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Study Guide Basic Physiology ~TABLE OF CONTENTS~ Page Table of Content 1 Introduction 2 Planner team & Lecturers 3 Facilitators 4 Time Table (Regular Class) 5 Time Table (English Class) 7 Meeting of the students’ representative 9 Assessment Method 9 Student’s Project 9 References 10 Learning Programs 11 Practical Guidelines 23 Curriculum Mapping 24 Udayana University Faculty of Medicine, DME, 2015 1 Study Guide Basic Physiology ~INTRODUCTION~ Physiology is the study of the functions of living organisms and how they are regulated and integrated. A concept of homeostasis is necessary for normal cell function, to maintenances of the steady states in the body by coordinated physiologic mechanism. Negative and positive feedback are used to modulate the body’s response to changes in the environment. In this block, we will learn about the basic of physiology. The function of human body processes at the cellular, organ and system level. This block will takes 15 meeting, each meeting consist of introductory lecture, individual learning, small group discussion, practical, student project and ending with plenary session. Planners Udayana University Faculty of Medicine, DME, 2015 2 Study Guide Basic Physiology ~PLANERS TEAM AND LECTURERS ~ No 1 2 3 4 4 5 6 7 8 9 10 11 Name Dr. dr.Susy Purnawati,MKK. Department Phone Physiology 08123989891 dr. I Dewa Ayu Inten Dwi Primayanti,M.Biomed Physiology Prof.Dr.dr Nyoman Adiputra,MOH Physiology Dr. Ketut Karna,M.Kes Physiology Prof. dr.I Dewa Putu Sutjana,M.Erg Physiology Prof.dr. Ketut Tirtayasa,M.Sc Physiology Prof.Dr.dr I Putu Gede Adiatmika,M.Kes Physiology Dr. dr. Made Muliarta,M.Kes Physiology Dr. Luh Made Indah Sri handari,S.Psi.,M.Erg Physiology dr. Putu Adiartha Griadhi,M.Fis Physiology dr. Luh Putu ratna Sundari,M.Biomed Physiology dr. Made Krisna Dinata,M.Erg Physiology 081337761299 0811397971 08123814104 08123924477 08123623422 08123811019 081338505350 081337095870 081999636899 081933070077 08174742566 ~FACILITATORS ~ NO NAME GROUP DEPT 1 dr. I Putu Bayu Mayura, S.Ked 1 Microbiology 2 2 Biochemistry 3 Psychiatry 4 dr. Ida Ayu Dewi Wiryanthini, M Biomed dr. I Gusti Ayu Indah Ardani, Sp.KJ dr. Tjahya Aryasa E M, Sp.An 4 Anasthesi 5 dr. Ni Made Susilawati, Sp.S 5 Neurology 6 dr. Ni Luh Putu Ariastuti, MPH 6 Public Health 7 dr. Putu Yuliandari, S.Ked 7 Microbiology 8 dr.Ni Putu Ekawati, M.Repro, Sp.PA dr. Ida Bagus Wirakusuma, MOH dr. I Putu Adiartha Griadhi, M.Fis, AIFO 8 9 Anatomy Pathology Public Health 10 Fisiology 3 9 10 Udayana University Faculty of Medicine, DME, 2015 PHONE 082236165801 081239990399 08123926522 081339713553 08124690137 0818560008 089685415625 08113803933 08124696647 081999636899 VENUE 2nd floor: R.2.01 2nd floor: R.2.02 2nd floor: R.2.03 2nd floor: R.2.04 2nd floor: R.2.05 2nd floor: R.2.06 2nd floor: R.2.07 2nd floor: R.2.08 2nd floor: R.2.21 2nd floor: R.2.22 3 Study Guide Basic Physiology ENGLISH CLASS NO 1 GROUP 1 DEPT Interna 2 Opthalmology 3 NAME dr. Pratihiwi Primadharsini, M.Biomol, Sp.PD dr. I Wayan Eka Sutyawan, Sp.M dr. Lisna Astuti, Sp.Rad(K) 3 Radiology 4 dr. Sianny Herawati, Sp.PK 4 5 dr. Gusti Ngurah Mayun, Sp.HK 5 Clinical Pathology Histology 6 dr. Lely Setyawati , Sp.KJ 6 Psychiatry 7 dr. I Kadek Swastika , M Kes 7 Parasitology 8 dr. Jaqueline Sudirman, GrandDipRepSc, PhD dr. I Gde Haryo Ganesha 8 Obgyn 9 DME dr. I Wayan Gede Sutadarma, M Gizi 10 Biochemistry 2 9 10 Udayana University Faculty of Medicine, DME, 2015 PHONE 081805530196 081338538499 081337934497 0818566411 08155715359 08174709797 08124649002 082283387245 081805391039 082144071268 VENUE 2nd floor: R.2.01 2nd floor: R.2.02 2nd floor: R.2.03 2nd floor: R.2.04 2nd floor: R.2.05 2nd floor: R.2.06 2nd floor: R.2.07 2nd floor: R.2.08 2nd floor: R.2.21 2nd floor: R.2.22 4 Study Guide Basic Physiology ~TIME TABLE~ REGULAR CLASS DAY/ DATE 1 Monday 30 Nov 15 2 Tuesday 1 Dec 15 Wednesday 2 Dec 15 TIME 08.00 - 09.00 09.00 – 10.00 10.00 – 11.00 11.00 – 12.30 12.30 – 13.00 13.00 – 15.00 08.00 - 09.00 09.00 – 10.00 10.00 – 11.00 11.00 – 12.30 12.30 – 13.00 13.00 – 15.00 09.00 – 10.00 4 Friday 4 Dec 15 5 Monday 7 Dec 15 10.00 – 11.00 11.00 – 12.30 12.30 – 13.00 13.00 – 15.00 08.00 – 09.00 09.00 – 10.00 10.00 – 11.00 11.00 – 12.30 12.30 - 13.00 13.00 – 15.00 08.00 – 09.00 09.00 – 11.30 11.30 – 12.30 12.30 - 15.00 08.00 - 09.00 6 Tuesday 8 Dec 15 7 Wednesday 9 Dec 15 Lecture 1 : Introduction of Physiology Lecture 2 : Muskuloskeletal System Individual Learning SGD BREAK Student Project (SP) Lecture 3 : Human blood, Immunity and blood clotting Lecture 4 : Respiratory system Individual Learning SGD BREAK SP CONVEYER VENUE Prof.Adiputra Prof. Adiatmika Class R. Class R. Facilitator Disc. R. Facilitator dr. Inten Disc. R. Class R. Dr. Susy Class R. Facilitator Facilitator Disc. R. Disc. R Prof.Dewa Pt Sutjana Class R. Dr. Muliarta Class R Fasilitator Fasiliator Disc R. Disc.R Lecture 7 : The Digestive System Lecture 8 : The Neuroscience System Individual Learning SGD Break SP Lecture 9: Metabolism and Temperature regulation Practical lecture 2 (group A1) (group A2 : Independent Learning/ SP) Break Practical lecture 2 ( Group A2) (group A1 : individual Learning / SP) Dr.Susy Dr. Indah Fasilitator Fasilitator dr. Adiarta Class R. Class R. Disc.R. Disc R. Class R. Team Lab. Physiology Lecture 10: Endocrinology 1 (introduction, general endocrinology) Individual Learning SGD Break SP Lecture 11 : Endocrinology 2 (growth hormone and other pherifer hormone) Practical lecture 3&4 (group A1) (group A2 : Independent Learning/ SP) Break dr.Karna Fasilitator Fasilitator Class R. Disc R. Disc R. dr. Karna Class R. Team Lab. Physiology Libur pagerwesi 08.00 - 09.00 3 Thursday 3 Dec 15 ACTIVITY 09.00 – 10.00 10.00 – 12.00 12.00 – 13.00 13.00 – 15.00 08.00 – 09.00 09.00 – 11.30 11.30 – 12.30 Lecture 5 : Cardiovascular system 1 - Heart as a pump Lecture 6 : Cardiovascular System 2 - The circulation Individual Learning SGD BREAK SP Udayana University Faculty of Medicine, DME, 2015 Team Team 5 Study Guide Basic Physiology 8 Thursday 10 Dec 15 12.30 - 15.00 Practical lecture 3&4 ( Group A2) (group A1 : individual Learning / SP 08.00 - 09.00 09.00 – 10.00 10.00 – 12.00 12.00 – 13.00 13.00 – 15.00 Lecture 12 : Female Reproductive system Individual learning SGD Break SP Lecture 13 : The Male Reproductive Practical lecture 7 (group A1) (group A2 : Independent Learning/ SP) Break Practical lecture 7 ( Group A2) (group A1 : individual Learning / SP 08.00 – 09.00 09.00 – 11.30 9 Friday 11 Dec 15 10 Monday 14 Dec 15 11 Tuesday 15 Dec 15 12 Wednesday 16 Dec 15 13 Thursday 17 Dec 15 14 Friday 18 Dec 15 11.30 – 12.30 12.30 - 15.00 dr. Inten Fasilitator Fasilitator Class R. Disc.R Disc R Dr. Inten Team Class R. Team Lab physiology 08.00 - 09.00 09.00 – 10.00 10.00 – 12.00 12.00 – 13.00 13.00 – 15.00 Lecture 14 : The Urinary System Individual learning SGD Break SP Prof. Tirtayasa Class R. 08.00 – 09.00 Lecture 15 : The Special senses dr. Krisna Dinata 09.00 – 10.00 10.00 – 11.00 11.00 – 12.00 12.00 – 13.00 14.00 – 15.00 08.00 – 09.00 Plenary Lecture: endocrinology Individual learning Break Student project presentation Student project presentation Plenary Lecture : Cardio 1 & 2 dr. Karna Class R. Class R. Class R. Class R. 09.00 – 10.00 10.00 – 11.00 11.00 – 12.00 12.00 – 13.00 14.00 – 15.00 08.00 – 09.00 Plenary Lecture : Urinary system Individual learning Break Student project presentation Student project presentation Plenary Lecture : Neuroscience and special senses Plenary