PHYSIOLOGY AND PATHOLOGY

Integrated educational activity

Course Sheet

Course code:

TRM12A6

Academic Year of enrolment:

2022

Year of supply:

2022/2023

Degree:

Course of 1st Cycle Degree in IMAGING AND RADIOTHERAPY TECHNIQUES

Moduls:

PHYSIOLOGY - 2 credits
GENERAL PATHOLOGY - 3 credits
CLINICAL PATHOLOGY - 1 credits

Location:

Credits:

Programme Year:

Cycle:

Second semester

Obligatory attendance:

Yes

Hours of classroom activity:

Prerequisites:

PHYSIOLOGY
Physiology is an integrative discipline that - to be successfully followed and learned in class
(and successfully studied for passing the exam) requires that the student has acquired basic knowledge of Chemistry, Biochemistry, Physics, Histology, and Anatomy.
For the aforementioned reasons - before being admitted to the exam of Human Physiology - the student must have passed the exam of Human Anatomy.
CLINICAL PATHOLOGY
Knowledge of biochemistry
GENERAL PATHOLOGY:
Requirements
To the whole understanding of the disciplines is required: sufficient knowledge of histology, anatomy, biochemistry.

To take the exam of the Integrated Course it is necessary to have passed the exam of the IC. of Systematic and Topographical Human Anatomy.

Objectives

PHYSIOLOGY
Physiology is an integrative discipline that studies the functioning of life processes at many levels of complexity: from cells, to organs and apparatuses, to whole organisms, up to the populations of a species. The objective of this course is to provide the theoretical bases that will allow students to understand the cellular mechanisms that underlie the functioning of the major apparatuses that constitute the human organism.
EXPECTED LEARNING OUTCOMES
• Knowledge and understanding
The student during the examination must:
i) present and discuss exhaustively the questions using an appropriate language to describe the concepts of Physiology;
ii) prove comprehension of the mechanisms underlying cell and organ functions;
iii) show communication skills of the concepts learned;
iv) draw schematically the structures, diagrams and graphics requested (see program);

• Applying knowledge
The student must prove to be able to apply learned Physiology concepts integrated with those of previous courses.

• Soft skills
i) Making judgments
The student must prove to be able to show independent judgments of the concepts learned.
ii) Communications skills
The student must be able to have communication skills of the concepts learned
iii) Learning skills
The student, through the Physiology course, must acquire the theoretical bases necessary to independently undertake further studies.

CLINICAL PATHOLOGY: The objectives that the course aims are:
a) acquire the basic elements in the clinical diagnosis of the main diseases;
b) acquire the elements that allow us to prepare diagnostic frameworks
through the study of bio-cellular and biochemical parameters of the organism;
c) acquiring the principles of molecular investigation applied to predictive medicine in main degenerative and tumor syndromes.

GENERAL PATHOLOGY
LEARNING OBJECTIVES
The teaching of General Pathology contributes to the realization of the educational objective of the Study Programme in Medical Radiology Techniques, for Imaging and Radiotherapy (Article 3 of the REGULATION - Specific training objectives and expected skills. "TRAINING PATTERN 1st year - Finalized in provide a good knowledge of the essential theoretical disciplines that derive from the basic sciences, in the perspective of their subsequent professional application.") providing the student with the scientific basis necessary for the identification not only of pathologies but also of preventive and therapeutic approaches suitable for the protection of individual and community health. In particular, the conceptualization of the disease will be emphasized as a deviation of the general laws aimed at maintaining the state of health.

EXPECTED LEARNING OUTCOMES
• Knowledge and understanding
At the end of the course the student will be able to:
to the different levels of complexity (molecules, cells, tissues, organism), the etiopathogenetic factors underlying the structural and functional alterations found in the pathological processes, as well as the damage response mechanisms and the related disorders.

• Applying knowledge and understanding
The student must also be able to apply the knowledge acquired from the course, integrated with those deriving from previous courses, to the understanding of the pathophysiology of the main human pathologies.
The student will be able to deal with the clinical problem in a rational way both in the diagnostic-therapeutic approach and in the preventive one.
Transversal skills (Soft skills):
¬Making judgments
The student will be able to collect and interpret data useful for defining judgments in an autonomous way.

