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 Relationship structure-function of physiological systems.
2. PHYSIOLOGY OF MUSCLE APPARATUS
2.1 The three types of muscle in our body: skeletal, cardiac and smooth; general structure.
2.2 Skeletal Muscle: anatomy. Molecular basis of contraction: general structure of skeletal muscle fibers: myofibrils, sarcomeres, and membrane systems.
2.3 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.
2.4 The sarcomere; 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.
2.5 Classification of muscle fibers based on metabolism and speed of contraction; structural and functional differences between slow, intermediate and fast fibers; classification of fibers in red and white; concept of motor unit and motor unit recruitment; relationship between electrical and mechanical events; single twitch, summation mechanism, incomplete and complete tetanus; definition of fatigue; isometric and isotonic contractions (and role of elastic and contractile components). Muscle strength graduation mechanisms. Muscle plasticity.
3. PHYSIOLOGY OF THE CARDIOVASCULAR SYSTEM
3.1 Introduction to the cardiovascular system: anatomy and general functions.
3.2 The heart: pacemaker and contractile tissues; contractile myocardial cells and intercalated disks; the conduction system; the action potential of pacemaker cells; the action potential of contractile cells; the cardiac cycle explained with the 5 phases; the cardiac cycle explained with the pressure-volume curve of the left ventricle; cardiac output; Frank-Starling's law.
3.3 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.
4. PHYSIOLOGY OF THE KIDNEY
4.1 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.
4.2 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 (i.e.: sodium, glucose, urea).
NEUROPHYSIOLOGY:
1. CELLULAR PHYSIOLOGY AND ELECTROPHYSIOLOGY
1.1 Distribution of solutes in the different liquid compartments of the organism; ionic bases of membrane potential in resting cells; equilibrium potentials for a single ionic species (Nernst equation). Role of the Na+-K+ pump.
1.2 Relationships between variations in membrane potentials, ion fluxes, membrane permeability; concept of depolarization and hyperpolarization; the generation of graduated potentials; concept of subthreshold and suprathreshold potential; spatial and temporal summation of graduated potentials; mechanisms of propagation of graduated potential and the influence of passive electrical properties of the membrane. Time trend of action potential and main phases related to variations in membrane permeability; meaning of threshold for the action potential; absolute and relative refractory period; propagation of action potentials, differences in myelinated and unmyelinated fibers.
1.3 Transmission of the electrical signal through synapses: electric synapses and chemical synapses and their anatomical and functional differences. Anatomy and functional characteristics of the central and peripheral synapses; neuromuscular junction; excitatory and inhibitory synapses; concepts of stimulus intensity and frequency related to the release of the neurotransmitter.
2. CENTRAL NERVOUS SYSTEM (CNS): STRUCTURE AND FUNCTION
2.1 Introduction to the central nervous system (CNS): anatomo-functional organization of the brain and spinal cord (anatomy recalls); spinal cord structure and its functional organization; structure and function of the brain: brainstem (medulla, pons and midbrain); cerebellum; cerebral cortex; basal ganglia.
2.2 Brain functions: organization of the cerebral cortex in sensory, association and motor areas; concept of lateralization of brain functions.
3. PERIPHERAL NERVOUS SYSTEM (PNS): SENSORY DIVISION.
3.1 General properties of sensory systems; types of sensory receptors; generator and receptor potential; primary and secondary receptive field; spatial resolution of stimuli; processing and coding of the intensity, modality, duration and location of the stimulus; concept of lateral inhibition; receptor adaptations.
3.2 Somatic sensitivity: mechanisms and central organization of the somatic system. Anterolateral somesthesic system. Thermal and pain sensitivity. Gate theory in pain modulation. Lemniscal somesthesia sensitivity.
3.3 Ear and hearing: general principles of acoustics; anatomy and functional organization of the auditory system; the meccano-electric transduction of the sound; ionic bases of meccano-transduction in ciliate cells; central auditory pathways; auditory cortex.
3.4 Vestibular system: anatomy and functional organization of the vestibular system; static and dynamic balance; otoliths and semicircular canals; vestibular nerve pathways; vestibulo-ocular reflex; central pathways to thalamus and cortex.
