecular structure of the myosin molecule, its light and heavy chains, actin binding sites and ATP binding sites. Explain how the energy of ATP is used during cross bridge cycling.

8. Summarize the actions of ATP during skeletal muscle contraction (table 9-1).

9. Describe the mechanism of muscle relaxation.

10. Define the following terms as they apply to contraction of a muscle fiber: isometric, isotonic, lengthening contraction, twitch, latent period, contraction time, summation, tetanus, shortening velocity.

11. Explain why a skeletal muscle fiber develops its greatest tension at its normal resting length.

12. Compare the roles of stored ATP, creatine phosphate, oxidative phosphorylation and glycolysis as energy supplies at different work rates of skeletal muscle.

13. Define the motor unit.

14. Compare the properties of slow-oxidative fibers with fast-glycolytic fibers. Be aware that fast-oxidative fibers (with intermediate properties) exist.

15. Describe how the tension of a muscle can be varied by the recruitment of different sized motor units.

16. Describe the changes in muscle which occur in response to various exercise regimens.

17. Compare smooth muscle with skeletal muscle in terms of its structure (dense bodies, myosin and actin content), its length/tension relationship, and the mechanism of its contraction.

18. Describe the factors which alter smooth muscle contraction, including spontaneous depolarization, autonomic nervous system, hormones, local chemical changes, and stretch (table 9-5).



Chapter 10: omitted

Chapter 12: cardiovascular system

1. Define “hematocrit” and distinguish between plasma and serum.

2. Outline the overall design of the circulatory system.

3. Describe the relationship between pressure, flow and resistance.

4. Describe how the resistance of a vessel varies with its length, radius, and the viscosity of the fluid flowing through it.

5. Describe the structure of the heart (including atria, ventricles, valves and large vessels), and trace the sequence of blood flow through the heart and vasculature.

6. Describe the structure of cardiac muscle, and the regulation of its blood supply.

7. Describe the structure of the conducting system of the heart, including the sinoatrial node, atrial conducting system, atrioventricular node, bundle of His, right and left bundle branches, and Purkinje fibers.

8. Which part of the conducting system has the slowest conduction rate, and why does the sinoatrial node function as the pacemaker?

9. Describe the action potential of ventricular muscle, relating its shape to the permeabilities of Na+, K+ and Ca++, and defining its duration and refractory period.

10. Describe the action potential of nodal tissue, relating its shape to the permeabilities of Na+, K+ and Ca++.

11. Explain how excitation (the action potential) is coupled to contraction (muscle shortening), contrasting the process with that of skeletal muscle.

12. Relate the features of the electrocardiogram to the electrical events of conduction and contraction.

13. Describe the four phases of the cardiac cycle including:

a. the cause of the two heart sounds

b. the pressures in the chambers, aorta and pulmonary artery, and the relationship between those pressures and the state of the heart valves

c. the volumes of the ventricles

d. a comparison of the hemodynamics of left and right heart

14. Describe the relationship between cardiac output, stroke volume (end-diastolic volume minus end-systolic volume), and heart rate.

15. Describe how the autonomic nervous system and circulating epinephrine affect heart rate, explaining the mechanisms involved.

16. Describe how end-diastolic volume (Starling's law of the heart), the sympathetic nervous system and epinephrine affect stroke volume. Define cardiac contractility and ejection fraction.

17. Describe how the structure of arteries is related to their function as low resistance conduits and pressure reservoirs.

18. Describe how blood pressure is measured. Define systolic pressure, diastolic pressure, pulse pressure and mean arterial pressure. Define arterial compliance, and explain why pulse pressure increases with aging.

19. Describe how the following factors regulate arteriolar tone and hence blood flow through organs:

a. active hyperemia caused by such metabolites as O2, CO2, H+, adenosine, K+, osmolarity, eicosanoids and bradykinin; reactive hyperemia

b. flow autoregulation

c. injury

d. sympathetic and parasympathetic nerves

e. epinephrine, angiotensin II, vasopressin (antidiuretic hormone), and NO (endothelium-derived relaxing factor)

20. Describe the anatomy of the capillary system including metarterioles, precapillary sphincters, endothelial cells, intercellular clefts, and fused vesicle channels.

