Hatziefthimiou Apostolia, Zarogiannis Sotirios, Hatzoglou Chryssi, Gogou Evdoxia

Only students who can speak Greek can attend lectures. Erasmus students can take written exams in English.

Face to Face:

Teaching of Introduction to Physiology consists of lectures and laboratory practicals.  Attendance of Laboratory Practicals is obligatory.

The lectures content is described above.

Laboratory exercises (in 4 student groups of students, 3 instructors per group of 25-30 students) composing the students’ practical are complementary to the lectures and they aim to familiarize the student with the application of experimentation, the operation of simple laboratory instruments and the experimental procedures that are often used in Physiology, as well as to help the students comprehend concepts that are not easily presented theoretically (learning based on practical experience).

The attendance of Lectures is not mandatory.

The attendance of practicals is mandatory.

Information and Communication Technologies are used for the preparation of the lecture material, the online information and provision of supplementary learning material to students.

Specifically:

• Common software (e.g. MS powerpoint) is used to prepare lecture material and display slides and videos.
• Laboratory practicals 2 and 3 are performed in the Bioinformatics laboratory, using simulation programs.
• The study guide (detailed supplementary material & additional bibliography), the tutorial material (clinical cases), the theory and protocols of the laboratory exercises, the slides of each lecture as well as relevant videos and scientific articles made available electronically and online to students through the e-class system of our university.
• Information about the course, instructors and their research interests and in general the Laboratory of Physiology of the Faculty of Medicine are available online on the website of the Faculty of Medicine.
• Common software (e.g. MS excel) is used to statistically process student assessment.

Announcements, information etc are available online via e-class. Communication is also done via e-mail.

The language of assessment is Greek.

Evaluation methods: Written Exams

The course exams are written, last 1,5 hours and take place according to the official Examination program. The exams are composed 50 multiple choice questions and 10 true/false, matching, fill the gap, put in the right order or short answer questions. The examination material is covered in the lectures and tutorials as described above. Only those students who have attended the Laboratory practicals have the right to participate in the course exams.

Aims of the course

The course provides the background for understanding the basic principles that govern the mechanisms of operation of the human body.

The course introduces the student to the concepts of physiology and homeostasis, the organization and role of the nervous and endocrine systems, and the regulation of human body energy balance and temperature. In addition, it covers the topics of blood and muscle physiology.

Therefore, the course is the basis for the detailed study of the integrated human body systems physiology, taught in the next semesters.

Upon successful completion of the course the student will be able to:

• Recognize and describe the mechanisms of action of excitable cells
• Understand how the individual systems of the body and the functions interact to accomplish the optimal function of the human body.
• Distinguishes the mobilization of regulatory mechanisms in cases of dysfunction of these systems and the onset of pathological conditions when these mechanisms fail.

• Use the acquired knowledge to understand a) the causes and b) the mechanisms that can lead to pathogenesis.

General Abilities

• Research, analysis and synthesis of data and information, using the necessary technologies
• Adaptation to new situations
• Decision making
• Autonomous work
• Teamwork
• Exercise criticism and self-criticism
• Promoting free, creative and inductive thinking

The content of the course includes the following major items:

Α.The content of the lectures together with the relevant clinical insights the students need to learn/acquire per chapter.

Β. The content of the laboratory practical together with the relevant practical & clinical skills the students need to learn/acquire per exercise.

Α. Lectures

Lesson 1: Homeostasis highlights

• Levels of organization in the human body.
• Concept of homeostasis.
• Factors regulated by homeostasis.
• Homeostatic control systems.

Lesson 2: The blood: Plasma and cells of the blood, Hematopoiesis, Erythrocytes

• Blood composition.
• Definition of hematocrit.
• Plasma components and their functional role.
• Types and normal values of blood cells.
• Production and differentiation of blood cells.
• Hematopoetic growth factors.
• Red blood cells

o Structure and function of erythrocytes

o Regulation of erythrocyte production

• Anemia
• Blood types
• White blood cells.

Lesson 3: Megakaryocytes and platelets, Hemostasis

• Megakaryocytes.
• Platelets.
• Definitions: hemorrhage, hemostasis, hematoma.
• Stages of physiologic response to vessel injury.
• Platelet aggregation.
• Blood clotting: formation of blood plug.
• Definition and description of the intrinsic and extrinsic pathway of blood clotting.
• Collaboration of intrinsic and extrinsic pathways of blood clotting. The mechanism of blood clotting in physiologic conditions.
• Anticoagulation systems.
• Fibrinolytic system. Fibrin resolution cascade.
• Synopsis of the anticoagulant function of the endothelial cells and their results.
• Disturbances of hemostasis.
• Clot and plug.
• Thrombosis prevention.
• Thrombolytic factors.

Lesson 4: The plasma membrane and membrane transport

• Structure and functions of the plasma membrane.
• Cell junctions.
• Membrane transport.

o Diffusion.

o Mediated-transport Systems.

o Osmosis.

o Vesicular transport.

o Epithelial transport.

Lesson 5: The plasma membrane potential, Graded and action potentials

• Resting potential.
• Action potential.
• Graded potentials.
• Excitable tissues.

Lesson 6: Synapses of the Central Nervous System

• Functional anatomy of synapses.
• Electric synapses.
• Chemical synapses.
• Activation of the postsynaptic cell.

o Excitatory and inhibitory postsynaptic potential.

o Spatial and temporal summation (integration) of postsynaptic potentials.