Lecture : Neuroscience and special senses Individual learning Break Student project presentation Student project presentation FINAL EXAM 09.00 – 10.00 10.00 – 11.00 11.00 – 12.00 12.00 – 13.00 14.00 – 15.00 08.00 – 12.00 Udayana University Faculty of Medicine, DME, 2015 Dr.dr. Muliartha & Prof Sutjana Prof Tirtayasa Class R. Class R. Class R. Class R. Dr. Karna & dr. Krisna Class R. Class R. Class R. Class R. LB 6 Study Guide Basic Physiology ~TIME TABLE~ ENGLISH CLASS DAY/ DATE 1 Monday 30 Nov 15 2 Tuesday 1 Dec 15 Wednesday 2 Dec 15 TIME 09.00 – 10.00 10.00 – 11.00 11.00 – 12.00 12.00 – 12.30 12.30 – 14.00 14.00 – 16.00 09.00 – 10.00 10.00 – 11.00 11.00 – 12.00 12.00 – 12.30 12.30 – 14.00 14.00 – 16.00 pagerwesi 09.00 – 10.00 10.00 – 11.00 3 Thursday 3 Dec 15 4 Friday 4 Dec 15 5 Monday 7 Dec 15 6 Tuesday 8 Dec 15 11.00 – 12.00 12.00 – 12.30 12.30 – 14.00 14.00 – 16.00 09.00 – 10.00 10.00 – 11.00 11.00 – 12.00 12.00 – 12.30 12.30 – 14.00 14.00 – 16.00 09.00 – 10.00 10.00 – 11.00 11.00 – 12.00 12.00 – 14.00 14.00 – 16.00 08.00 – 09.00 09.00 - 10.00 10.00 - 12.30 12.30 – 13.30 13.30 - 16.00 09.00 – 10.00 7 Wednesday 9 Dec 15 10.00 - 11.00 11.00 – 12.00 12.00 – 14.00 14.00 – 16.00 ACTIVITY Individual Learning Lecture 1 : Introduction of Physiology Lecture 2 : musculoseletal system BREAK SGD SP Individual Learning Lecture 3: Human blood, immunity and blood clotting Lecture 4: The respiratory system BREAK SGD SP Individual Learning Lecture 5: Cardiovascular system - Heart as a pump Lecture 6: Cardiovascular system - Circulation BREAK SGD SP Individual Learning Lecture 7: The Digestive system Lecture 8 : Neuroscience system BREAK SGD SP Individual Learning Lecture 9: Metabolism and Temperatu regulation BREAK SGD SP Individual Learning Lecture 10: Endocrinology 1 (introduction, general endocrinology) Practical lecture 2 (group B1) (group B2 : Independent Learning/ SP) Break Practical lecture 2 ( Group B2) (group B1 : individual Learning / SP) Lecture 11 : Endocrinology 2 (growth hormone and other pherifer hormones) Individual learning Break CONVEYER VENUE Prof. Adiputra Prof.Adiatmika Facilitator Facilitator dr. Inten Class R. Class R. Disc. R. Disc. R. Class R. Dr. Susy Facilitator Facilitator Class R. Disc. R. Disc. R Prof. Sutjana Class R. Dr.Muliarta Class R. Fasilitator Fasilitator Dr. Susy dr. Karna/Indah Facilitator Fasilitator Dr. Adiarta Disc. R Disc R. Class R. Class R Disc R Disc R. Class R. Facilitator Facilitator dr. Karna Disc. R. Disc. R Class R. Team Lab. Physiology Team dr. Karna Fasilitator Fasilitator Class R. Disc R. Disc R. SGD SP Udayana University Faculty of Medicine, DME, 2015 7 Study Guide Basic Physiology 8 Thursday 10 Dec 15 9 Friday 11 Dec 15 10 Monday 14 Dec 15 11 Tuesday 15 Dec 15 12 Wednesday 16 Dec 15 13 Thursday 17 Dec 15 14 Friday 18 Dec 15 09.00 – 10.00 10.00 – 12.30 12.30 – 13.30 13.30 – 16.00 09.00 – 10.00 10.00 – 11.00 11.00 – 12.00 12.00 – 14.00 14.00 - 16.00 09.00 – 10.00 10.00 – 12.30 Lecture 12 : Female Reproductive system Practical Lecture 3&4 Group B1 ( Group B2 : Independent Learning/SP) Break Practical Lecture 3&4 Group B2 ( Group B1 : Individual learning/SP) Lecture 13 : Male Reproductive system Individual learning Break SGD SP 09.00 – 10.00 10.00 – 12.00 12.00 – 13.00 13.00 - 14.00 14.00 – 16.00 Lecture 14 : The Urynary System Practical lecture 7 group B1 ( Group B2 : individual learning/SP) BREAK Practical lecture 7 Group B2 ( Group B1 : individual learning/SP) Individual learning Lecture 15 : The special senses Break Plenary lecture endocrinology Student project presentation 09.00 – 10.00 10.00 – 12.00 12.00 – 13.00 13.00 – 14.00 14.00 – 15.00 Individual learning Plenary Lecture : cardio 1 & 2 Break Plenary lecture : Urinary system Student project presentation 09.00 – 10.00 10.00 – 12.00 14.00 – 16.00 Individual learning Plenary Lecture : neuroscience & special senses Break Plenary Lecture : neuroscience & special senses Student project presentation 08.00-12.00 FINAL EXAM 12.30 – 13.30 13.30 - 16.00 12.00 – 13.00 13.00 – 14.00 dr. Inten Team Team Class R. Lab Physiology dr. Inten Facilitator Fasilitator Class R. Disc R Disc R. Prof. Tirtayasa Team Class R. Lab physiology Team dr. Krisna Dinata Dr. Muliartha & Prof Sutjana -. Class R. Class R. -. Class R. Class R. Prof Tirtayasa dr. Karna & dr Krisna Class R. Class R. LB There are several types of learning activity: Lecture independent learning Small group discussion Practical Student project Lecture, Plenary and student project presentation will be held at room 402, practical session at Lab. Physiology 2nd floor, while discussion rooms available at 3rd floor (room 3.09-3.17&3.19) Udayana University Faculty of Medicine, DME, 2015 8 Study Guide Basic Physiology ~MEETING OF THE STUDENTS’ REPRESENTATIVE~ In the middle of block schedule, a meeting is designed among the student representatives of each small group discussion, facilitators, and resource persons. The meeting will discuss the ongoing teaching learning process, quality of lecturers and facilitators as a feedback to improve the learning program. The meeting will be held based on schedule from Department of Medical Education. ~ASSESSMENT METHOD~ Assessment in this theme consists of: SGD : 5% Practical Exam : 40% Final Exam : 40% Student Project : 15% Total result will contribute as much as 35 % to overall score of The Cell as Biochemical Machinery Block ~STUDENT PROJECT~ Each group should write a paper about certain topics related to basic physiology. This paper should be discussed with the related lecture and would be presented/collected at the end of this block. The topics are: NO SGD TITTLE EVALUATOR 1 A1, B1 Shock hypovolemia and fluid intake ballance Dr. Muliarta 2 A2, B2 Hemostasis ( Blood clotting) dr. Inten 3 A3, B3 Control of body movement dr Karna 4 A4, B4 Cardiovascular Response to exercise Prof Sutjana 5 A5, B5 Respiratory / breathing sound, normal and abnormal dr. Susy 6 A6, B6 Fever and mechanism Dr. Indah 7 A7, B7 Factors influence on defecation and mechanism dr Adiartha 8 A8, B8 Urine formation Prof. Tirtayasa 9 A9, B9 Transfer of Stimulus from neuron to skeletal muscle and its factors. Prof Adiatmika 10 A10,B10 Colour Weakness Dr Krisna Dinata Udayana University Faculty of Medicine, DME, 2015 9 Study Guide Basic Physiology Format of the paper : 1. Cover Tittle Name Student Registration Number Faculty of Medicine, Udayana University 2015 2. 3. 4. 5. Introduction Content Conclusion References (minimal 3 references) Example : Journal Porrini M, Risso PL. 2011. Lymphocyte Lycopene Concentration and DNA Protection from Oxidative Damage is Increased in Woman. Am J Clin Nutr 11(1):79-84. Textbook Abbas AK, Lichtman AH, Pober JS. 2011. Cellular and Molecular Immunology. 4th ed. Pennysylvania: WB Saunders Co. Pp 1636-1642. Note. 5-10 pages; 1,5 spasi; Times new roman 12 ~REFERENCES~ Standard reference: Guyton & Hall, 2006. Medical Physiology. 