Systems Integrated Physiology

After the study of General Physiology (1st semester, 1st year) and Medical Physiology (1st semester, 2nd year) the student will learn the physiological mechanisms coordinating different organs and systems to maintain the proper function of the entire human body.

Block I.: 17 exp +4 sem. ENDOCRINE SYSTEM AND METABOLISM

The Endocrine System: endocrine glands and endocrine organs. Organization of the neuroendocrine system in the rest of the body.
Neuroendocrine integration between Hypothalamus and Hypophysis: Communication systems between hypothalamus and pituitary gland.
Neurohypophysis: Structure and function of neurophysins. Regulatory mechanisms and actions of the Antidiuretic Hormone (ADH) or vasopressin.
Adenohypophysis: Different cellular types of the pituitary gland. Characteristics of adenohypophysis hormones. Physiological effects, regulatory mechanisms, and actions of pituitary hormones. Physiological effects of hypothalamic hormones.
The Thyroid gland: Functional Morphology of Thyroids. Synthesis, secretion, and transport of thyroid hormones.
Thyroid-stimulating hormone (TSH) action. Thyroid hormone actions. Hypothalamus-pituitary-thyroid axis regulation: TRH-TSH-T4/T3. Differences between increases and decreases in thyroid primary, or secondary hypophysiary thyroid function. C cells and Calcitonin as a tumor marker.
The adrenal gland: Functional structure of the adrenal glands.
Steroid hormones of the adrenal cortex: Glucocorticoids and Mineralocorticoids. Corticoid Synthesis Enzymes.
Physiological functions of Cortisol. Hypothalamus-Hypophysis-Adrenal gland axis: the corticotrophin-releasing hormone (CRH) and corticotropin-releasing hormone (ACTH).
Adrenal marrow: Synthesis of adrenal marrow hormones and their regulation. Different receptors of catecholamines and their actions on different organs and tissues.
Regulation and actions of Aldosterone. The renin-angiotensin-aldosterone system.
Integrated regulation of the Osmolarity. ADH. Headquarters Regulation. Regulation of Salt Ingestion.

An integrated response to stress.
Endocrine pancreas: the Islet of Langerhans. Synthesis, secretion, regulation, and metabolic actions of insulin. Synthesis, regulation, and physiological functions of glucagon release.
Actions of somatostatin. Global glycaemic regulation as an overarching response consisting of several hormones, hypoglycaemic (insulin) and hyperglycaemic agents (glucagon, adrenaline, cortisol, and GH).
The adipose tissue as an endocrine organ: Endocrine function of adipose tissue: leptin and adiponectin. Regulation of energy homeostasis: Regulation of energy consumption and expenditure.
Endocrine regulation of calcium, phosphate, and magnesium metabolism: Functions and distribution of calcium, phosphate, and magnesium in the body. Bone physiology related to calcium and phosphate and the role of bone in the regulation of calcaemic. Synthesis, regulation, and actions of vitamin D. Synthesis, regulation, and actions of parathyroid hormone (PTH). Integrated calcaemic regulation. The overall response of the body to a decrease in calcium or body phosphate.
Reproduction physiology. Endocrine embryology of reproductive organs.
Male reproductive system: Functional structure of the male reproductive system. Structure and cellular types of the seminiferous tubule. Spermatogenesis, its endocrine regulation, and the role of different cell types in this process. Leydig-Sertoli integration: Testicular endocrine function. Biosynthesis of testosterone, transport mechanisms, metabolism, and elimination. Mechanisms of action of testosterone, its target cells, and their effects. Hormonal regulation of male gonadal function by hypothalamus and pituitary gland, effects of gonadotrophins, and control of their release.
Puberty integration of gonadotrophin-releasing hormone GNRH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, activins, inhibins, and kisspeptin.
Menopause and its physiology.
Integrated regulation of post-natal growth: Role of GH, thyroid hormones, sex hormones, glucocorticoids.
Pregnancy endocrinology. Functions of progesterone, estrogen, and oxytocin at the beginning of delivery. Breastfeeding: PRL and Oxytocin

Block II.: 19 exp+1 sem. NERVOUS SYSTEM
Somatosensory systems:
Tact, proprioception, temperature, and pain.
Hearing.
External, middle, and internal ear.
Central mechanisms of hearing.
Vision.
Physiology of the eye.
Physiology of the retina.
Optic pathways.
Central mechanisms of the vision.
Taste and olfaction.
Physiology of the balance.
Central receptors, mechanisms, and effectors.
Integrated and motor neurophysiology:
Control of the motor function
Control of the movement.
Mechanisms at spinal, mesencephalic, and cortical levels.
Basal ganglia and cerebellum.
Sleep and wakefulness.
Higher functions.

