SCHOOL OF BIOMEDICAL SCIENCES DEPARTMENT OF HUMAN BIOLOGY PHYSIOLOGY 232. Semester 2, on the successful completion of this unit

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1 SCHOOL OF BIOMEDICAL SCIENCES DEPARTMENT OF HUMAN BIOLOGY PHYSIOLOGY 232 Semester 2, 2009 INDEX NO: CONTACT HOURS TUITION PATTERN: CREDITS: 5 hours per week (average) 3hr lectures AND 2hr laboratory.* 25 on the successful completion of this unit PRE-REQUISITE: Human Biology 134 This is a SIGNIFICANT UNIT: UNIT CO-ORDINATOR Fail this unit TWICE and it may lead to the termination of your course. Dr Phil BOURNE P.Bourne@curtin.edu.au OFFICE: Building 308; Room 223 PHONE: (08) *Average over semester. Laboratory times vary depending upon the particular practical exercise. ASSESSMENT: 2hr Theory Test 20% Completion by Week 14 Assessment for Physiology 232 is Practical Reports (5) 30% Due biweekly continuous and will be evaluated on the following components: Written Examination 50% Held in Exam Period TEXTBOOK: Silverthorn, DU (2007). Human Physiology: An Integrated Approach (4 th Ed.); Pearson Education, Inc., publishing as Benjamin Cummings, San Francisco, CA 94111, USA. # Silverthorn, DU and Hill, RD (2007). Student Workbook: Human Physiology: An Integrated Approach, (4 th Ed.); Pearson Education, Inc., publishing as Benjamin Cummings, San Francisco, CA 94111, USA. # Zao, P, Stabler, T, Smith, L, Peterson, G, and Lokuta, A (2008). PhysioEx 8.0 for Human Physiology: Laboratory Simulations in Physiology. Pearson Benjamin Cummings, San Francisco, USA. # Recommended purchase from the University Bookshop

2 OUTCOMES: A. Professional Skill Outcomes On successful completion of this unit you will have completed tasks that will have developed the following skills: Effective Communication: o Use of written, verbal and electronic media. Analysis and Evaluation of Information: o Accessing, analysing and critically evaluating relevant information. Problem Solving and Decision Making: o Organisational skills to study, research, revise and review unit materials o Reviewing lecture materials o Submitting practical write-ups o Completion of assessments. Teamwork: o Completing group-study exercises and assignments o Revision and discussion of unit materials. Practical Competence: o Hands-on experiments in practical sessions o Completion of practical exercises competently and safely. Awareness of Issues Affecting Health Professionals: o Development of high ethical standards. B. Learning Outcomes (Content Knowledge) This unit is designed to introduce you to both theoretical and practical aspects of physiology. On successful completion of this unit you will be able to: MODULE ONE: CARDIOVASCULAR PHYSIOLOGY 1. Describe the composition, physical characteristics and general functions of blood. 2. Describe the composition of blood plasma and the functions of its constituents. 3. Describe the life cycle of the red blood cell and those factors which influence its production and destruction. 4. Diffentiate between haemostasis and the process of blood coagulation. 5. Describe the process of blood clotting, noting the differences between the intrinsic and extrinsic pathways. 6. Identify the major factors that determine cardiac output. 7. Describe the electrical activity in the sino-atrial node and explain why this tissue functions as the normal pacemaker of the heart. 8. Describe the sequence of events in a cardiac cycle and explain the regulation of both the cardiac cycle and cardiac output. 9. Describe the intrinsic and extrinsic regulation of stroke volume of the heart. 10. Describe the relationship between blood flow, driving pressure and resistance. 11. Compare and contrast the mechanisms by which blood pressure and blood flow are maintained at the systemic and tissue level. 12. Identify and indicate the timecourse of action of those mechanisms which seek to return MAP to normal following an abrupt change. 13. Compare the structure of an artery and vein, and explain how the structure of each type of vessel relates to its function. 14. Explain the value and function of the capillaries and describe the different mechanisms by which materials cross the capillary wall. MODULE TWO: RESPIRATORY PHYSIOLOGY 1. Explain how the intrapulmonary and intrapleural pressures vary during ventilation and contribute to the proper functioning of the lung. PHYS φ pkb 2/2009