11th ed. Philadelphia : Elsevier Saunders Udayana University Faculty of Medicine, DME, 2015 10 Study Guide Basic Physiology ~LEARNING PROGRAMS~ LECTURE 1: INTRODUCTION OF PHYISIOLOGY Prof.Dr. dr.Nyoman Adiputra,MOH Introduction “The physiology of today is the medicine of tomorrow.” Ernest H. Starling, Physiologist (1926) Human physiology is the science of the mechanical, physical, and biochemical function of humans, and serves as the foundation of modern medicine. As a discipline, it connects science, medicine, and health, and creates a framework for understanding how the human body adapts to stresses, physical activity, and disease. Human physiology is closely related to anatomy, in that anatomy is the study of form, physiology is the study of function, and there is an intrinsic link between form and function. The study of human physiology integrates knowledge across many levels, including biochemistry, cell physiology, organ systems, and the body as a whole. Contemporary research in human physiology explores new ways to maintain or improve the quality of life, development of new medical therapies and interventions, and charting the unanswered questions about how the human body works. Human physiology seeks to understand the mechanisms that work to keep the human body alive and functioning, through scientific enquiry into the nature of mechanical, physical, and biochemical functions of humans, their organs, and the cells of which they are composed. The principal level of focus of physiology is at the level of organs and systems within systems. The body comprises of a number of systems including the: Cardiovascular system, Digestive system, Endocrine system, Muscular system, Neurological system, Respiratory system and the Skeletal system. Learning Tasks: 1. Describe the general phase in the medical education, based on the departments must be followed by every medical students 2. Describe the preclinical science in the medical education process. 3. Describe the science categorized into a preclinical department. 4. Describe function and place of physiology among the preclinical sciences. 5. Describe the definition of physiology. 6. General classification of physiology as a science. 7. Describe a general principle how medical physiology can be applied for an individual or as a community. 8. Describe what doest it mean by the pathophysiology. 9. Describe the future’ roles of physiology. ___________________________________________________________ LECTURE 2 : MUSCULOSKELETAL SYSTEM Prof. Dr.dr.I Putu Gede Adiatmika,M.Kes Introduction The musculoskeletal system consists of the bones, muscles, ligaments and tendons. The function of the musculoskeletal system is to: (1) protect and support the internal structures and organs of the body; (2) allow movement; (3) give shape to the body; (4) produce blood cells; (5) store calcium and phosphorus; (6) produce heat. Udayana University Faculty of Medicine, DME, 2015 11 Study Guide Basic Physiology The muscular system allows us to move and you will need to learn about the muscles of the body in order to understand how this system contributes to the overall design of the human body. The human body is composed of over 500 muscles working together to facilitate movement. It is very important to understand the muscular system and how it works in conjunction with the skeletal system to allow us to move and maintain our posture. The major function of the muscular system is to produce movements of the body, to maintain the position of the body against the force of gravity and to produce movements of structures inside the body. Muscles contract (shorten) and relax in response to chemicals and the stimulation of a motor nerve. Some examples of muscles are the triceps, deltoid and the biceps in the upper arm and the gluteal muscle, the hamstrings and the quadriceps in the buttocks and the top of the leg. Learning Task: 1. Explain about contraction of skeletal muscle! 2. Explain about neuromuscular transmission and excitation-contraction coupling! ____________________________________________________ LECTURE 3 : HUMAN BLOOD, IMMUNITY & BLOOD CLOTTING dr. I Dewa Ayu Inten D.P.,M.Biomed Introduction Blood forms about 79% of the body weight consisting of Plasma, Corpuscles and Platelets. Erythrocyte (red blood cells) transport oxygen and carbon dioxide, leucocytes (white blood cells), produced in red bone marrow (myeloid tissue), and lymphocytes fight infection and thrombocyte (platelet) are essential to blood clotting at the site of an injury. Plasma is a clear slightly alkaline yellow fluid in which the following are dissolved - blood, proteins, salts, waste materials, gases, enzymes, hormones and vitamins. The blood has three main functions, transport, regulation, and protection. Erythrocyte have the shape of biconcave disk, with diameter of about 7 μm and a maximum thickness of 2,5 μm. Erythrocytes are responsible for providing oxygen to tissue and for recovering carbondioxide as waste. White blood cells, or leukocytes are delivered by the blood to cites of infection or tissue disruption, where that defends to body against infecting organism. Leukocytes comprise five cell types, neutrophil, eosinophils, basophils, lymphocytes and monocytes. Neutrophils defend against bacterial and fungal infection through phagocytosis. Basophils release histamine, causing the inflammation of allergic and antigen reaction monocytes migrate from the blood stream and become macrophages. Lymphocytes comprise three cell types participating in the immune system. Thrombocytes are irregularly shaped, small, anuclear, control blood clotting and promote wound healing. Blood cell production ( hematopoiesis) is the development of circulating blood cells from the uncommitted multipotent stem cell of bone marrow. Hematopoises begins with the proliferation of multipotent stem cell. Promoted by hematopoietins and other cytokines. The immune system is a complex system that is responsible for protecting us against infections and foreign substances. There are three lines of defense: the first is to keep invaders out (through skin, mucus membranes, etc), the second line of defense consists of non-specific ways to defend against pathogens that have broken through the first line of defense (such as with inflammatory response and fever). The third line of defense is mounted against specific pathogens that are causing disease (B cells produce antibodies against bacteria or viruses in the extracellular fluid, while T cells kill cells that have become infected). The immune system is closely tied to the lymphatic system, with B and T lymphocytes being found primarily within lymph nodes. Udayana University Faculty of Medicine, DME, 2015 12 Study Guide Basic Physiology Hemostasis, the cessation of blood loss from a damaged vessel; can be organized into four process : vasoconstriction, the formation of a temporary loose platelet plug, formation of the more stable fibrin clot and finally, clot retraction and dissolution. Learning Tasks 1. List the cellular elements found in blood and describe the characteristic and function of each! 2. Describe about osmotic changes to red blood cell shape! Mention the clinical conditions that contribute to the change as an example! 3. Explain about the production and development of blood cells ? List the cytokines that involved in hematopoiesis; which cells produced and its role! 4. What is the role of each type of leucocytes in host defenses? How do they participate in host defense? 5. Female, 20 years old, she complained prolonged bleeding after got toots extraction. What are possible thing that happened to this patient? 6. Explain three major steps of hemostasis! 