¬ Communication skills
The student will be able to communicate information to specialist interlocutors and not.
¬ Learning skills
The student, through the methodological criterion that the study of the General Pathology provides, will be able to develop the skills necessary to undertake further studies with a good degree of autonomy.

Contents

PHYSIOLOGY
1. Introduction to Physiology.
2. Neuron and generation of electrical signals.
3. Skeletal Muscle: structure and function.
4. Smooth Muscle: structure and function.
5. Cardicac Muscle: structure and function.
6. Physiology of the Cardiovascular System.
7. Physiology of the Respiratory System.

CLINICAL PATHOLOGY
The course of Clinical Pathology intends to clarify the different elements that contribute to study the physiology and pathophysiology of organs and tissues with reference to
biocellular and biochemical parameters that measure the main pathological conditions. The discipline is also interested in the application of disease prediction markers in
oncological, cardiovascular and neurological fields.
GENERAL PATHOLOGY
Knowledge of physical, chemical, biological and genetic causes responsible for the occurrence of human diseases.
Knowledge of the fundamental cellular and molecular pathogenesis mechanisms of diseases: genetic alterations, mechanisms of inflammation, degeneration processes, changes in cell proliferation.
Knowledge of the pathophysiological and molecular alterations responsible of functional modifications of organs and systems.

Extended Syllabus

PHYSIOLOGY
1 Introduction to Physiology.
1.1 Definition of Physiology and its areas of interest; concept of internal and external environment for the cell and for the organism; concept of homeostasis.
1.2 General characteristics of plasma membranes; fluid mosaic model; integral and associated membrane proteins; receptors and transport proteins; difference between carriers and channels.
1.3 The movement of substances through membranes and epithelia; concept of simple or mediated diffusion through membranes; active transport; concept of uniport, symport, and antiport: the examples of Na+/K+ pump and of the Na + -glucose symport; transport by vesicles: exocytosis, endocytosis and transcytosis.
1.4 Distribution of solutes in the different liquid compartments of the organism (schematic drawing); resting membrane potential; equilibrium potentials of Na+ and K+.

2. Neuron physiology and generation of electrical signals.
2.1 Nervous system’s functional anatomy organization: central and peripheral nervous system
2.2 structure of the neuron (schematic drawing of its different parts); glial cells; myelin sheath; axonal transport.
2.3 Resting membrane potential of neurons; changes in membrane potential and generation of signals; concept of depolarization and hyperpolarization; the generation of graduated potentials (graph); concept of subthreshold and suprathreshold potential (graph); spatial and temporal summation of graduated potentials; action potential (graph); absolute and relative refractory periods (graph); saltatory conduction.
2.4 Communication between neurons: chemical synapses (schematic drawing of its different parts) and electrical synapses; mechanisms of release and inactivation of neurotransmitters in chemical synapses; concept of convergence and divergence of the signal; concept of stimulus intensity: how the discharge frequency/pattern of neuron influence the release of the neuro-transmitters.

3. Skeletal Muscle: structure and function.
3.1 The three types of muscle in our body: skeletal, cardiac and smooth; general structure of skeletal muscle fibers: myofibrils, sarcomeres, and membrane systems.
3.2 The excitation-contraction (EC) coupling
mechanism and the transduction of the electrical into a chemical signal; transversal tubules and sarcoplasmic reticulum; the voltage sensor (DHPR); the Ca2+-release channel of the sarcoplasmic reticulum (RYR); the triad or calcium release unit (schematic drawing of its different parts); differences between skeletal and cardiac EC coupling.
3.3 The sarcomere (schematic drawing of the organization of filaments, lines, and bands); the main sarcomeric proteins: contractile, regulatory and accessory; role of troponin and tropomyosin in the activation of the contraction; myosin head cycle; tension-length regulation curve of the sarcomere (graph); concept of motor unit and recruitment.
3.4 Classification of muscle fibers based on metabolism and speed of contraction; classification of fibers in red and white; functional differences between slow, intermediate and fast fibers;
3.5 Contraction mechanics: relationship between electrical and mechanical events; simple twitch (graph), summation mechanism (graph), incomplete and complete tetanus (graphs); definition of fatigue (graph); isometric and isotonic contractions (and role of elastic and
contractile components).
3
4. Smooth muscle: structure and function
4.1 Ultrastructure of smooth muscle
4.2 Activation of smooth muscle contraction: role of phosphorylation and calcium
5. Cardiac muscle: structure and function
5.1 Ultrastructure of cardiomyocyte: role of intercalated discs
5.2 The excitation-contraction (EC) coupling: calcium release induced by calcium