3 2. Define the terms compliance and elasticity and explain how these lung properties affect the ventilatory process. 3. Discuss the significance of surface tension in lung mechanics, explain how the law of LaPlace applies to lung function, and describe the role of pulmonary surfactant as an energy-saving substance in the lungs. 4. Describe the conditions under which there may be an imbalance in the ventilation-perfusion ratio of regions of the lung, and show how this affects the O 2 and CO 2 content of alveolar gas 5. Explain why the S-shaped oxyhaemoglobin dissociation curve maximises O 2 loading in the lungs and unloading at the tissues. 6. Describe those factors that shift the oxyhaemoglobin dissociation curve to the right. Explain the Bohr Effect in tissues and Haldane Effect at the lungs. 7. List the different forms of carbon dioxide transport in the blood and explain how the chloride shift in red blood cells is driven by the PCO 2 in the tissues and also at the lungs. 8. Explain how, by monitoring the ph of CSF, the central chemoreceptors serve to regulate the arterial PCO Describe factors that may be involved in determining the ventilatory increase during exercise. MODULE THREE: RENAL PHYSIOLOGY 1. Define the physiological mechanisms involved in the filtration, reabsorption and secretion of substances within the kidney tubule. 2. Describe glomerular filtration, the factors that influence it and how glomerular filtration is measured. 3. Discuss the mechanisms involved in the autoregulation of GFR. 4. Describe the mechanism for reabsorption of most of the filtered Na + and water in the proximal tubule and understand how this leads to the passive reabsorption of other small solutes. 5. Illustrate with examples the mechanisms of active reabsorption and secretion in the nephron and also define the transport maximum of a substance. 6. Explain how activation of the renin-angiotensin system results in the stimulation of aldosterone secretion. 7. Discuss the effects of atrial natriuretic hormone on glomerular filtration rate and Na + reabsorption. 8. Discuss the three scenarios of plasma clearance performance of substances and its effects upon urine composition. 9. Describe how the loop of Henle acts to create an osmotic gradient in the kidney medulla and how the passive movement of urea contributes to this process. 10. Explain the process of urea recycling in the kidney tubules. 11. Describe how antidiuretic hormone affects the water permeability of the collecting duct. MODULE FOUR: ACID-BASE & FLUID BALANCE 1. Discuss in general terms how the extracellular fluid ph is buffered by the bicarbonate buffer system, and how the state of this buffer system is controlled by the combined action of lungs and kidneys. 2. Describe the role of the kidneys in the regulation of acid-base balance. 3. Describe how H + secretion first recovers filtered HCO 3 -, and then results in the formation of "new" HCO 3 - from CO 2, increasing plasma [HCO 3 - ] and ph. 4. Explain how the acid-base balance of the blood is affected by CO 2 and bicarbonate, and describe the roles of the lungs and kidneys in maintaining acid-base balance. 5. Define those factors affecting the distribution of water between cellular and extracellular fluids between blood plasma and interstitial fluid. 6. Describe mechanisms that regulate water balance and describe body responses to cellular dehydration and extracellular dehydration. 7. Explain the role of aldosterone, atrial natriuretic factor and ADH in sodium and water balance in the kidneys. 8. Review the role played by the kidney in electrolyte and fluid balance. 9. Consider the regulation of K + balance in the body. Discuss factors affecting the distribution of potassium between cells and extracellular fluid and potassium excretion. PHYS φ pkb 2/2009