7. Describe the main steps in the process of clot formation; what factors involved? What keeps it from continuing until the entire circulation has clotted? LECTURE 4 : THE RESPIRATORY SYSTEM Dr.dr. Susy Purnawati,M.KK Introduction The respiratory system is crucial to every human being. Without it, we would cease to live outside of the womb. Let us begin by taking a look at the structure of the respiratory system and how vital it is to life. During inhalation or exhalation air is pulled towards or away from the lungs, by several cavities, tubes, and openings. The organs of the respiratory system make sure that oxygen enters our bodies and carbon dioxide leaves our bodies. The four processes of respiration. They are: breathing or ventilation, external respiration, which is the exchange of gases (oxygen and carbon dioxide) between inhaled air and the blood, internal respiration, which is the exchange of gases between the blood and tissue fluids, cellular respiration. In addition to these main processes, the respiratory system serves for: regulation of blood ph, which occurs in coordination with the kidneys, and as a defense against microbes, control of body temperature due to loss of evaporate during expiration. Inspiration is initiated by contraction of the diaphragm and in some cases the intercostals muscles when they receive nervous impulses. During normal quiet breathing, the phrenic nerves stimulate the diaphragm to contract and move downward into the abdomen. This downward movement of the diaphragm enlarges the thorax. When necessary, the intercostal muscles also increase the thorax by contacting and drawing the ribs upward and outward. As the diaphragm contracts inferiorly and thoracic muscles pull the chest wall outwardly, the volume of the thoracic cavity increases. The lungs are held to the thoracic wall by negative pressure in the pleural cavity, a very thin space filled with a few milliliters of lubricating pleural fluid. The negative pressure in the pleural cavity is enough to hold the lungs open in spite of the inherent elasticity of the tissue. Hence, as the thoracic cavity increases in volume the lungs are pulled from all sides to expand, causing a drop in the pressure (a partial vacuum) within the lung itself (but note that this negative pressure is still not as great as the negative pressure within the pleural cavity--otherwise the lungs would pull away from the chest wall). Assuming the airway is open, air from the external environment then follows its pressure gradient down and expands the alveoli of the lungs, Udayana University Faculty of Medicine, DME, 2015 13 Study Guide Basic Physiology where gas exchange with the blood takes place. As long as pressure within the alveoli is lower than atmospheric pressure air will continue to move inwardly, but as soon as the pressure is stabilized air movement stops. During quiet breathing, expiration is normally a passive process and does not require muscles to work (rather it is the result of the muscles relaxing). When the lungs are stretched and expanded, stretch receptors within the alveoli send inhibitory nerve impulses to the medulla oblongata, causing it to stop sending signals to the rib cage and diaphragm to contract. The muscles of respiration and the lungs themselves are elastic, so when the diaphragm and intercostal muscles relax there is an elastic recoil, which creates a positive pressure (pressure in the lungs becomes greater than atmospheric pressure), and air moves out of the lungs by flowing down its pressure gradient. Although the respiratory system is primarily under involuntary control, and regulated by the medulla oblongata, we have some voluntary control over it also. This is due to the higher brain function of the cerebral cortex. When under physical or emotional stress, more frequent and deep breathing is needed, and both inspiration and expiration will work as active processes. Additional muscles in the rib cage forcefully contract and push air quickly out of the lungs. In addition to deeper breathing, when coughing or sneezing we exhale forcibly. Our abdominal muscles will contract suddenly (when there is an urge to cough or sneeze), raising the abdominal pressure. The rapid increase in pressure pushes the relaxed diaphragm up against the pleural cavity. This causes air to be forced out of the lungs. Another function of the respiratory system is to sing and to speak. By exerting conscious control over our breathing and regulating flow of air across the vocal cords we are able to create and modify sounds. There are two pathways of motor neuron stimulation of the respiratory muscles. The first is the control of voluntary breathing by the cerebral cortex. The second is involuntary breathing controlled by the medulla oblongata. There are chemoreceptors in the aorta, the carotid body of carotid arteries, and in the medulla oblongata of the brainstem that are sensitive to pH. As carbon dioxide levels increase there is a buildup of carbonic acid, which releases hydrogen ions and lowers pH. Thus, the chemoreceptors do not respond to changes in oxygen levels (which actually change much more slowly), but to pH, which is dependent upon plasma carbon dioxide levels. In other words, CO2 is the driving force for breathing. The receptors in the aorta and the carotid sinus initiate a reflex that immediately stimulates breathing rate and the receptors in the medulla stimulate a sustained increase in breathing until blood pH returns to normal. Learning tasks: “I Must Stop Running” Dewi, 18 y.o has decided to reduce her body weight through do an aerobic program. At the first day she did her running program at Lapangan Puputan Renon, after 10 minute she felt very hard to breath. Then, she stopped running and continue her aerobic programs with just do walking. Discus with your group about: 1. The terms and words of above scenario that you don’t understand. 2. The mechanism of quite breathing and forced inspiration and expiration. 3. Oxygen and Carbon-dioxide transport 4. Gas diffusions 5. Controls of respiratory system ___________________________________________________________________ Udayana University Faculty of Medicine, DME, 2015 14 Study Guide Basic Physiology LECTURE 5: THE CARDIOVASCULARSYSTEM 1 : HEART AS A PUMP Prof.dr. I Dewa Putu Sutjana,M.Erg Introduction Introduction” The cardiovascular system serves a number of important functions in the body. Most of these support other physiological systems. The major cardiovascular functions divided into five categories: 1.delivery; 2. removal; 3. transport; 4. maintenance; 5. prevention. Any system of circulation requires three component : 1. a pump (the heart); 2. a system of channels (the blood vessel); 3. a fluid medium (the blood). The heart is two pumps in series (the right and left sides) that are connected by pulmonary and systemic circulations. The heart consists of four chambers : the right atrium, right ventricle, left atrium, and left ventricle. The right atrium receives oxygen poor blood from systemic veins; blood moves to the right ventricle and is pump out to the pulmonary arteries to the lungs. The left atrium receives oxygenated blood from pulmonary veins; and moves to the left ventricle and is pump out the systemic arteries to the body tissues. Each side of the heart consist of two valves that normally maintain one way flow of blood. Atrioventricular (AV) valves separate the atria from the ventricle. a. The right AV valve is the tricuspid valve. b. The left AV valve is the mitral valve c. These valves open during ventricular relaxation (diastole) to allow blood flow to the ventricles and close during ventricular contraction (systole) to prevent back flow (regurgitation) of blood from the ventricles into the atria Learning Task: 1. Describe the general functions of the cardiovascular system 2. Describe the cardiac cycle 3. Name and explain the phases of cardiac cycle ______________________________________________________________ LECTURE 