Block III: 8 exp +2 Sem
Body temperature regulation: Homeothermic: heat thermogenesis and dissipation. Mechanism of body temperature regulation: Thermorreception, CNS integration, cold and heat responses, the role of the thyroid gland, UCP protein, and sweat. Febrile reaction. Hypothermia.

Regulation of the pH. Factors that determine body pH: carbonic, bicarbonate, and hemoglobin. Regulation of the corporal pH: sensors, integration in the SNC, the role of alveolar ventilation and of the kidney. Renal bicarbonate reabsorption and production. Renal secretion of acid and urine buffers. Davenport diagram and physiopathological basis of acidosis and alkalosis.

Long term regulation of arterial pressure, regulation of water volume and electrolytes.

Basic
Medical Physiology. Walter F. Boron, Emile L. Boulpaep. Elsevier-Saunders, 2017.
https://clinicalkeymeded.elsevier.com/#/books/9788491131267/
Physiology. Berne y Levy. Sexta edición. Elsevier-Mosby. 2009.
https://www-clinicalkey-com.ezbusc.usc.gal/student/content/toc/3-s2.0-C…
Goodman's Basic Medical Endocrinology Book • Fifth Edition • 2021
https://www-sciencedirect-com.ezbusc.usc.gal/book/9780128158449/goodman…
Complementary
Human Physiology. Stuart Ira Fox, McGraw Hill-Interamericana, 2008.
Medical Physiology. Arthur C. Guyton, John E. Hall. Elsevier-Saunder, 2011.
Human Physiology: an integrated view. Silverthorn, Panamericana 2008.
Principles of Neural Science. (eds. E.R.Kandel, J.H.Schwartz, T.M. Jessell). McGraw-Hill Interamericana. 2009.

To understand and to recognize the normal function of the human body, at molecular, cell, tissue, organ and system levels.
To understand the mechanisms of adaptation and regulation of these functions and to recognize the information flow that makes possible this regulation.
To be able to formulate hypothesis, to collect information and critically value it for the resolution of problems, following the scientific method.
To interpret normal values obtained from a clinical lab report.

Attendance of lectures, seminars, and laboratories is compulsory.

Classroom lectures: 44 hours. They shall be delivered in the classroom, within the relevant regulatory limits.
Interactive teaching: Seminars 8 hours. Labs 6 hours. Mentoring: 3 hours

Some activities may be performed using tools/software/resources of knowledge in English to increase students' skills since this is considered the international vehicular language of knowledge for the medical professional.

The labs will be based on the use of laboratory simulations of physiology. Students shall have in advance the material necessary to ensure their active participation in the lab sessions.
Information and materials for lab sessions will be available in advance in the USC virtual classroom.
Inclusion in one lab group can be interchanged if there is an exchange with a peer in another group. Students involved in the interchange should notify the subject coordinator in advance of the lab session.

- The final grade will depend on a 20% of continuous evaluation (provided that the final exam grade reaches 40%), and 80% of the final exam type test.- A nota final dependerá nun 20% de avaliación continua (sempre que a nota do exame final alcance un 40%), e nun 80% do exame final tipo test

- In the continuous evaluation, participation in seminars, the completion of exercises in person or independently, or answering questions in person or telematically may be considered. The mere presencialidade will not score for the continuous evaluation.

- The final exam will be face-to-face type test and the answers corresponding to the questions of each practice will be evaluated only if all the practices are attended.

For cases of fraudulent performance of exercises or tests will apply the provisions of the rules of evaluation of academic performance of students and review of qualifications.

Lectures: 44 hours.
Seminars: 7 hours.
Laboratory: 6 hours.
Tutoring: 3 hours.
Test of evaluation: 1 hour.
Individual work: 92 hours.

It is advisable for the students to use text books to consult doubts and summarize study contents, helping them to comprehend the Human Physiology.

During the course, 2024-2025 will act as subject coordinator Prof. Francisco Javier Martín Cora (franciscoj.martin.cora@usc.es). He may be contacted for any incident.
e-Communication between students and teachers will be through the email addresses provided by the USC server for teachers and students (@usc or @usc.rai)
The Moodle virtual classroom is an appropriate communication media between teachers and students throughout the course .