4. PERIPHERAL NERVOUS SYSTEM (PNS): MOTOR DIVISION.
4.1 Hierarchical organization of motor control systems; types of movement.
4.2 The spinal cord as a center of reflexes; proprioceptors (joint receptors, neuromuscular spindles, Golgi tendon organs); motor efferences of the spinal cord; concept of myotatic unit and mutual inhibition; spinal reflex arcs; spinal generators of rhythm: the locomotion and biomechanics of the path; muscular stiffness; the cycle of the step; nervous control of locomotion.
4.3 Voluntary movement: nerve centers responsible for movement; relationship between motor neurons and muscles; somatotopic organization of motoneurons; motor program.
4.4 Movement planning and organization: primary motor cortex, posterior parietal cortex and premotor cortex; mirror neurons.
4.5 Modulation of the movement by brain stem and spinal cord: lateral and medial motor descending pathways; posture, balance and visual orientation; final common pathway.
4.6 Modulation of the movement by basal ganglia: anatomy and functional organization of the basal ganglia; afferent and efferent fibers of the basal ganglia; saccadic eye movements; direct and indirect pathways of the basal ganglia; dopaminergic pathway.
4.7 Modulation of the movement by the cerebellum: anatomy and functional organization of the cerebellum; afferent and efferent fibers of the cerebellum; basic cerebellar circuits; control of the cerebellum on voluntary movement; role of the cerebellum in motor learning.
4.8 Memory and learning: definitions. Memory: locations, mechanisms, neurobiological bases of short and long-term memory; role of the hippocampus; long term potentiation (LTP). Associative learning and conditional learning. Procedural learning and procedural memory; steps of motor learning, role of the cerebellum in motor learning; striatal circuit and cerebellar circuit.
5. AUTONOMOUS NERVOUS SYSTEM (ANS).
5.1 The autonomic nervous system: sympathetic and parasympathetic branch; localization of the cell bodies of autonomic neurons in the spinal cord; differences and similarities between sympathetic and parasympathetic pathways: localization of pre-ganglional neurons and ganglia; neurotransmitters and receptors of the autonomous system; differences between ionotropic and metabotropic receptors; signal transduction mechanisms used by adrenergic and cholinergic receptors; neuro-effector junction; medulla of the adrenal gland and catecholamines.
GENETICS:
- Gene structure and function. Protein synthesis, genetic code, regulation of gene expression.
- Cell division. Mitosis, meiosis,
- Cytogenetics. Notes on cytogenetic techniques, normal human karyotype, chromosomal banding.
- Chromosomal abnormalities. Numerical and structural alterations of chromosomes. Main chromosomal syndromes.
- Prenatal diagnosis.
- Mendel's laws. Autosomal dominant and recessive inheritance, heterosomal inheritance, mitochondrial inheritance. Polygenic inheritance. Particularity of the Mendel laws.
- Mutations. Point mutations, frameshift, dynamics. Chemical and physical mutagens.
Chromosomal alterations and spontaneous abortions.
- Principal techniques of molecular biology and their applications. Gene cloning.
- Oncogenes and oncosuppressor genes.
PHARMACOLOGY:
Introduction to Pharmacology, definition of active drugs
Pharmacokinetic elements: main routes of drug administration (outline of the main pharmaceutical forms and the correct administration of drugs); absorption, distribution, biotransformation and excretion of drugs; bioavailability; therapeutic range; plasma half-life; therapeutic index.
Elements of Pharmacodynamics: drug-receptor interactions; main receptor classes; main signal transduction pathways; receptor agonists and antagonists; definition of power and maximum efficacy of a drug.
Special pharmacology:
1) Drugs acting on the central nervous system (anxiolytics, hypnotics and sedatives, antidepressants, drugs for Parkinson's disease, antiepileptics); drugs active on the peripheral nervous system (adrenergic agonists and antagonists, cholinergic agonists and antagonists)
2) Non-steroidal anti-inflammatory drugs (NSAIDs); glucocorticoids; centrally acting analgesic drugs (morphine).