6 : THE CARDIOVASCULAR SYSTEM 2 : CIRCULATION Dr.dr. I Made Muliarta,M.Kes Introduction: Blood vessels leaving the heart generally carry oxygenated blood through vessels known as arteries. These are large, hollow elastic tubes with thick muscular walls that are designed to withstand the high pressure with the blood leaving the heart. Their size gradually diminishes as they spread throughout the body, ultimately reaching fine, hair-like vessels known as capillaries. Blood vessels that return blood to the heart are known as veins which generally carry de-oxygenated blood to the heart. They are elastic tubes containing valves to help prevent back flow of blood. Blood is forced through arteries by the pressure from the heart whereas venous flow is aided by muscular contraction. The only two exceptions to the above are the pulmonary artery, which carries deoxygenated blood from the heart to the lungs, and the pulmonary vein, which carries oxygenated blood from the lungs to the heart. The circulation is divided into two principle systems known as the general or systemic circulation, that is the circulation around the body, and the pulmonary circulation to and from the lungs. As blood is the main transport system to the body, so it may also bring bacteria to the tissues. The lymphatic system is the protective system that picks up materials, cleanses them of waste products and toxins, and returns them to the blood. Although it is described Udayana University Faculty of Medicine, DME, 2015 15 Study Guide Basic Physiology as a separate system, it is really part of the vascular system, being intertwined with the blood circulation. Learning Tasks 1. To relate the blood pressure in the various parts of the vascular system 2. List the factors that regulate the arterial blood pressure 3. Describe the baroreceptor reflex and explain its significance in blood pressure regulation 4. Describe of the arteriole controlled the mechanism that allow many organs and tissues to adjust their vascular resistance and maintain a relatively constant blood flow in the presence of change arterial pressure (metabolic and myogenic theory. 5. Describe extra cellular fluid (any leakage proteins, and tissue contaminants (such as bacteria) are picked up, destroyed by the lymph system 6. Describe how blood pressure is measured and state normal value 7. Explain how cardiac output and peripheral resistance affect arterial blood pressure 8. Provide an integrated description of how nerves and hormones regulate blood pressure __________________________________________________________ LECTURE 7 : DIGESTIVE SYSTEM Dr.dr. Susy Purnawati, M.K.K. Introduction The alimentary tract provides the body with a continual supply of water, electrolytes, and nutrients. The amount of food that a person ingest is determined principally by the intrinsic desire for food called hunger. The type of food that a person preferentially seeks is determined by appetite. These mechanisms in themselves are extremely important automatic regulatory system for maintaining an adequate nutritional supply for the body. The foods on which the body lives, with the exception of small quantities of substances such as vitamins and mineral, can be classified as carbohydrates, fats, and proteins. They generally cannot be absorbed in their natural forms through the gastrointestinal mucosa and for this reason, are useless as nutrients without preliminary digestion. Absorption through the gastrointestinal mucosa occurs by active transport, by diffusion, and possibly, by solvent drag. Active transport imparts energy to transport the substance to the other side of the membrane. Conversely, transport by diffusion means simply transport of substances through the membrane as a result of random molecular movement. Transport by solvent drag means that any time a solvent is absorbed because of physical absorptive forces, the flow of the solvent will “drag” dissolved substances along with the solvent. Learning Tasks It’s coming mostly in the morning Yunita, 20 yo, medical student, in a hurry up should go to Campus this morning as she has getting late for lab work. She pass her “routine agenda” (defecation) at home that always done. At Campus, after she has her lunch, suddenly she feel stomach ache and wants to go to toilet for defecation. She delay her feeling to go to toilet because the class plenary already in time. Udayana University Faculty of Medicine, DME, 2015 16 Study Guide Basic Physiology Discuss with your group: 1. What happen in Yunita? 2. How the intestinal motility is being controlled? 3. Explain about gastro intestinal tract secretion 4. Explain the differentiation of fat absorption mechanism comparing with protein and carbohyrat 5. Explain about mass movement and defecation mechanism ___________________________________________________________________ LECTURE 8 : NEUROSCIENCE SYSTEM dr. Ketut Karna M.Kes/ Dr. Luh Made Indah SHA,S.Psi Introduction The human nervous system is divided into the central nervous system (CNS) and the peripheral nervous system (PNS). The CNS, in turn, is divided into the brain and the spinal cord, which lie in the cranial cavity of the skull and the vertebral canal, respectively. The CNS and the PNS, acting in concert, integrate sensory information and control motor and cognitive functions. The adult human brain weighs between 1,200 to 1,500 g and contains about one trillion cells. It occupies a volume of about 1400 cc - approximately 2% of the total body weight, and receives 20% of the blood, oxygen, and calories supplied to the body. The adult spinal cord is approximately 40 to 50 cm long and occupies about 150 cc. The brain and the spinal cord arise in early development from the neural tube, which expands in the front of the embryo to form the three primary brain divisions: the prosencephalon (forebrain), mesencephalon (midbrain), and rhombencephalon (hindbrain). These three vesicles further differentiate into five subdivisions: telencephalon, diencephalon, mesencephalon, metencephalon, and the myelencephalon. The mesencephalon, metencephalon, and the myelencephalon comprise the brain stem. The spinal cord is an elongated cylindrical structure lying within the vertebral canal, which includes the central canal and the surrounding gray matter. The gray matter is composed of neurons and their supporting cells and is enclosed by the white matter that is composed of a dense layer of ascending and descending nerve fibers. The spinal cord is an essential link between the peripheral nervous system and the brain; it conveys sensory information originating from different external and internal sites via 31 pairs of spinal nerves. These nerves make synaptic connections in the spinal cord or in the medulla oblongata and ascend to subcortical nuclei. The periphery nervous system (PNS) includes 31 pairs of spinal nerves, 12 pairs of cranial nerves, the autonomic nervous system and the ganglia (groups of nerve cells outside the CNS) associated with them. Also included in the PNS are the sensory receptor organs. The receptor organs are scattered in all parts of the body, sense and perceive changes from external and internal organs, then transform this information to electrical signals, which are carried via an extensive nervous network to the CNS (Figure 1.15). The cranial and spinal nerves contain nerve fibers that conduct information to-afferent-(Latin for carry toward) and from-efferent (Latin for carry away) the CNS. Afferent fibers convey sensory information from sensory receptors