B014490 - PHYSIOLOGY

Italian

Cellular physiology - Membranes and trasnport mechanisms. Membrane potential, action potential. Synaptic transmission. Skeletal, smooth and cardiac muscle. Neurophysiology. Cardiovascular system. Respiratory system. Urinary system. Gastro-intestinal system. Stomatognatic system physiology.

• “Fisiologia Medica” a cura di Fiorenzo Conti – Edi-Ermes (2 volumi)
• Berne & Levy “Fisiologia” – Casa Editrice Ambrosiana
• Diego Manzoni, Eugenio Scarnati “Fisiologia orale e dell’apparato stomatognatico” – Edi-Ermes

Objects of the course are the knowledge of the basic functions of the human apparatuses and their regulation, with particular reference to the functions of which the dentist is required to have specific knowledge. A special focus of the concepts inherent to the stomatognathic system is aimed at the understanding of the pathophysiological and clinical knowledge necessary for exerting the profession.

Propedeuticity approved by degree course

Frontal lessons

Oral examination

Physiology of nerve and muscle cell
Electrical phenomena of membrane - Selective membrane permeability. Intracellular and extracellular ionic concentrations. Equilibrium potential and the Nernst equation. Equilibrium potential for the principal ions. Ion channels. Active and passive ion currents. The resting membrane potential. Sodium – potassium ATPase. Passive electrical properties of the membrane. Subthreshold graded potentials, depolarization and hyperpolarization. Action potential: characteristics, ionic basis and genesis. Action potential conduction in myelinated and unmyelinated fibers. Classification of nervous fibers.
Cell-to-cell communication - General properties of synaptic transmission. Electrical synapses. Chemical synapses: the neuromuscular junction, the central synapses. Electrical events in the postsynaptic neurons. Neuronal integration of synaptic inputs: spatial and temporal summation. Mechanisms of postsynaptic and presynaptic inhibition. Neurotransmitters in the central nervous system.
Muscle physiology - Skeletal muscle: functional organization. Mechanism of the contraction. Sliding filaments theory. Cross-bridges cycle. Excitation-contraction coupling. Mechanics of muscle contraction. Twitch and tetanus. Isometric and isotonic contractions. Length-tension relation. Force-velocity relation. Classification of skeletal muscle fibers. Motor unit. Smooth muscle: functional organization. Excitation-contraction coupling. Regulation of the electrical and contractile activity. Cardiac muscle: functional organization. Similarities and differences compared to the skeletal muscle and smooth muscle.

Neurophysiology
Sensory systems - Organization and general mechanisms. Sensory receptors: definition and classification. Sensory transduction and signal coding. Adaptation. Dimensions of sensation: modality, location, intensity, duration. Somatic sensation: mechanic, proprioceptive, thermal and pain sensation. Ascending pathways of somatic sensibility. Somatosensory cortex. Pain: mechanisms of activation and sensitization of nociceptors. Central pathways of pain perception. Referred pain. Antinociceptive endogenous systems. Special sense organs: the chemical senses, equilibrium reception, hearing and vision.
Motor systems - General characteristics. Organization of the motor system. Motor functions of the spinal cord: spinal reflexes. Muscle spindle reflex, Golgi tendon organ reflex, flexor reflex. Spinal shock. Motor functions of the brainstem and cerebral cortex: decerebrated animal. Posture and its maintenance. Vestibular reflexes and cervical reflexes. Cortical motor areas and their functional role. Cerebellum and basal ganglia: role in motor control.
Autonomic nervous system - Functional organization. sympathetic, parasympathetic and enteric nervous system. Organization of autonomic reflexes. Vegetative brain stem functions. Nervous centers of visceral functions.

Cardiovascular system physiology
Blood: hemostasis and coagulation.
Heart: Cardiac conduction system and contractile myocardium. Excitation-contraction coupling. Cardiac electrophysiology. Myocardic action potentials. Pacemakers and electrical conduction, refractory periods. The electrocardiogram. Contractility and cardiac cycle. Cardiac output and regulation of the stroke volume and heart rate. Role of the autonomic nervous system on. Length-tension relation and Frank-Starling’s law of the heart.
Circulation: Characteristics and function of the blood vessels. Pressure, volume, flow and resistance. Poiseuille’s law. The arterial system and the arterioles. Systolic, diastolic and mean arterial blood pressure. Determinants of the arterial pressure. The arterial pulse. Measurement of arterial pressure. The arterioles and resistance. The venous system. Microcirculation and exchange at the capillaries. Starling's hypothesis.
Cardiovascular regulatory mechanisms. Regulation of blood pressure.

Respiratory system physiology
Mechanical aspect of respiration. Lung volumes and capacities. The spirometry. Respiratory muscles. Elastic properties of the lung, intrapleural pressure, pressure-volume curve, surfactant. Compliance and airways resistance. Ventilation and perfusion. Alveolar ventilation-perfusion relationship. Gas exchange. Pulmonary and alveolar ventilation. Oxygen and carbon dioxide transport in the blood. Nervous control of respiration.

Urinary system physiology
Nephron. Renal blood flow and its regulation. Glomerular filtration and glomerular filtration rate. Tubular reabsorption and secretion. Water and electrolytes reabsorption. Antidiuretic hormone and aldosterone effects. Use of renal clearance for kidney efficiency determination.

Gastro-intestinal system physiology
General physiologic functions: secretion, motility, digestion and absorption. Enteric nervous system. Cephalic, gastric and intestinal phases. Digestion and absorption.

Stomatognathic apparatus physiology
Salivation: Saliva composition. Ionic mechanisms of salivary secretion. Enzyme secretion. Regulation of salivary secretion.
Oro-facial sensitivity: sensory innervation. Mechanoreceptors, thermal receptors and nociceptors of the oro-facial regions. Temporo-mandibular joint receptors. Muscle and tendon receptors. Sensory innervation of the tooth: interdental and periodontal ligament innervation. The trigeminal territory. The trigeminal pain.
Biomechanics of mastication: movements of the temporo-mandibular joint. Lowering, elevation, projection and laterality movements of the jaw. The dento-alveolar articulation and dental occlusion. The chewing muscles. The length-tension relation. Movements of the jaw and muscle activity during chewing.
Central integration of masticatory system sensation and motility: the brainstem. Masticatory muscles reflexes. Specialization of jaw reflexes. Regulation of reflexes during chewing.
Masticatory function: Chewing cycle: opening, closing and occlusal phases. Peripheral and central control of the chewing.
Swallowing: Voluntary and involuntary phases of swallowing. Influence of the pharyngeal phase on breathing. Nervous control of swallowing. Esophageal motility and the lower esophageal sphincter function.