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留学生生理教学大纲

The Teaching Outline of Physiology

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 to the
necessity of medicine, the teaching contents must be the basic concept and knowledge, as well as
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 text book 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 196, among which 136 for lectures and 60 for
experiments.
Chapter contents lecture hours
1 Introduction 2
2 Basic function of cell 18
3 Blood 8
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 10
12 Reproduction 4

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
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
3. 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; motilityof 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, indirectcalorimetry.
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

Chapter 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 accommodationreflex, 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: inhibitorypostsynaptic 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 ofvisceral 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 relationshipbetween
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 theiractions
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,