21. Explain how the permeability properties and passage time of blood are related to capillary function.

22. Describe the factors (Starling forces) which regulate the distribution of fluid across the capillary endothelial wall. Define edema.

23. Describe how the veins act as capacitance vessels, and how the sympathetic nervous system, blood volume, the skeletal muscle pump and respiratory movements affect venous return.

24. Describe the source, composition, and mechanism of movement of lymph.

25. Integrate the factors which regulate cardiac output with those that regulate peripheral resistance to define the factors which regulate systemic arterial pressure (fig 12-51).

26. Describe how the baroreceptor reflex operates to regulate arterial blood pressure in response to hemorrhage, or standing up.

27. Describe how exercise affects cardiac output, blood pressure, peripheral resistance, and blood flow to the heart, skeletal muscle, brain, skin and viscera, explaining the mechanisms involved.

Chapter 11: endocrine system

1. Compare the properties of these hormone classes, catecholamines, peptides, steroids, & thyroid hormones, by the following criteria:

a. site and mechanism of synthesis

b. blood transport & excretion rate

c. receptor location & general mechanisms of action

Note the common features of catecholamines and peptides when compared with steroid and thyroid hormones with respect to transport, excretion, receptor location, and mechanism of action.

2. Describe in general terms the factors that regulate release of hormones.

3. Describe the sites of synthesis, storage and regulation of release of the posterior pituitary hormones, oxytocin and ADH (antidiuretic hormone or vasopressin). Describe the actions of oxytocin (ADH will be considered later).

4. Consider the following hormones: follicle stimulating hormone (FSH) and luteinizing hormone (LH); growth hormone (GH); thyroid stimulating hormone (TSH); prolactin (PRL); adrenocorticotropic hormone (ACTH). For each, describe its hypothalamic control, target endocrine organ (if any), target organ hormones, and sphere of influence (general actions) - see fig 11-14.

5. Outline the mechanism of synthesis of tri- (T3) and tetraiodothyronine(T4).

6. Describe the hypothalamic-pituitary-end organ axis of the thyroid gland. Use that outline to explain mechanism for the development of an iodine-deficient goiter of the thyroid.

7. Outline the actions of T3 on metabolism, growth and development, and its permissive effect on catecholamine action. (See also table 16-6).



Chapter 13: Respiration

1. Describe the gross structure of the respiratory system including the nasal cavity, pharynx, larynx, trachea, bronchi, bronchioles, respiratory bronchioles, alveolar ducts and alveolar sacs.

2. Describe the functions of the conducting zone including regulating air flow, protection, warming and moistening air, and phonation.

3. Describe the microstructure of the alveolus including type I and type II epithelial cells, capillary endothelial cells, phagocytes and elastic fibers.

4. Describe the relationship between the lungs, the thoracic cavity and the pleural cavity. Compare the pressures within the alveolus, the pleural cavity, and atmospheric pressure when the lung volume is at its functional residual capacity.

5. Describe how alveolar and pleural pressures change during ventilation.

6. Describe how the diaphragm, ribs and intercostal muscles function during quiet inspiration and expiration.

7. Define lung compliance. Describe its components and explain the role of pulmonary surfactant in the normal lung and with respiratory distress syndrome of the newborn.

8. Describe how transpulmonary pressure, lateral traction, epinephrine, and leukotrienes affect airway resistance.

9. Define the following spaces and learn their approximate volumes: tidal volume, inspiratory reserve volume, expiratory reserve volume, residual volume, functional residual capacity, vital capacity, and total lung capacity. (Learn these in the laboratory.)

10. Relate the terms minute ventilation, tidal volume, ventilation rate, anatomic dead space, and alveolar ventilation. Given suitable data, calculate minute ventilation and alveolar ventilation rate.

11. Define the term "partial pressure" and explain how the concept relates to the solubility and diffusion of gases in liquids.