4 READING LIST: All held in closed reserve in the library Berne, RM and Levy, MN (2005). Physiology (5 th ed.). C.V. Mosby & Company, St. Louis & Washington, USA. Boron, WF and Boulpaep, EL (2003). Medical Physiology: A Cellular and Molecular Approach. Saunders Publishing, Philadelphia, Penn , USA. Crystal, RG and West, JB (1991). The Lung: Scientific foundations. Vols I & II. Raven Press, New York. Davies, A, Blakeley, AGH and Kidd, C (2001). Human Physiology. Churchill Livingstone, London, UK. Fishman, AP (1997). The Respiratory System. American Physiological Society, Bethesda, Maryland, USA. Fozzard, HA et al. (1996). The Heart and Cardiovascular System: Scientific Foundations. Vols I & II. Raven Press, New York, USA. Ganong, W.F. (1999). Review of Medical Physiology (19 th ed.). Appleton and Lange, Englewood Cliffs, New Jersey, USA. Guyton, AC and Hall, JE (2000). Textbook of Medical Physiology (10 th ed.). WB Saunders, Philadelphia, Pennsylvania 19106, USA. Jennett, S (1989). Human Physiology. Churchill Livingstone, Melbourne, Australia. Johnson, L R (2003). Essential Medical Physiology (3 rd ed.). Academic Press, San Diego, California, USA. Patton, HD, Fuchs, AF, Hille, B, Scher, AM and Steiner, R (1989). Textbook of Physiology: Volumes 1 & 2. WB Saunders Company, Philadelphia, USA. Pocock, G and Richards, CD (2004). Human Physiology: The Basis of Medicine (2 nd ed.). Oxford University Press, Oxford OX2 6DP, United Kingdom. Rhoades, R. and Pflanzer, R. (2003). Human Physiology (4 th ed.). Brooks/Cole Publishing, Pacific Grove, CA93950, USA. Rhoades, R and Tanner, GA (2003). Medical Physiology (2 nd ed.). Lippincott, Williams & Wilkins, Philadelphia, Pennsylvania 19106, USA. Schmidt RF and Thews, G (1989). Human Physiology (2 nd ed.). Springer-Verlag, Berlin. Sherwood, L (2004). Human Physiology: From Cells to Systems (5 th ed.). Brooks/Cole Publishing, Pacific Grove, CA93950, USA. Sperelakis, N and Banks, RO (1993). Physiology. Little, Brown & Company, Boston, USA. Vander, AJ Sherman, JH and Luciano, DS (2001). Human Physiology: The Mechanisms of Body Function (8th ed.). McGraw-Hill, Sydney, Australia. West, JB (1990). Respiratory Physiology: The Essentials (4 th ed). Williams and Wilkins, Baltimore, USA. PHYS φ pkb 2/2009

5 SYLLABUS: 1. Cardiovascular Physiology: Blood; Composition and function of plasma constituents; Haemostasis; Instrinsic & extrinsic pathways for blood clotting; Electrical activity of the Heart; Cardiac cycle; Control of HR & SV; Intrinsic and extrinsic regulation of blood flow/pressure. Dynamics of blood flow; Capillary exchange; Circulatory patterns and special regulation of the CVS. Hypotension, hypertension and circulatory shock. 2. Respiratory Physiology: Respiratory mechanics; Gas transport & release; Alveolar ventilation and blood flow; O 2 & CO 2 transport; Chemoreceptors and respiratory control; Acid-base balance. Hyper- and hypocapnia; Regulation of ventilation; Hypoxia and exercise. 3. Renal Physiology: Glomerular filtration; factors affecting GFR; Tubular reabsorption and secretion; Plasma clearance; Renal circulation; Countercurrent mechanisms; Urea recycling; Water and salt reabsorption. Diuresis. 4. Fluid and Electrolyte Balance: Na + & K + balance; Acid-base balance; Body fluid compartments. Regulation/integration of acid-base balance. ASSESSMENT: Assessment for Physiology 232 is continuous and will be evaluated on the following components: 2hr Theory Test 20% Completion by Week 14 Practical Reports (5) 30% Due biweekly Written Examination 50% During Exam Period ALL ASSESSMENTS MUST BE COMPLETED AND PRESENTED FOR MARKING TO PASS THIS UNIT. Please note that it is the responsibility of the student to have all requested reports submitted by the due dates. Failure to fulfil this obligation without adequate reason may result in the loss of marks allocated for that particular assessment. Similarly, students are reminded that absenteeism from scheduled assessment and laboratory practicals must be supported with a valid medical certificate. Students choosing not to do so, will forfeit the mark allocated for that particular assessment. Plagiarism Monitoring: Some reports in this unit will be monitored for plagiarism using Turnitin plagiarism detection service (see < Students, who do not want reports to be retained in the Turnitin database, must lodge a special request using the form available at: This form must be submitted along with your report. For further advice see Penalties for Late Submission of Assessments Late submission penalties have been standardised across the Faculty of Health Sciences. Assessments must be submitted in the specified format to the School Office by the specified time. The submission time is indicated by the date stamped by the School Office on the assignment or time that electronic submission is recorded. Students will have 10% of the total assessment mark deducted for each day (including both Saturday and Sunday) the assessment is late without prior negotiation with the relevant subject/unit Co-ordinator. Assessments will not be marked if they are submitted more than 10 days (including both Saturday and Sunday) after the due date (or revised due date if an extension has been granted). Work not submitted after this time (due date plus 10 days) may result in an F-IN (Fail - Incomplete) grade being awarded. Late assessments submitted PHYS φ pkb 2/2009