• Modification of synaptic transmission by drugs and disease.

Lesson 7: Neurotransmitters

• Neurotransmitters and their receptors.
• Biogenic amines.
• Acetylcholine.
• Amino acid neurotransmitters.
• Neuropeptides.
• Neuromodulators.

Lesson 8: Organization of the Nervous System – Protection and Nourishment of the Brain -Autonomic nervous system

• Structure of the Nervous System
• Cells of the Nervous System

o Structure and Maintenance of Neurons

o Functional Classes of Neurons

o Glial Cells

o Neural Growth and Regeneration

• Protective elements associated with the brain

o Cerebrospinal fluid (CSF): composition and changes in pathological conditions

o Meninges and subarachnoid space

o Choroid plexuses, CSF production and absorption

o Blood-brain barrier

o The role of astrocytes in the blood-brain barrier

o The role of endothelial cells in the blood-brain barrier

o The importance of the blood-brain barrier in the distribution of lipophilic and hydrophobic drugs in the CNS.

• Autonomic nervous system (ANS).
• Comparison of the sympathetic and parasympathetic nervous system.
• General principles of the responses of effector organs to autonomic nerve impulses.
• Pre- and postganglionic fibers of the ANS.
• Neurotransmitters in ganglia and target organs of the ANS.

Lesson 9: Skeletal muscle – Muscle contraction – The neuromuscular junction

• Skeletal muscle structure
• Contraction and relaxation
• Sliding-filament mechanism
• Cross bridge cycle
• The role of troponin, tropomyosin and calcium in contraction
• Excitation-contraction coupling
• Sarcoplasmic reticulum and transverse tubes
• Motor neurons and motor units
• The neuromuscular junction
• Motor end plate
• Acetylcholine release
• End plate potential
• Modification of neuromuscular junction by drugs and disease

Lesson 10: Mechanics of muscle contraction

• Tension and load
• Isometric, isotonic and lengthening contraction
• Twitch contraction
• Load-velocity relation
• Frequency-tension relation
• Contraction summation and tetanus
• Length-tension relation – Optimal length
• Skeletal muscle energy metabolism
• Muscle Fatigue
• Types of skeletal muscle fibers
• Whole muscle contraction
• Control of muscle tension – Recruitment
• Control of shortening velocity
• Muscle adaptation to exercise
• Lever action of muscles and bones
• Skeletal muscle disease

Lesson 11: Smooth muscle

• Smooth muscle structure
• Smooth muscle contraction
• Cross-bridge activation
• Sources of cytosolic calcium
• Membrane activation
• Types of smooth muscle
• Comparison of skeletal, smooth and cardiac muscle characteristics

Lesson 12: Principles of hormonal communication

• The role of the endocrine system
• Comparison of endocrine and exocrine glands
• Signaling via endocrine, paracrine or autocrine pathways
• Organization of the endocrine system: the main endocrine glands
• Regulation of hormone action: negative feedback
• Hormone classes: synthesis, storage, release
• Transfer of hormones via the blood
• Hormone metabolism and excretion
• Hormonal action- Hormonal receptors
• Regulation of hormonal action: dose response curve
• Endocrine Disorders: hyposecretion, hypersecretion, reduced hormonal response, excessive hormonal response
• Quantification of hormonal secretion

Lesson 13: Energy balance and temperature regulation

• Energy balance
• Energy expenditure
• Metabolic rate and basic metabolic rate
• Factors that affect the basic metabolic rate
• Regulation of total body energy stores
• Control of food intake
• Adjusting body weight
• Overweight and obesity – Eating disorders
• Regulation of body temperature
• Heat production and loss
• Temperature-regulating mechanisms
• Fever
• Hyperthermia
• Heat stroke and heat collapse
• Hypothermia

 Β. Laboratory Practicals

Hands-on learning: Acquisition of general and specific practical & clinical skills:

General Skills

Observing phenomena of human physiology, obtaining and analyzing experimental data

Interpretation of experimental data

Resolving practical problems

Producing graphical displays of data

Operating basic laboratory equipment

Working as a team

Following instructions

Following safety regulations

Trouble-shooting in laboratory results

Clinical significance of lab results

Specific Skills

Exercise 1: Blood and cells of the blood.

• Hematocrit test.
• Erythrocyte sedimentation rate (ESR) test.
• White blood cell differential counting.

Exercise 2: Rest and action potential

• Effect of stimulus intensity on electrical stimulation
• Effect of extracellular Na+ concentration on the generation of an action potential
• Influence of changes in membrane conductance on Na+ or K+ – Refractory period
• Ionic currents
• Power-potential graph (I-V plot)
• Effect of extracellular sodium concentration [Na+]out on the inversion potential

Exercise 3: Skeletal muscle contraction

• Muscle contraction as a function of stimulation intensity
• Superposition of single twitches
• Single twitches vs. tetanic contractions
• Resting tension curve
•  Muscle fatigue

1.Introduction to Human Physiology, International Edition.

Author: Lauralee Sherwood.

Greek edition

2. Vander’s Human Physiology: The Mechanisms of Body Function.

Authors: Eric Widmaier, Hershel Raff, Kevin Strang.