EXTENDED PROGRAM

1. Introduction to Physiology (3 hours).
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 symport and antiport: the examples of Na+/K+ pump and of the Na + -glucose symport.

2. Neuron physiology and generation of electrical signals (4 hours)
2.1 Distribution of solutes in the different liquid compartments of the organism (schematic drawing); resting membrane potential; equilibrium potentials of Na+ and K+.
2.2 Introduction to the nervous system: basic 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; neuromuscular junction (schematic drawing of its different parts).

3. Skeletal and Smooth Muscle: structure and function (5 hours).
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 Coupling-excitation contraction in striated muscles (1 hour): transverse tubules and sarcoplasmic reticulum; the voltage sensor (DHPR); the Ca2 + release channel of the sarcoplasmic reticulum (RyR); the triads or calcium release units (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.
3.4 Classification of muscle fibers based on metabolism and speed of contraction; classification of fibers in red and white; structural and functional differences between slow, intermediate and fast fibers; concept of motor unit and motor unit recruitment; relationship between electrical and mechanical events; simple twitch (graph), summation mechanism (graph), incomplete and complete tetanus (graphs); definition of fatigue (graph).
3.5 General characteristics of smooth muscle cells; organization of thick and thin myofilaments; molecular mechanisms of contraction; molecular mechanisms of contraction: role of calmodulin and phosphorylation of the myosin light chain.

4. Physiology of the Cardiovascular System (5 hours).
4.1 Introduction to the cardiovascular system: anatomy and general functions.
4.2 The heart (schematic drawing): 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 electrocardiogram (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); modulation of heart rate by the autonomic nervous system.
4.3 Large and small circulation; arterial pressure and its measurement (concept of systolic and diastolic pressure); mean arterial pressure and factors affecting it; structure of blood vessels: differences between arteries and veins; the role of arteries and veins in helping the heart to pump blood; regulation of arterial pressure and baroceptor reflex (schematic drawing of its functioning).

5. Physiology of the Respiratory System (4 hours).
5.1 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; the four phases of external respiration.
5.2 Ventilation (inhalation and exhalation) gas exchange between alveoli and blood; 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); and air exchange between external space and lungs.
5.3 Transport of gasses in the blood and gas exchange blood-tissues; transport of O2; hemoglobin/ O2 dissociation curve (graph); blood transport of CO2 and its effect on blood pH.

6. Physiology of Kidney (3 hours).
6.1 Introduction to the urinary system: urinary tract and kidney; main function of the kidneys; cortex and medulla regions; the nephron: tubular and vascular elements; the structure of the renal corpuscle.
6.2 The nephron: the four basic processes (filtration, reabsorption, secretion, excretion); concepts of filtration fraction; and filtration pressure; self-regulation of glomerular filtration rate: myogenic response and tubulo-glomerular feedback; reabsorption (example: sodium, glucose, urea).
6.3 The water-electrolyte balance: water balance and the role of the kidney in its regulation; vasopressin or antidiuretic hormone; countercurrent exchange in the medulla of the kidney (schematic drawing of its functioning); sodium and potassium balance and renin-angiotensin-aldosterone pathway; behavioral mechanisms in the hydro-electrolyte balance: thirst, appetite for salt, avoidance of heat.

Insights

a. Muscle metabolism (1 hour): exergonic systems of skeletal muscle; alactacid anaerobic metabolism; anerobic lactacid metabolism; aerobic metabolism of sugars and fatty acids; speed of production of ATP by the various exergonic systems and their use in operation; use of fatty acids and sugars in relation to the intensity of the exercise (graph).
b. Reflex control of blood pressure and ventilation (1 hour): aortic and carotid baroreceptors; bulbar cardiovascular control center; autonomous efferent pathways: targets and effects of sympathetic and parasympathetic regulation; baroceptive reflex (schematic drawing of its functioning); central and peripheral chemoreceptors; bulbar and pontine ventilation control centers; efferent pathways to the ventilator muscles.