12. State the partial pressures of O2 and CO2 in the atmosphere, alveolar air, arterial and venous blood.

13. How does the composition of alveolar air vary with changes in alveolar ventilation rate? Define the terms “hypoventilation” and “hyperventilation”.

14. Explain how changes in P.O2 alters pulmonary blood flow and changes in P.CO2 alters air flow to achieve matching of ventilation and perfusion.

15. Outline the time course for the equilibration of O2 between alveolar gas and pulmonary capillary blood.

16. Outline the structure of hemoglobin. Relate the O2 saturation of hemoglobin to the P.O2 (the oxygen-hemoglobin dissociation curve), and explain its sigmoid shape.

17. Explain the physiological significance of the effects of CO2, pH, temperature, and 2, 3-diphosphoglycerate concentration on the oxygen-hemoglobin dissociation curve.

18. Describe the various ways in which CO2 is carried from the tissues to the lungs including the function of carbonic anhydrase, the chloride shift, and the buffering properties of de-oxyhemoglobin.

19. Describe how the rhythmical nature of ventilation is generated. Explain how P.O2, P.CO2 and pH control ventilation rate.

20. Describe what are, and what are not, plausible mechanisms to explain the increase in ventilation rate seen with exercise.

Chapter 14: Kidneys and the regulation of inorganic ion and water balance

1. Outline the functions of the kidneys.

2. Describe the structure of the urinary system including kidneys, ureters, bladder, urethra, cortex, medulla and position of the nephron.

3. Describe the structure of the nephron including Bowman's capsule, proximal tubule, descending and ascending loops of Henle, distal tubule, collecting duct, and juxtaglomerular apparatus.

4. Describe the blood supply to the nephron including the afferent arteriole, glomerular capillaries, efferent arteriole and peritubular capillaries (note terminology of renal corpuscle & glomerulus).

5. Define the terms filtration, reabsorption, secretion and excretion.

6. Describe the glomerular filtration barrier, outline the composition of the filtrate, define the forces which control glomerular filtration, and relate the glomerular filtration rate to cardiac output and renal blood flow.

7. Describe how the kidney handles glucose, amino acids and urea.

8. Explain how the clearance of inulin or creatinine gives a measure of the glomerular filtration rate.

9. Outline the routes (in qualitative terms) by which sodium and water enter and leave the body. Explain why the volume of extracellular fluid depends on total body sodium content.

10. Describe the approximate percentages of filtered Na+ reabsorbed in various parts of the nephron.

11. Describe how the rate of sodium excretion is regulated by the sympathetic nervous system, the renin/angiotensin/aldosterone system, and atrial natriuretic factor.

12. Describe the mechanism of water reabsorption in various parts of the nephron and the role of antidiuretic hormone (ADH).

13. Describe how extracellular osmolarity and volume regulate the rate of water excretion.

14. Explain how severe sweating can alter the rates of sodium and water excretion.

15. Explain how thirst is regulated.

16. How is K+ handled by the kidney, and how is its rate of excretion regulated?

Chapter 15: Gastrointestinal System

1. Define the terms “digestion”, “secretion”, “absorption” and “motility”.

2. Outline the functions of these structures: mouth, pharynx and salivary glands; esophagus; stomach; pancreas; liver; gall bladder; small intestine; large intestine; (fig. 15-3).

3. Outline the fluid exchanges which occur across the gastrointestinal wall, describing the mechanisms involved and the pathological consequences of malfunctions.

4. Describe the microscopic features of a generalized cross section of the GI tract including:

a. mucosa (epithelium, exocrine glands, muscularis mucosa)

b. sub mucosa (submucosal nerve plexus)

c. muscularis externa (circular muscle, myenteric nerve plexus, longitudinal muscle)

d. serosa and mesentery

5. Explain how the surface area and life cycle of the intestinal cell is appropriate for its function.

Digestion & Absorption

6. Describe the digestion and absorption of carbohydrate, protein, lipid, vitamins, water and minerals.

Secretion

7. List the luminal stimuli which regulate gastrointestinal processes.

8. Describe the roles of the enteric and autonomic nervous systems in control of the gastrointestinal processes including a description of short and long loop reflexes.