6 electronically over the weekend should be submitted to the unit co-ordinator with a copy of the preferred format provided on the first working day after submission. The relevant website is: LABORATORY CLASSES: Students are reminded that attendance of practical classes is compulsory. Absenteeism for reasons other than medical, which must be supported with a medical certificate, will only be granted in exceptional circumstances, with prior communication. Students who absent themselves from practical classes without valid medical certificates may find that their evaluation marks for their continuous assessment are adjusted pro rata. Physiology-based labs will be held in the Physiology Laboratory, Room University safety regulations require that students wear white lab coats and suitable closed-top shoes for all practicals held in the laboratory area. Failure to comply with this rule may result in exclusion from the laboratory class. A statement on University regulations about Laboratory Safety Policy can be viewed at EXAMINATIONS: 1. Final Examinations The final examination will be a 3 hour extended-answer paper based on the lecture material. There will be some choice. It will be a closed book exam, and conducted during the official university examination period. In order to successfully complete this unit the final theory examination MUST be passed, and an overall mark of 50% or greater for the COMBINED total assessment MUST be attained. 2. Deferred Examinations: Deferment of an examination is not automatic. Students may be permitted by the relevant Board of Examiners to defer an examination or other assessment where circumstances outside their control have arisen. However, a student's overall performance may be taken into account in granting permission to defer an examination. Applications for deferment on health grounds or as a result of extenuating circumstances must be submitted not later than seven (7) days after the end of the relevant examination period or assessment date during the semester. Detailed medical certificates should be attached to the application where appropriate. 3. Supplementary Examinations Supplementary examinations are awarded only at the discretion of the Board of Examiners. The aim of a supplementary examination is to allow the student to correct minor problems/deficiencies in the initial assessment and not to gain extra study time or correct major problems. Supplementary examinations, if awarded, will be indicated on the official Curtin examination result statement posted to all students, and will also be listed on the School (or Departmental) noticeboard 24 hours after the Board of Examiners meeting. It is your responsibility to check your status. Students should note that supplementary examinations for units conducted in the School will be held during the week beginning December 7 th, A student who does not sit for a scheduled supplementary examination has no claim to a further examination. If you are awarded a supplementary examination it is imperative that you confirm the time and venue for the exam. The prescribed application form may be obtained either from Admission and Student Records or the Course Administrator. Completed forms must be submitted to the Course Administrator. This includes applications for deferred assessment for units in your course of study conducted by other Schools. PHYS φ pkb 2/2009

7 UNIVERSITY POLICIES: The following University policies apply to this unit: The University statement on the nature and unacceptability of academic dishonesty including cheating, plagiarism and the fabrication or falsification of data. The University statement on individual rights and responsibilities regarding the proper use of copyright material. Student Charter. Grievance Procedures. Students are required to be aware of these policies which can be accessed using the A-Z index at: School Statement on Plagiarism It is not acceptable to simply copy the words of other students or authors when completing the weekly exercises and assignments in this unit. This action constitutes plagiarism and is regarded as academic malpractice. The penalties for plagiarism can be severe and may include termination from your course of study. All direct quotes must be correctly attributed to the author and should be kept to a minimum. Also, you should include a list of references to acknowledge the source(s) of information used to produce any written work. Information (or references) to University policy on academic integrity, including plagiarism can be found at: A new website is currently being developed to support both staff and students in matters related to academic or educational integrity. The URL will be The policy Academic Misconduct is still current and can be found at: As a guide only, typical penalties which may be imposed by the School of Biomedical Sciences for some of the more common types of plagiarism (including collusion) are shown in the Table below. Please note that each case of academic malpractice is assessed individually, and that penalties actually imposed by the Head of School (or delgatee) may vary from the examples shown in the following table. Example Degree of Seriousness Typical Penalty Students submitting very similar work (even as a result of legitimate co-operation) Not referencing input (factual statements, definitions etc) where students words are used Not referencing input where plagiarised words are used Not acknowledging ideas or concepts of others (i.e., stealing intellectual property). Collusion Minor to Severe Minor to Intermediate Depends on context, but may be serious Usually serious. Loss of marks for that question or assignment etc by both students Loss of 5% of assessment entity for each instance Loss of % of marks for that question or assignment as appropriate. Loss of marks plus an additional penalty which could entail failure of unit and/or possible termination from course depending on the circumstances. PHYS φ pkb 2/2009

