SYSTEMS PHYSIOLOGY

Attendance at laboratory exercises is mandatory.

Attendance at lectures is not mandatory.

The lectures include power point presentations and, where necessary, a video is shown.

Learning process support through the electronic educational environment (e-Class) of the Department of Medicine.

The schedule of lectures and laboratory exercises, learning objectives, relevant bibliography, lecture presentation files, educational material for laboratory exercises, as well as all course-related information are posted on the course page in the e-class

Communication via e-mail and electronic platform (e-class.uth.gr).

-Short development questions.

-Multiple choice questions.

Final oral exams may be given in special cases, such as students with special learning or mobility difficulties.

The evaluation method is communicated to the students at the beginning of the course and is available in the course information in eclass.

The course material aims to unify the individual functions of the above systems, so that the student has a general picture of their position and role in the overall functioning of the human body.

It also provides the student with the necessary knowledge of the body's physiological responses and adaptations to extreme environments and makes references to clinical physiology and pathophysiology. In this sense, the course forms the basis on which the student will become familiar with the fundamental relationship between physiology and clinical medicine.

Finally, the aim of the course is for the students to understand the importance of a comprehensive and in-depth knowledge of the physiology of the systems dealt with in this course, in order to form a basis that will facilitate young doctors of all specialties to assimilate the extensive volume of new data resulting from the rapid development of health sciences.

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

• Knows the functioning mechanisms of the respiratory, immune, urinary, gastrointestinal and cardiovascular systems of the human body with integrated and critical thinking.
• It understands how the individual mentioned body systems and functions interact with each other in order to obtain an overall and comprehensive picture of the normal functioning of the human body.
• It distinguishes the mobilization of the compensatory mechanisms in cases of disturbances in the functioning of the above systems and the induction of pathological conditions, when the compensatory mechanisms are not sufficient.
• He uses the knowledge he acquires to make assumptions about the disorders and pathological conditions that result from a change or abolition of some physiological function of the above systems, to analyze the mechanisms and to recognize the possible pharmaceutical targets for the treatment of the pathological conditions, so that the student to acquire useful and applicable knowledge.

General Skills

Search, analysis and synthesis of data and information, also using the necessary technologies.

Adaptation to new situations.

Decision making.

Autonomous work.

Teamwork

Promotion of free, creative and inductive thinking.

Unit 2: IMMUNE SYSTEM
2.1. Introduction to Immunology. Cells Mediating Defense Mechanisms. Cytokines.
• Introduction to immunology.
• Definition of the concept of immunity.
• Defense mechanisms.
• Lymphatic tissues.
• Functions of lymphatic tissues.
• Types of immune response.
• Effector cells of the immune response.
 Neutrophils.
 Eosinophils.
 Basophils.
 Mast cells.
 Macrophages.
 Lymphocytes.
• Cytokines: production-action-physiology.
• Chemokines.
2.2. Innate (non-adaptive) Immunity.
• Definition and characteristics of natural immunity.
• Physical and mechanical barriers such as skin and mucous membranes. Chemical and microbial barriers.
• Cellular elements such as neutrophils, macrophages and natural killer cells.
• Plasma factors (complement and acute phase proteins).
• Inflammation – Stages of inflammation.
• Process of phagocytosis.
• Opsonization.
• Interferons.
2.3. Antigens – Immunoglobulins.
• Antigone.
• Immunoglobulins – Antibodies.
 Structure and heterogeneity of immunoglobulins.
 Biological action of immunoglobulins.
 The effects of antibody action.
 Immunization and polyclonal antibodies.
 Production and use of monoclonal antibodies.
2.4. Specific Immune Defense.
• Lymphatic tissues and organs.
• Characteristics and phases of the specific immune response.
• Stages of specific immune response.
 Meeting and recognition of the antigen by lymphocytes.
 Lymphocyte activation.
 Attack by activated lymphocytes.
• Antigen-mediated or chemical immunity.
• Functions of B lymphocytes.
• Cell-mediated immunity or cellular immunity.
• T lymphocytes.
 Types of T lymphocytes.
 T lymphocyte receptors.
 Functions of T lymphocytes.
• T cytotoxic lymphocytes.
• T helper lymphocytes.
• Defense mechanisms to fight virus-infected cells and cancer cells.
• Regulatory T lymphocytes.
• Antigen-presenting cells.
• Antigen presentation.
• Enrollment of an acquired immune response.
• Interactions of B and T lymphocytes.
• Comparison of B and T lymphocytes.
• Development of immune tolerance.
• Immune surveillance against cancer.
• Possible causes of autoimmune attack.
• Adverse immune responses.
2.5. Hematopoietic-Immune System Physiology Based on Medical Cases.