9. Describe the source, regulation of release and major actions of gastrin, cholecystokinin, secretin and GIP (glucose insulinotropic peptide).

10. Outline the functions of saliva and the regulation of salivary secretion.

11. Which stomach cells secrete mucus, pepsinogen, HCl, intrinsic factor, and gastrin, and how is the rate of that secretion regulated?

12. List the three phases of gastric secretion of HCl and pepsin, and describe the neural and hormonal control mechanisms involved.

13. Describe the control of the pancreatic secretion of enzymes and bicarbonate ion.

14. Describe the composition of bile and the regulation of its release, including the role of its enterohepatic circulation.

15. Describe the mechanisms by which gastric and pancreatic enzymes are activated in the intestinal lumen.

Motility

16. Describe the process by which food is moved from the mouth to the stomach.

17. Describe the contributions of receptive relaxation, basic electrical rhythm and peristalsis against a closed pyloric sphincter to gastric function.

18. Describe how the rate of emptying of stomach contents into the duodenum is regulated.

19. Describe the roles of segmentation and migrating motility complexes in the movement of chyme within the small intestine.

20. Outline the functions of the colon and describe its movements (segmentation and mass movements).

Liver

21. Review the functions of the liver noting those which are exclusively or predominately performed by that organ (table 15-2).



Chapter 16: Metabolism, and Energy Balance

1. Define the absorptive (fed) and post absorptive (fasted) states.

2. In the absorptive state describe the ways in which the body handles absorbed glucose, triglyceride and amino acids.

3. In the post-absorptive state describe the sources of blood glucose and the extent to which the body uses fatty acid as an energy source.

4. Describe the source, structure, actions, mechanism of action and regulation of release of insulin.

5. Compare the characteristics of insulin-dependent and non-insulin-dependent diabetes mellitus.

6. Describe the source, structure, actions, mechanism of action and regulation of release of glucagon.

7. Describe the actions of epinephrine and the sympathetic nervous system on metabolism.

8. Outline the factors which regulate plasma cholesterol concentration, including the roles of diet, liver, low-density lipoproteins and high-density lipoproteins.

Chapter 17: Reproduction

1. Describe the structure of the male reproductive tract including the testis, epididymis, vas deferens, seminal vesicle, prostate, ejaculatory duct, bulbourethral gland, and urethra.

2. Describe the structure of the seminiferous tubules including the Leydig (interstitial) cells, Sertoli cells and developing germ cells.

3. Describe the sequence of cell divisions leading to spermatogenesis, indicating which are the first and second meiotic divisions, and the developmental stage at which the germ cell crosses the tight junction between adjacent Sertoli cells.

4. Describe the functions of the Sertoli cell.

5. Identify the head, midpiece, flagellum, acrosome, nucleus and mitochondria of the spermatozoon.

6. Describe the mechanisms of erection and ejaculation, noting the interplay between the autonomic nervous system and higher brain centers.

7. Describe how gonadotropin releasing hormone (GnRH), luteinizing hormone (LH) and follicle stimulating hormone (FSH) interact to promote spermatogenesis and testosterone secretion by the testes.

8. Describe the physiological effects of testosterone, and its mechanism of action.

9. Describe the structure of the female reproductive tract including the ovary, fimbriae, uterine tube (oviduct), uterus, cervix, vagina, clitoris, labia majora and minora, and the vaginal and urethral openings.

10. Describe the sequence of cell divisions leading to oogenesis indicating the time frame of the events, and which are the first and second meiotic divisions.

11. Describe the structural changes which occur during follicular development, ovulation, and corpus luteum formation noting the time frame of the described events.

12. Describe how the events of the menstrual cycle regulate, and are regulated by, GnRH, LH, FSH, estrogens and progesterone concentrations.

13. Describe how estrogen and progesterone regulate endometrial structure during the menstrual cycle.

14. Describe the physiological effects of estrogens, and compare with the effects of progesterone.

15. Describe the female sexual responses, noting the interplay between the autonomic nervous system and higher brain centers.



16. Describe the events of fertilization, and implantation noting the times and location of each event.

Chapter 18: omitted




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