in the skin, mucous membranes, and internal organs and from the eye, ear, nose and mouth to the CNS; the efferent fibers convey signals from cortical and subcortical centers to the spinal cord and from there to the muscle or autonomic ganglia that innervate the visceral organs. The afferent (sensory) fibers enter the spinal cord via the dorsal (posterior) root, and the efferent (motor) fibers exit the spinal cord via the ventral (anterior) root. The spinal nerve is formed by the joining of the dorsal and the ventral roots. The cranial nerves leave the skull and the spinal cord nerves leave the vertebrae through openings in the bone called foramina (Latin for opening). The PNS is divided into two systems: the visceral system and the somatic system. The visceral system is also known as the autonomic system. The autonomic nervous Udayana University Faculty of Medicine, DME, 2015 17 Study Guide Basic Physiology system (ANS) is often considered a separate entity; although composed partially in the PNS and partially in the CNS, it interfaces between the PNS and the CNS. The primary function of the ANS is to regulate and control unconsciousness functions including visceral, smooth muscle, cardiac muscle, vessels, and glandular function Learning Tasks : 1. Explain about intellectual function of the brain , learning and memory! 2. Explain about motor function of the spinal cord! 3. Explain about behavioral and motivational mechanism of the brain (involvement of limbic system and hypothalamus)! ___________________________________________________________________ LECTURE 9 : METABOLISM AND TEMPERATURE REGULATION dr.Putu Adiarta Griadi,M.Fis Introduction Metabolic system is a series of physiological processes that occur after ingestion of food. Food nutrients that absorbed by the body after digestion will undergo a series of chemical processes and energy changes. A series of chemical changes that occur is the realignment process of nutrients to form body structure, we named it anabolic process. The breakdown of reserves and deposits of nutrients that have been stored in the body to maintain energy source are known as catabolic process. Anabolic processes will occur during the absorptive phase of digestion and catabolic processes occur in postabsorptifphases of digestion. Both of these metabolic processes, anabolic and catabolic, ensure individual's ability to remain active throughout the day. Energy obtained from nutrients in the form of glucose during the anabolic and catabolic process. The energy will be stored in the form of ATP, a molecule with a high-energy bond. Energy is mainly used to perform the activity, mental, physical, and chemical processes within the body. Keep in mind that nearly half of the energy obtained from food is also used as a heat source of the body. Thus, humans are classified into homoioterm living creatures. To maintain body temperature within normal limits, there should be mechanisms of heat loss from the human body continuously. Those process are radiation, conduction, convection, and evaporation. The balance between production and release of heat will keep the body temperature remains normal. Learning tasks 1. Explain the definition of metabolism, anabolic, catabolic, absorptive phase, phase postabsorptif, fed state, and fasted state! 2. Explain the relationship between meals and the metabolic process (anabolic and catabolic), and explain the role of insulin and glucagon in each process! 3. Explain the definition of heat production and heat loss and explain the mechanisms involved in each of these processes! 4. On a cloudy day, the weather was hot and sultry. Please, explain this phenomenon! LECTURE 10: ENDOCRINOLOGY dr. Ketut Karna,M.Kes Introduction The endocrine system affects bodily activities by releasing chemical messages, called hormones, into the bloodstream from exocrine and endocrine glands. The function of hormones is to: (1) Control the internal environment by regulating its chemical composition and volume; (2) Respond to environmental changes to help the body cope with Udayana University Faculty of Medicine, DME, 2015 18 Study Guide Basic Physiology emergencies - infection, stress etc; (3) Help regulate organic metabolism and energy balance; (4) Contribute to the management of growth and development. Hormones are chemicals that cause certain changes in particular parts of the body. Their effects are slower and more general than nerve action. They can control long-term changes such as rate of growth, rate of activity and sexual maturity. The endocrine or ductless glands secrete their hormones directly into the blood stream. The hormones are circulated all over the body and reach their target organ via the blood stream. When hormones pass through the liver, they are converted by the kidneys. Tests on such hormonal products in urine can be used to detect pregnancy. The endocrine system consists of a series of glands that secrete hormones; they are found throughout the body and include the pituitary, thyroid, parathyroids, thymus, suprarenal or adrenal glands, part of the pancreas and parts of the ovaries and testes. Although these glands are separate, it is certain that they are functionally closely related because the health of the body is dependent upon the correctly balanced output from the various glands that form this system. Learning task : 1. Describe the main features of hormonal control! 2. Describe how hormone release is control! 3. Explain how pituitary is controlled and the role negative feed back at hypothalamic and ___________________________________________________________________ LECTURE 11: REPRODUCTIVE SYSTEM ( MALE & FEMALE) dr. I Dewa Ayu Inten D.P.,M.Biomed Introduction Reproduction can be defined as the process by which an organism continues its species. In the human reproductive process, two kinds of sex cells ( gametes), are involved: the male gamete (sperm), and the female gamete (egg or ovum). These two gametes meet within the female's uterine tubes located one on each side of the upper pelvic cavity, and begin to create a new individual. The female needs a male to fertilize her egg; she then carries offspring through pregnancy and childbirth. The reproductive systems of the male and female have some basic similarities and some specialized differences. They are the same in that most of the reproductive organs of both sexes develop from similar embryonic tissue, meaning they are homologous. Both systems have gonads that produce (sperm and egg or ovum) and sex organs. And both systems experience maturation of their reproductive organs, which become functional during puberty as a result of the gonads secreting sex hormones. The differences between the female and male reproductive systems are based on the functions of each individual's role in the reproduction cycle. A male who is healthy, and sexually mature, continuously produces sperm. The development of women's "eggs" are arrested during fetal development. This means she is born with a predetermined number of oocytes and cannot produce new ones. At about 5 months gestation, the ovaries contain approximately six to seven million oogonia, which initiate meiosis. The oogonia produce primary oocytes that are arrested in prophase I of meiosis from the time of birth until puberty. After puberty, during each menstrual cycle, one or several oocytes resume meiosis and undergo their first meiotic division during ovulation. This results in the production of a secondary oocyte and one polar body. The meiotic division