Unit 3: URINARY SYSTEM (KIDNEYS)
3.1. Kidneys: Functions and Structure. Urination.
• Renal functions.
• Brief description of urinary system.
• Structure of the nephron.
 Vascular part of the nephron.
 Tubular part of the nephron.
 Comparison of paramedullary and cortical nephrons.
• Basic functions of nephrons.
• Urination.
3.2. Renal Processes.
• Glomerular filtration.
 Glomerular membrane layers.
 Paraglomerular device.
 Forces involved in glomerular filtration.
 Glomerular filtration rate (GFR).
 Mechanisms of GFR regulation.
• Tubular reabsorption.
 Transepithelial transport.
 Sodium reabsorption.
 Renin-angiotensin-aldosterone system.
 Natriuretic peptides.
 Glucose reabsorption.
 Maximum tubular transport.
 Osmotic – Aqueous diuresis.
 Reabsorption of amino acids, oligopeptides and protein.
 Water reabsorption.
 Reabsorption of urea.
• Tubular secretion.
 Secretion of hydrogen ions.
 Excretion of potassium ions.
 Mechanisms of potassium secretion.
 Regulation of potassium secretion.
 The importance of regulating plasma potassium concentration.
3.3. Urinary Excretion and Plasma Purification.
• Definition of plasma clearance of a substance.
• The use of clearance to estimate glomerular filtration rate.
• The use of clearance to estimate renal plasma flow.
• Filtration fraction.
• Condensation and Dilution of Queues.
 Renal medulla osmotic gradient.
 Backflow proliferation in renal medulla.
 Mechanism of action of vasopressin (or antidiuretic hormone).
 Counterflow exchange in the renal medulla.
3.4. Fluid and Electrolyte Balance.
• The concept of balance.
• Ionic composition of major body fluid compartments.
• Fluid balance.
 Water balance.
 Sodium balance.
 Volume defense.
 Tonality defense.
• Diuretics.
• Renal failure treatments.
3.5. Acid-Base Balance.
• Acid-base balance.
• pH homeostasis.
• Hydrogen ion neutralization systems in the body.
• Sources of hydrogen ion gain and loss.
• Renal mechanisms of acid-base regulation.
• Management of dittanarthaks.
• Cellular models of H+ secretion.
• Normal balance of acids and bases.
• Regulatory systems of acid-base balance.
• Acid-base balance disorders.
 Respiratory acidosis
 Respiratory alkalosis.
 Metabolic acidosis
 Metabolic alkalosis.
• Compensated disturbances of the acid-base balance.
• Uncompensated disturbances of the acid-base balance.
Unit 4: GASTROINTESTINAL SYSTEM
4.1. General Principles of Digestion.
• Functions of organs of the gastrointestinal system.
• Anatomy of the various parts of the gastrointestinal system.
• Basic processes of the gastrointestinal system.
• Gastrointestinal wall structure.
• Villous structure.
• Enteric nervous system (ENS).
• Connections of neurons in the ENS.
• Regulation of digestion.
• Pathways that control the functions of the gastrointestinal system.
4.2. Mouth, Pharynx and Esophagus.
• Mouth.
• Chewing.
• Soul.
• Functions of saliva.
• Salivary glands and control of saliva secretion.
• Pharynx and esophagus.
• Ingestion.
4.3. Stomach.
• Stomach anatomy.
• Stomach functions.
• Stomach motility.
• Factors affecting gastric motility and emptying rate.
• Vomiting.
• Gastric mucosa and gastric glands.
• Mural cells.
 Mechanism of HCl secretion.
 HCl functions.
• Gastric secretions.
• Control of gastric fluid secretion.
• Protection of the gastric surface epithelium.
4.4. Pancreatic and Biliary Secretions.
• Pancreatic exocrine secretions.
 Pancreatic enzymes.
 Aqueous alkaline solution.
• Regulation of pancreatic secretion.
• Prevention of pancreatic autodigestion.
• Liver functions.
• Liver perfusion.
• Liver organization.
• Bile production.
• Bile secretion.
• Enterohepatic circulation of bile salts.
• Function of bile salts.
4.5. Small Intestine.
• Small bowel motility.
 Segmentation and blending.
 Migratory motor complex.
• Ileocecal clamp.
• Absorptive surface of small intestine.
• Peripheral spectroid enzymes.
• Digestion and absorption of carbohydrates.
• Digestion and absorption of proteins, peptides and amino acids.
• Digestion and absorption of lipids
• Absorption of vitamins and minerals.
• Summary of fluid and electrolyte movement in the gut.
• Regulation of intestinal ion transport.
• Renewal of the small intestine mucosa.
• Diarrhea.
4.6. Large Intestine.
• Anatomy of the large intestine.
• Colon functions.
• Colon motility.
• Defecation reflex.
 Constipation.
• Colonic bacterial populations.
4.7. Overview of gastrointestinal hormones.
• Gastrin.
• Secretin.
• Cholecystokinin.
• Glucose-dependent insulinotropic peptide.