6. Physiology of the Cardiovascular System.
6.1 Introduction to the cardiovascular system: anatomy and general functions.
6.2 The heart : pacemaker and contractile tissues; contractile myocardial cells and intercalated disks (schematic drawing); the conduction system (schematic drawing of its various components); the action potential of pacemaker cells (graph); the action potential of contractile cells (graph); the cardiac cycle explained with the 5 phases; the cardiac cycle explained with the pressure-volume curve of the left ventricle (graph); cardiac output (formula); Frank-Starling's law (graph).

7. Physiology of the Respiratory System.
7.1 Introduction to the respiratory system: anatomy and general functions; the reasons for an internalized respiratory system; upper and lower airways; structure of the lung and alveoli; the pleurae and their role in ventilation; inspiratory and expiratory muscles; concepts of lung compliance and elasticity; concept of instability of the alveoli; the four phases of external respiration.
7.2 Ventilation (inhalation and exhalation) and air exchange be; the laws of gases; muscles involved in ventilation at rest and under stress; ventilation mechanics; spirometry and measurement of pulmonary volumes and capacities (graph); concept of pulmonary and alveolar ventilation (formulas); gas exchange between alveoli and blood; hyperventilation and hypoventilation curve (graph).
7.3 Transport of gasses in the blood and gas exchange blood-tissues; transport of O2; hemoglobin/ O2 dissociation curve (graph);
effects of pH (Bohr effect) and temperature on the hemoglobin/ O2 dissociation curve; blood transport of CO2 and its effect on blood pH.
7.4 Reflex control of breathing (schematic drawing of its functioning); respiratory centers of medulla oblongata and pons Varolii; dorsal and ventral respiratory groups; central and peripheral chemoreceptors.

CLINICAL PATHOLOGY
The program is divided into the following points:
a) acquisition of the basic elements related to the pathophysiology of blood and blood
components. Clinical evaluation of anemias and study of related parameters. Analysis
clinics of leukemias and lymphomas and staging.
b) Pathophysiology of haemostasis. Analysis of the components of the coagulation cascade.
Clinical evaluations of coagulative-deficient states. Deficiency of the factors and their
role in hemorrhagic states.
c) Parameters of immunological investigation.
Diagnostic-clinical evaluation
inflammation and the role of cellular components. Immunophenotyping and his
application in the principals of immunodeficiency and neoplastic induction.
Study of autoimmunity and description of the main autoimmune syndromes: disease
celiac disease, reactive pathologies of the gastro-enteric system (M. of Chron, rectocolitis
ulcerative), Sijogren's syndrome, SLE, rheumatoid arthritis, scleroderma
d) Tumor serological markers. Analysis of the molecular alterations of the main ones
genes in the pathogenic processes of tumors. Pathogenesis of gastro-enteric tumors.
Predictive Medicine principles and study of prediction markers for the main ones
family oncological syndromes: breast and ovary cancer, HNPCC, tumors
Hereditary thyroid, retinoblastoma, Li-Fraumeni syndrome
e) Principles of pharmacogenetics and pharmacogenomics. Prediction of the answer
therapeutic in tumors. Presentation of the main application protocols
molecular-diagnostic in the chemotherapeutic orientation