is arrested in metaphase II. Fertilization triggers completion of the second meiotic division and the result is one ovum and an additional polar body. Udayana University Faculty of Medicine, DME, 2015 19 Study Guide Basic Physiology The ovaries of a newborn baby girl contain about one million oocytes. This number declines to 400,000 to 500,000 by the time puberty is reached. On average, 500-1000 oocytes are ovulated during a woman's reproductive lifetime. When a young woman reaches puberty around age 10 to 13, a promary oocyte is discharged from one of the ovaries every 28 days. This continues until the woman reaches menopause, usually around the age of 50 years. Occytes are present at birth, and age as a woman ages. The male reproductive system includes the scrotum, testes, spermatic ducts, sex glands, and penis. These organs work together to produce sperm, the male gamete, and the other components of semen. These organs also work together to deliver semen out of the body and into the vagina where it can fertilize egg cells Learning tasks: 1. New parents come to consult their 25 days baby. They consult about the genitalia was not clearly appearance, from the examination found an enlargement of clitoris. a. Sexual differentiation occurs early in development. Explain ! b. What do you know about “XRY gene” and “anti-mullerian hormone” ? explain its role! 2. Explain the hypothalamic and anterior pituitary hormones that control reproduction! 3. Explain about the Sperm production! What do sertoli cells and Leydig cell roles in this process? 4. A 30 years old man, have take an anabolic steroid to build muscle. Can you predict how affect of its drug to the reproductive system/organ? 5. Explain about the menstrual cycle?. 6. Describe the role of each hormones in pregnancy, labor and delivery, mammary gland development and lactation : a. Human chorionic gonadotropin b. Luteinizing hormone c. Estrogen d. Progesterone e. Prolactin ___________________________________________________ LECTURE 12 : THE URINARY SYSTEM Prof.dr. Ketut Tirtayasa,MS Introduction The urinary system consists of the kidneys, ureters, urinary bladder, and urethra. The kidneys filter the blood to remove wastes and produce urine. The ureters, urinary bladder, and urethra together form the urinary tract, which acts as a plumbing system to drain urine from the kidneys, store it, and then release it during urination. The kidneys are a pair of bean-shaped organs found along the posterior wall of the abdominal cavity. The left kidney is located slightly higher than the right kidney because the right side of the liver is much larger than the left side. The kidneys, unlike the other organs of the abdominal cavity, are located posterior to the peritoneum and touch the muscles of the back. The kidneys are surrounded by a layer of adipose that holds them in place and protects them from physical damage. The kidneys filter metabolic wastes, excess ions, and chemicals from the blood to form urine. The ureters are a pair of tubes that carry urine from the kidneys to the urinary bladder. The ureters are about 10 to 12 inches long and run on the left and right sides of the body parallel to the vertebral column. Gravity and peristalsis of smooth muscle tissue in the walls of the ureters move urine toward the urinary bladder. The ends of the ureters Udayana University Faculty of Medicine, DME, 2015 20 Study Guide Basic Physiology extend slightly into the urinary bladder and are sealed at the point of entry to the bladder by the ureterovesical valves. These valves prevent urine from flowing back towards the kidneys. The urinary bladder is a sac-like hollow organ used for the storage of urine. The urinary bladder is located along the body’s midline at the inferior end of the pelvis. Urine entering the urinary bladder from the ureters slowly fills the hollow space of the bladder and stretches its elastic walls. The walls of the bladder allow it to stretch to hold anywhere from 600 to 800 milliliters of urine. Inside each kidney are around a million tiny structures called nephrons. The nephron is the functional unit of the kidney that filters blood to produce urine. Arterioles in the kidneys deliver blood to a bundle of capillaries surrounded by a capsule called a glomerulus. As blood flows through the glomerulus, much of the blood’s plasma is pushed out of the capillaries and into the capsule, leaving the blood cells and a small amount of plasma to continue flowing through the capillaries. The liquid filtrate in the capsule flows through a series of tubules lined with filtering cells and surrounded by capillaries. The cells surrounding the tubules selectively absorb water and substances from the filtrate in the tubule and return it to the blood in the capillaries. At the same time, waste products present in the blood are secreted into the filtrate. By the end of this process, the filtrate in the tubule has become urine containing only water, waste products, and excess ions. The blood exiting the capillaries has reabsorbed all of the nutrients along with most of the water and ions that the body needs to function. Learning Tasks : 1. Explain about nephron function! 2. Explain about urine formation by the kidneys! 3. Explain about integration og renal mechanism for control of blood volume and extracellular fluid volume! 4. Explain about micturition process! ______________________________________________________________________ LECTURE 13: THE SPECIAL SENSES dr. Made Krisna Dinata,M.Erg Introduction NEUROPHYSIOLOGY – SPECIAL SENSE dr. I Made Krisna Dinata, M.Erg. Abstract Sensory systems receive information from the environment via specialized receptors in the periphery and transmit this information through a series of neurons and synaptic relays to the CNS. Sensory receptors are activated by stimuli in the environment. The nature of the receptors varies from one sensory modality to the next. In the visual, taste, and auditory systems, the receptors are specialized epithelial cells. In the somatosensory and olfactory systems, the receptors are first-order, or primary afferent, neurons. Regardless of these differences, the basic function of the receptors is the same: to convert a stimulus (e.g., sound waves, electromagnetic waves, or pressure) Receptors are classified by the type of stimulus that activates them. The five types of receptors are mechanoreceptors, photoreceptors, chemoreceptors, thermoreceptors, and nociceptors. Mechanoreceptors are activated by pressure or changes in pressure. Mechanoreceptors include, but are not limited to, the pacinian corpuscles in subcutaneous tissue, Meissner’s corpuscles in nonhairy skin (touch), baroreceptors in the carotid sinus (blood pressure), and hair cells on the organ of Corti (audition) and in the semicircular canals (vestibular system). Photoreceptors are activated by light and are involved in vision. Udayana University Faculty of Medicine, DME, 2015 21 Study Guide Basic Physiology Chemoreceptors are activated by chemicals and are involved in olfaction, taste, and detection of oxygen and carbon dioxide in the control of breathing. Thermoreceptors are activated by temperature or changes in temperature. Nociceptors are activated by extremes of pressure, temperature, or noxious chemicals. Sensory transduction is the process by which an environmental stimulus (e.g., pressure, light, chemicals) activates a receptor and is converted into electrical energy. The conversion typically involves opening or closing of ion channels in the receptor