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 uniport, symport, and antiport: the examples of Na+/K+ pump and of the Na + -glucose symport; transport by vesicles: exocytosis, endocytosis and transcytosis.

2. Neuron physiology and generation of electrical signals (6 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 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; 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. Central Nervous System (CNS): structure and function (4 hours).
3.1 Introduction to the central nervous system (CNS): brain and spinal cord; gray and white matter (or substance) in the brain and in the spinal cord; spinal cord structure (schematic drawing of its transverse structure); meninges; cerebrospinal fluid; cerebral ventricles and choroid plexuses; hematoencephalic (or blood-brain) barrier.
3.2 Structure and function of the brain: encephalic trunk (medulla oblongata, pons and midbrain); the cerebellum; the diencephalon and the homeostatic control centers (thalamus, hypothalamus, pituitary gland or hypophysis; pineal gland or epiphysis); the telencephalon and the cerebral cortex; basal ganglia; limbic system: amygdala, cingulum bundle and hippocampus.
3.3 Brain functions: organization of the cerebral cortex in sensory, association and motor areas; concept of lateralization of brain functions.

4. Peripheral Nervous System (PNS): afferent (sensory) and efferent (motor-somatic and autonomous) divisions (6 hours).
4.1 General properties of sensory systems; types of sensory receptors; generator and receptor potential; concept of primary and secondary receptive field; spatial resolution of stimuli; encoding and processing of sensory stimuli (labeled line coding or principle, population coding, frequency coding); concept of lateral inhibition; receptor adaptations; the somatosensory pathways and cortex; cutaneous receptors; touch- and thermos-receptors; nociceptors and the retraction reflex; gate-control theory.
4.2 The autonomic nervous system: sympathetic and parasympathetic divisions; the centers of homeostatic control of the encephalic trunk and of the thalamus; localization of the cell bodies of autonomic neurons in the spinal cord; differences and similarities between sympathetic and parasympathetic pathways: localization of preganglionic neurons and ganglia; neurotransmitters used by pre- and post- ganglionic neurons; differences between ionotropic and metabotropic receptors; mechanisms of signal transduction of adrenergic and cholinergic receptors; the 5 different classes of adrenergic and cholinergic receptors; neuroeffector junction (schematic drawing of its different parts); adrenal medulla and catecholamines.
4.3 The somatic motor system: motoneuron and motor unit; localization of motoneuron cell bodies in the spinal cord; neuromuscular junction (schematic drawing of its different parts); acetylcholine, nicotinic acetylcholine receptor, and the transduction of the signal at the motor end plate; mechanisms of signal termination.

5. Skeletal and Smooth Muscle: structure and function (8 hours).
5.1 The three types of muscle in our body: skeletal, cardiac and smooth; general structure of skeletal muscle fibers: myofibrils, sarcomeres, and membrane systems.
5.2 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.
5.3 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).
5.4 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; 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).
5.5 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.

6. Applied Physiology 1: muscle and metabolic adaptations to training.
6.1 Classification of muscle fibers based on metabolism and speed of contraction: structural and functional differences between slow, intermediate and fast twitch fibers; classification of muscle fibers in red and white; concept of motor unit and recruitment; relationship between electrical and mechanical events; isometric and isotonic contractions (role of the elastic and contractile components of fibers).
6.2 Adaptations of skeletal muscle to endurance and to power exercise; fiber typing recruitment in different types of exercise; simple twitch (graph), summation of twitch contractions (graph), incomplete and complete tetani (graphs); definition of fatigue (graph); role played respectively by the nerve and muscle component in increasing muscle output; structural remodeling of muscle fibers in response to power and endurance exercise; role of satellite cells in fiber memory of exercise.
6.3 Muscle metabolism and different exergonic systems: anaerobic alactacid metabolism (phosphocreatine); anerobic lactacid metabolism (glycolysis); aerobic metabolism of
sugars and fatty acids and proteins (krebs cycle and mitochondrial respiration); accumulation of acid lactic acid in the blood stream and relationship with workload (blood lactate curve); velocity of ATP production by the various exergonic systems; use of fatty acids fats and sugars at different exercise intensities.

7. Physiology of the Cardiovascular System (7 hours).
7.1 Introduction to the cardiovascular system: anatomy and general functions.
7.2 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); Frank-Starling's law (graph) and the importance of venus return.
7.3 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 baroceptors reflex (schematic drawing of its functioning).
7.4 The blood; plasma composition; corpuscular blood component: red cells, white cells and platelets; hematocrit concept; hematopoiesis; hemostasis and coagulation.

8. Physiology of the Respiratory System (5 hours).
8.1 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.
8.2 Ventilation (inhalation and exhalation) and air exchange between external space and lungs; 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).
8.3 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.
8.4 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.

9. Applied Physiology 2: cardiovascular and ventilatory adaptations to exercise.
9.1 Concept of chronic and acute adaptations to physical exercise; VO2max: what it depends on and how it changes with aerobic exercise; training zone for VO2max.
9.2 Acute and chronic cardiovascular adaptations to exercise: changes in heart rate, systolic volume and cardiac output; changes in the pressure-volume curve of the left ventricle; changes in blood pressure in response to power or endurance exercise; venous return: the law of Frank-Starling; redistribution of blood flow during exercise; response of the various vascular districts to sympathetic innervation and adrenaline; active hyperemia of skeletal muscles during exercise: paracrine mediators of vasodilation; structural adaptations of the myocardium to training: eccentric and concentric hypertrophy; chronic changes in systolic output, output and heart rate with aerobic training.
9.3 Ventilatory adaptations to physical exercise: reflex control of ventilation (schematic drawing and function); respiratory centers in pons and medulla oblongata; dorsal and ventral respiratory nuclei; central and peripheral chemoreceptors; hyperventilation and hypoventilation curve (graph); relationship between ventilation and partial pressures of oxygen and carbon dioxide in alveoli and blood; relationship between blood lactic acid, pH and hyperventilation; effect of pH (Bohr effect), temperature, and PCO2 on the hemoglobin / O2 dissociation curve (graph).

10. Physiology of Kidney and the Hydro-electrolytic Balance (6 hours).
10.1 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.
10.2 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 (ex .: sodium, glucose, urea).
10.3 Hydro-electrolyte balance: water balance and role of the kidney in its regulation; vasopressin or antidiuretic hormone; countercurrent exchange in the medulla of the kidney; sodium and potassium balance and via renin-angiotensin-aldosterone; behavioral mechanisms in the hydro-electrolyte balance: thirst, salt appetite, heat avoidance behavior.
10.4 Renal regulation of acid-base equilibrium: blood buffer systems, ventilation, renal regulation of H+ e HCO3-; renal buffer systems; function of intercalated cells A and B in the collector duct.