GENERAL PATHOLOGY
Concept of illness and morbid status. Etiology and pathogenesis. Intrinsic and extrinsic causes of disease. Physical, chemical and viral agents as a cause of illness.
• Inflammation: definition and general characteristics. Acute flogosis: chemical mediators and cells involved; the formation of the exudate; various types of exudate. Phagocytosis. Chronic flogosis.
Thermoregulation. Thermogenesis and heat-dispersion. Non-febrile hyperthermia and hypothermia. Fever: etiopathogenesis of fever; the course of the fever; types of fever; metabolic alterations in fever.
Pathophysiology of the blood. Anaemia: general processes and classification.
Oncology: concepts of hyperplasia, hypertrophy, metaplasia, dysplasia, anaplasia, neoplasia. Benign and malignant tumours. Histogenetic classification of benign and malignant human tumours. Metastasis. The process of carcinogenesis. Concepts of n of neoplasms.
carcinogenicity from chemical, physical and viral agents. Stages of carcinogenesis: initiation, promotion and progression. Oncogenes and oncosuppressors and their role in tumours.

Recommended Bibliography

PHYSIOLOGY
The student will find and study the topics covered in class (listed in detail in the extended program, see below) in several books of Human Physiology available on the market. Following some of the text books among which the student could choose:
1. Human Physiology (or Physiology): an integrated approach. Author: Dee Unglaub Silverthorn.
2. VANDER- Physiology. Second edition; Authors: Eric P. Widmaier, Hershel Raff, Kevin T. Strang.
3.Human Physiology: from cells to systems. Author: Lauralee Sherwood.
4. Fundamentals of Human Physiology. Author: Lauralee Sherwood.

4. CLINICAL PATHOLOGY
G. Federici et al. Medicina di Laboratorio. McGraw Hill

GENERAL PATHOLOGY
-J. Anne Marie Maier, Massimo Mariotti “Elementi di Patologia generale e Fisiopatologia”, McGraw Hill, Milano.
-G.M. Pontieri “Patologia e Fisiopatologia Generale” per i corsi di laurea in Professioni Sanitarie Piccin, Padova.

-Teaching material provided by the teacher with express recommendation to the students to use it only as an aid/guide to the preparation of the exam. It is recalled, in fact, that the use of the recommended General Pathology books (exclusive choice of the student) is essential for a correct, useful and easier preparation of the subject. Students are required to perform all the topics indicated in the program even if not included in the teaching material. Finally, students are warned against the use of photocopies of educational material (presumed printouts of the lessons) ABUSIVELY sold at the copy shops.

Teaching Methods

PHYSIOLOGY
Teaching is structured in 20 hours of frontal teaching (for a total amount of 2 CFU), divided into 10 lessons of 2 hours each according to the educational calendar. The frontal teaching will be supported by the projection of slides (prepared by the teacher) and movie-animations related to the topics covered. Attendance is recommended, and in any case must respect the maximum number of absences established by the University, with the exam being the same for everyone.
CLINICAL PATHOLOGY: Frontal lessons
GENERAL PATHOLOGY
The course will be held through interactive lectures with the aid of iconographic material in Power Point files for a total of 3 CFU corresponding to a total of 30 hours. Individual work on a topic chosen by the student in the context of the contents developed during the lectures and part of the program.

Evaluation methods

Verification of learning:

REFERRED TO UNIVERSITY DIDATTICAL GUIDELINES Art. 32 Exams and profit tests
The exam will consist of an oral test. If the exams will not be completed in one day due to excessive numbers of students, the exam will be completed the first available day.

The final grade of the C.I. will be the result of the weighted average on the number of CFU of the final marks obtained in the individual modules.
More specifically:
1. the vote of the single module is multiplied by its value in CFU;
2. all the results obtained are added;
3. the credits of the C.I. (6 CFU);
4. divide the result obtained from the calculation in point 2. for the result obtained from the calculation referred to in point 3.
Example: Physiology: 2 CFU, 30/30 General Pathology: 3 CFU, 22/30 Clinical Pathology: 1 CFU, 30/30

The weighted average is calculated as follows: (30 * 2) + (22 * 3) + (30 * 1) /6=26/30.

Rounding rules: the final vote will be rounded down if the decimal place is less than or equal to 4.

Contacts/More Information

Students will be received by the teacher by appointment to be agreed by e-mail to the address:
marta.dinicola@unich.it
gabriella.mincione@unich.it
simona.boncompagni@unich.it
elena.toniato@unich.it

Università degli Studi
"G. d'Annunzio"

Chieti - Pescara

Aree