membrane, which leads to a flow of ions (current flow) across the membrane. Current flow then leads to a change in membrane potential, called a receptor potential, which increases or decreases the likelihood that action potentials will occur. SOMATOSENSORY SYSTEM AND PAIN The somatosensory system processes information about touch, position, pain, and temperature. The receptors involved in transducing these sensations are mechanoreceptors, thermoreceptors, and nociceptors. There are two pathways for transmission of somatosensory information to the CNS: the dorsal column system and the anterolateral system. The dorsal column system processes the sensations of fine touch, pressure, two-point discrimination, vibration, and proprioception (limb position). The anterolateral system processes the sensations of pain, temperature, and light touch. VISION The visual system detects and interprets light stimuli, which are electromagnetic waves. The eye can distinguish two qualities of light: its brightness and its wavelength. For humans, the wavelengths between 400 and 750 nanometers are called visible light. AUDITION Audition, the sense of hearing, involves the transduction of sound waves into electrical energy, which then can be transmitted in the nervous system. Sound is produced by waves of compression and decompression, which are transmitted in elastic media such as air or water. These waves are associated with increases (compression) and decreases (decompression) in pressure. The units for expressing sound pressure are decibels (dB), which is a relative measure on a log scale. Sound frequency is measured in cycles per second or hertz (Hz). A pure tone results from sinusoidal waves of a single frequency. Most sounds are mixtures of pure tones. The human ear is sensitive to tones with frequencies between 20 and 20,000 Hz and is most sensitive between 2000 and 5000 Hz. VESTIBULAR SYSTEM The vestibular system is used to maintain equilibrium or balance by detecting angular and linear accelerations of the head. Sensory information from the vestibular system is then used to provide a stable visual image for the retina (while the head moves) and to make the adjustments in posture that are necessary to maintain balance. OLFACTION The chemical senses involve detection of chemical stimuli and transduction of those stimuli into electrical energy that can be transmitted in the nervous system. Olfaction, the sense of smell, is one of the chemical senses. In humans, olfaction is not necessary for survival, yet it improves the quality of life and even protects against hazards. Anosmia is the absence of the sense of smell, hyposmia is impaired sense of smell, and dysosmia is a distorted sense of smell. Head injury, upper respiratory infections, tumors of the anterior fossa, and exposure to toxic chemicals (which destroy the olfactory epithelium) all can cause olfactory impairment. TASTE The second chemical sense is gestation, or taste. For the sense of taste, chemicals called tastants are detected and transduced by chemoreceptors located in taste buds. Tastes are Udayana University Faculty of Medicine, DME, 2015 22 Study Guide Basic Physiology mixtures of five elementary taste qualities: salty, sweet, sour, bitter, and umami (savory, including monosodium glutamate). Disorders associated with the sense of taste are not life threatening, but they can impair the quality of life, impair nutritional status, and increase the possibility of accidental poisoning. Taste disorders include ageusia (absence of taste), hypogeusia (decreased taste sensitivity), hypergeusia (increased taste sensitivity), and dysgeusia (distortion of taste, including taste sensation in the absence of taste stimuli). Vignette A woman, 21 yo, came to physician with a complaint blurred vision. After get examination, she was diagnosed with myopia both of her eyes. Learning Task 1. Describe the abnormalities structure and function of this patient eyes? 2. Describe the mechanism of the ciliary muscles in the eye accommodation? 3. What is the function of pinna, auditory canal, tympanic membrane, ossicles/ middle ear bones, and oval window? 4. Could listen the music with an earphone makes deafness? Please explain about your answer! 5. If the head is rotated to the right, which horizontal semicircular canal (right or left) is activated during the initial rotation? When the head stops rotating, which canal (right or left) is activated? 6. Explain why your sense of smell is reduced when you have a cold, even though the cold virus does not directly adversely affect the olfactory receptor cells. 7. Patients with certain nerve disorders are unable to feel pain. Why is this disadvantageous? Refferences 1. Medical Physiology eleventh edition, Guyton & Hall. 2. Physiology fifth edition, Linda S. Costanzo. 3. Silverthorn, D.U. 2010. Human Physiology. An Integrated Approach. Fifth Ed. Pearson. San Fransisco PRACTICAL GUIDELINES~ WOULD BE GIVEN DURING LECTURE Udayana University Faculty of Medicine, DME, 2015 23 Study Guide Basic Physiology CURRICULUM MAP Smstr 10 9 8 7 6 5 4 3 2 1 Health Systembased Practice (3 weeks) BCS (1 weeks) The Cardiovascular System and Disorders (3 weeks) BCS (1 weeks) Neuroscience and neurological disorders (3 weeks) BCS (1 weeks) Musculoskeletal system & connective tissue disorders (3 weeks) BCS (1 weeks) Basic microbiology & parasitology (3 weeks) Basic Infection & infectious diseases (3 weeks) BCS (1 weeks) Medical communication (3 weeks) Basic pharmacology (2 weeks) BCS (1 weeks) Studium Generale and Humaniora (2 weeks) Basic Anatomy ( 4 weeks) Program or curriculum blocks Senior Clerkship Senior Clerkship Senior Clerkship Community-based Evidence-based Elective Study IV practice Medical Practice (evaluation) (4 weeks) (2 weeks) (3 weeks) Special topics : Health Ergonomic & Health Environment (2 weeks) Medical Emergency The Urinary The Reproductive (3 weeks) System and System and Disorders Disorders (4 weeks) (3 weeks) BCS (1 weeks) BCS (1 weeks) BCS (1 weeks) The Respiratory System The skin & hearing Special Topic : and Disorders system - Palliative med (4 weeks) & disorders - Complemnt & (3 weeks) Alternative Med. BCS (1 weeks) - Forensic BCS (1 weeks) (3 weeks) Alimentary The Endocrine Clinical Nutrition and & hepatobiliary systems System, Disorders & disorders Metabolism and (2 weeks) (3 Weeks) Disorders (4 weeks) BCS (1 weeks) BCS (1 weeks) BCS (1 weeks) Immune system & Hematologic Special Topic disorders system & disorder - sexology & anti (2 weeks) & clinical aging oncology - Geriatri (3 weeks) -Travel medicine BCS (1 weeks) BCS (1 weeks) (4 weeks) Medical Professionalism (2 weeks) + medical ethic (1 weeks) Basic Anatomy Pathology & Clinical pathology (3 weeks) BCS (1 weeks) Behavior Change and disorders (3 weeks) The cell as biochemical machinery (2 weeks) Basic Histology (2 weeks) & Basic Physiology (3 weeks) BCS (1 weeks) Growth & development (2 weeks) Basic Biochemistry (2 weeks) BCS (1 weeks) Comprehensi ve Clinic Orientation (Clerkship) + medical ethic (4 weeks) 19 weeks Elective Study III 19 weeks (3 weeks) Elective Study II (2 weeks) 18 weeks The Visual system & disorders (2 weeks) 19 weeks BCS (1weeks) Basic Pharmaceutica l medicine & drug etics 19 weeks (1 weeks) Elective Study I (2 weeks) 19 weeks BCS (1 weeks) 19 weeks Pendidikan Pancasila & Kewarganegaraan ( 3 weeks ) Inter Professional Education (smt 3-7) Udayana University Faculty of Medicine, DME, 2015 24 Study Guide Basic Physiology Udayana University Faculty of Medicine, DME, 2015 25