Unit 5: CARDIOVASCULAR SYSTEM
5.1. Cardiac Muscle Structure.
• Parts of the circulatory system.
• The heart as a pump.
• Heart valves.
• Heart walls.
• Cardiac muscle fibers.
• Pericardial sac.
5.2. Electrical Activity of the Heart.
• Cardiac muscle cells
 Contractile cells.
 Autoregulatory cells.
• Pacing of the heart.
• Pacemaker potentials and power potentials.
• Normal functioning of the heart's pacemaker system.
• Abnormal functioning of the heart's pacemaker system.
• Transmission of cardiac stimulation.
• Temporal correlation between action potential and subsequent contraction-failure of a myocardial cell.
• Cardiac muscle excitation-contraction coupling and the role of calcium ions.
• The unexcited period of the heart.
5.3. Electrocardiogram (ECG).
• ECG leads.
• Correlation of ECG leads with specific events of the cardiac cycle.
• Abnormal findings of heart rhythm, heart rate and myocardial damage.
5.4. Mechanical Events of the Cardiac Cycle.
• Cardiac cycle.
 Diastolic phases.
 Contraction.
• Heart sounds.
• Heart murmurs.
5.5. Cardiac Output and its Regulation.
• Cardiac output.
 Definition.
 Factors determining cardiac output.
• Heart rate regulation.
• Adjust pulse volume.
• Frank-Starling Law.
• Internality.
• Heart failure.
5.6. Systematic Traffic. Microcirculation and Lymphatic System.
• Heart muscle perfusion.
 Coronary circulation.
 Coronary artery disease
 Myocardial infarction.
- Spasm of coronary vessels.
-Atherosclerosis.
- Thromboembolism.
• Pressure, flow and resistances.
• Arteries.
 Characteristics of arteries.
 Arterial blood pressure.
 Mean blood pressure.
 Blood pressure measurement.
• Arterioles.
 Characteristics of arterioles.
 Local regulatory system.
 External control system.
• Capillaries.
 Characteristics of capillaries.
 Anatomy of the capillary network.
 Velocity of blood flow in the capillaries.
 The role of precapillary clamps.
 Diffusion through the capillary wall.
 Factors affecting capillary diffusion.
 Mass flow through the capillary wall.
 Forces affecting mass flow.
• Veins.
 Characteristics of veins.
 Determinants of venous pressure.
 Definition of venous return.
 Factors affecting venous return.
• Anatomy and importance of the lymphatic system.
5.7. Blood pressure.
• Blood pressure.
• Factors that determine mean blood pressure.
• Short-term regulatory mechanisms.
 Tonoreceptor reflexes.
 Other reflexes and responses.
• Long-term regulatory mechanisms.
• Hypertension.
• Traffic shock.

LABORATORY AND TUTORIAL EXERCISES

Exercise 1: Spirometry – Flow measurement – Pulse oximetry – eCO measurement.
• Brief description of each exam with video projection.
• Perform spirometry, flowmetry, pulse oximetry and measurement of carbon monoxide (CO) in exhaled air in the laboratory.
• Interpretation of normal and pathological findings of the above examinations.

Exercise 2nd: Physiology of the urinary system based on clinical cases.
• Discussion of a clinical case.

Exercise 3: Physiology of the gastrointestinal system based on clinical cases.
• Discussion of a clinical case.

Exercise 4th: Blood pressure – Heart auscultation.
• Brief description of listening to the heart and measuring blood pressure.
• Video.
• Listening to heart sounds in the laboratory.
• Laboratory blood pressure measurement and recording of systolic, diastolic, mean blood pressure and pulse pressure.

Exercise 5th: Electrocardiogram (ECG).
• Brief description of 12-lead ECG.
• Obtain an ECG in the laboratory.
• Heart rate measurement.
• Atrial and ventricular depolarization spasms.
• Measurement of intervals in the electrical conduction system of the heart.
• Normal and pathological heart rhythm findings.

1. HUMAN PHYSIOLOGY • Fundamentals • First edition

Carrie E. Mahoney (Editor English Edition)

Copyright © 2023 Edi.Ermes srl – Milan (Italy)

ISBN 978-88-7051-653-1

CONSTANTARA PUBLICATIONS

2. Guyton and Hall Textbook of Medical Physiology, 14th Edition, ELSEVIER 2020

CONSTANTARA PUBLICATIONS

Other writings in Greek

 Ganong's Medical Physiology

Authors: Barrett K.

Publishers: BROKEN HILL PUBLISHERS LTD

Vander's Human Physiology – The Mechanisms of the Body,

Authors: Widmaier E., Raff H. Strang K.

Publishers: BROKEN HILL PUBLISHERS LTD