8 PHYSIOLOGY 232 Textbook: Silverthorn, DU, Human Physiology: An Integrated Approach. Prentice Hall, Upper Saddle River, NJ 07458, USA. Chapter Topics Third Edition (2004) Fourth Edition (2007) Module One: Cardiovascular Physiology Blood components: Chapter 16, p Chapter 16, p Haemostasis: Chapter 16, p Chapter 16, p The Cardiac Cycle (review) Chapter 14, p Chapter 14, p Cardiac output & control: Chapter 14, p Chapter 14, p Coronary Artery Disease: Chapter 15, p Chapter 15, p Factors affecting BP (arterioles): Chapter 15, p Chapter 15, p Factors affecting BP (systemic): Chapter 15, p Chapter 15, p Haemodynamics: Chapter 14, p Chapter 14, p Regulation of Blood Pressure: Chapter 15, p Chapter 15, p Capillaries & capillary exchange: Chapter 15, p Chapter 15, p Lymph & lymph flow: Chapter 15, p Chapter 15, p Veins & venous return: Chapter 15, p Chapter 15, p Module Two: Respiratory Physiology Overview of Respiration: Chapter 17, p Chapter 17, p Ventilation: Chapter 17, p Chapter 17, p Pulm. surfactant; elasticity & compliance: Chapter 17, p Chapter 17, p Lung volumes: Chapter 17, p Chapter 17, p Ventilation perfusing matching: Chapter 17, p Chapter 17, p Gas exchange in alveoli: Chapter 18, p Chapter 18, p Transport of O 2 : Chapter 18, p Chapter 18, p Transport of CO 2 : Chapter 18, p Chapter 18, p Regulation of Ventilation: Chapter 18, p Chapter 18, p Exercise: Chapter 25, p Chapter 25, p Module Three: Renal Physiology Kidney: Overview of Structure to Function; Chapter 19, p Chapter 19, p Filtration; Chapter 19, p Chapter 19, p Reabsorption and Secretion; Chapter 19, p Chapter 19, p Excretion; Chapter 19, p Chapter 19, p Aldosterone; Chapter 20, p Chapter 20, p ADH; Chapter 20, p Chapter 20, p Loop of Henle; Chapter 20, p Chapter 20, p Module Four: Fluid & Electrolyte Balance Acid-Base Balance: Chapter 20, p Chapter 20, p Water Balance: Chapter 20, p ; Chapter 20, p ; Sodium Balance: Chapter 20, p Chapter 20, p Potassium Balance: Chapter 20, p Chapter 20, p PHYS φ pkb 2/2009

9 PHYSIOLOGY 232 LECTURE SCHEDULE Semester 2, 2009 Monday am, Room ; Wednesday pm, Room Week No. Date Lecture Topics July CVS Physiology August CVS Physiology August CVS Physiology August CVS Physiology August WEEK FREE FROM CLASS CONTACT August CVS Physiology September Respiratory Physiology September Respiratory Physiology September Respiratory Physiology September WEEK FREE FROM CLASS CONTACT October Renal Physiology October Renal Physiology October Fluid & Electolyte Balance October Fluid & Electolyte Balance November STUDY WEEK November EXAMINATIONS November EXAMINATIONS PHYS φ pkb 2/2009

10 PRACTICAL SCHEDULE FOR SEMESTER 2, 2009 Groups A & B: Thursdays: pm, Room Physiology-based labs will be held in the Physiology Laboratory, Room University safety regulations require that students wear white lab coats and suitable closed-top shoes for all practicals held in the laboratory area. Failure to comply with this rule may result in exclusion from the class. Week Date GROUP A Practical Topics GROUP B Practical Topics NO PRACTICAL THIS WEEK NO PRACTICAL THIS WEEK Introduction to the ECG (www) NO PRACTICAL THIS WEEK Electrical Activity of the Heart Introduction to the ECG (www) CVS Dynamics (PhysioEx) Electrical Activity of the Heart WEEK FREE Cardiovascular Homeostasis CVS Dynamics (PhysioEx) Respiratory mechanics (PhysioEx) Cardiovascular Homeostasis Respiratory Ventilation Respiratory mechanics (PhysioEx) NO PRACTICAL THIS WEEK Respiratory Ventilation WEEK FREE Physiology of Exercise NO PRACTICAL THIS WEEK Nephron (PhysioEx) Physiology of Exercise Water Diuresis Nephron (PhysioEx) NO PRACTICAL THIS WEEK Water Diuresis STUDY WEEK Nov. EXAMINATIONS * Practicals in bold type have to written-up as completed laboratory reports (see handout) and handed-in for assessment within 2 WEEKS of the conclusion of the lab activity. PHYS φ pkb 2/2009