The Teaching Outline of Physiology
(for International Students of Bachelor Medicine)
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 tothe necessity of
medicine, the teaching contents must be the basic concept and knowledge, as wellas
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 textbook Medical Physiology (edited by Guyton and Hall) and the
sixth edition of Physiology (People's 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
Chap
ter 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 nervous system; nutritive function of nerves.
2. Coordination of Reflex Activity: -master concept of reflex and
reflex arc; excitatory
postsynaptic potential (EPSP); characteristics of synaptic chemical
transmission:
unidirectional transmission, central delay. Summation,after discharge,
susceptibility
to change in internal and external environment,fatigue; central inhibition:
inhibitory
postsynaptic potential (IPSP), postsynaptic inhibition: reciprocal inhibition
and recurrent
inhibition; presynaptic inhibition; central facilitation: postsynaptic
facilitation and
presynaptic facilitation. understand neuronal circuits: convergence, divergence,
recurrent
circuit and chain circuit.
3. Sensory Functions of Nerve System: understand sensory function
of spinal cord and
ascending pathways; sensory function of thalamus: nuclei of thalamus, specific
sensory
projection system, ascending reticular activating system; somatic pain and its
pathways.
master nonspecific sensory projection system, somatic sensory cortex,
characteristics of
visceral pain and referred pain.
4. Motor functions of Nerve System: master motor neurons and motor
unit; flexor reflex,
crossed extension reflex; action of muscle spindle and Goligi tendon organ; motor
cortex:
primary motor cortex, premotor area and supplementary motor area; transmission
of signals
from the motor cortex to the muscles: pyramidal system and extra pyramidal system,
decerebrate
rigidity; clinical syndromes resulting from damage to the basal ganglia; motor
function of
cerebellum: function of vestibulocerebellum, spinocerebellum and
corticocrerebellum. understand
significance of stretch reflex, postural control.
5. Central Regulation of Visceral Function: Master structural and
functional
characteristics of parasympathetic and sympathetic nerves, function of
parasympathetic and
sympathetic nerve system,function of hypothalamus: regulation of body
temperature, food intake,
water balance. control of anterior pituitary secretion, control of emotion,
biological clock.
understand visceral activitycontrolled by spinal cord and brain stem. concept
and function of
limbic system, neuronal regulation of instinctual behavior and emotion,
emotional reaction.
7. Wakefulness, sleep and electric activity of the brain. master
concept of spontaneous
electric activity of the brain and evoked cortical potential, normal waves of
EEG, properties
and importance of slow wave sleep and fast wave sleep. understand maintenance
of wakefulness:
ascending reticular activating system; initiation of the sleep: ascending
inhibitory system.
6. Higher Function of Nervous System: master learning: concept of
nonassociative learning
and associative learning, concept of unconditioned and conditioned reflex,
formation and
significance of conditioned reflexes. Memory. Classification: declarative
memory and
nondeclarative memory,short-term,intermediate and long-term memory; procedure
and mechanism
of the memory. understand human's conditional reflex,loss of memory, language
function and
dominant hemisphere.
Chapter
11 Endocrine System
Purpose and Requirement
1. To understand importance of endocrine system in regulation of
physiological functions.
2. To master the actions of several important hormones and regulation
of their secretion.
Teaching contents
1. Overview: -master concepts of hormone and endocrine system,
chemical classification and
actions of hormones, general characteristics of hormonal actions. -understand
formation, storage,
release and transport of hormones, mechanisms of hormone action: hypothesis of
the second
messenger and hypothesis of the genes.
2. Endocrine function of hypothalamus: understand classification
and functional
characteristics of the neuro-endocrine neurons in hypothalamus. master
functional relationship
between hypothalamus and pituitary gland: hypothalamic hypophysial portal system
and
hypothalamo- hypophysial nerve tract, actions of several important hypothalamic
regulating
peptides: THR, GnRH, GHRIH, CRH, GHRH.
3. Pituitary: master biolgoical effects of adenohypophysial hormone
(GH, PRL) and
regulation of their secretion, actions of neurohypophysial hormones (vasopressin
and
oxytocin) andregulation of their secretion. understand morphological
characteristics
of adenohypophysialcells, structure and biosynthesis of neurohypophysial
hormones.
4. Thyroid: understand biosynthesis of thyroid hormone and iodine
metabolism. master
biological effects of thyroid hormone, regulation of thyroid hormone secretion.
5. Adrenal Gland: master actions of glucocorticoids and
mineralocorticoid, regulation of
their seretion, hormones (norepinehrine and epinephrine) produced by adrenal
medulla and their
actions as well as regulation of section. -understand synthesis and metabolism
of glucocoricoids ,
mineralocorticoida , norepinephrine and epinephrine.
Chapter
12 Reproduction
Purpose and Requirement
1. To master the major endocrine functions of sexual glands, actions
of sex hormones.
2. To understand the processes of spermatogenesis and progenesis.
menstrual cycle, main
steps of pregnancy.
Teaching contents
1. Male reproduction: master testicular function: spermatogenesis
by testes, actions of
testosterone, regulation of testicular function: hypothalamic pituitary-Leydig
cell axis
and hypthalamic-pituitary seminiferous tubule axis. understand endocrine
functions of testes:
synthesis and metabolism of testosterone, 2. Female reproduction: master
physiological
effects and mechanism of estrogens and progesterone; regulation of ovarian
function:
hypothalamic pituitary ovarian axis. understand ovulation, menstrual cycle,
processes of
pregnancy: fertilization, implantation, maintenance of pregnancy. parturition
and lactation.