COURSE OUTLINE
HUMAN PHYSIOLOGY
MPRI 7120
ACADEMIC YEAR: 2007-2008
COURSE DURATION: 9 WEEKS
COURSE DESCRIPTION
- SMALL CASE- BASED GROUP DISCUSSIONS (SGDs): 14 HOURS
- SELF DIRECTED GROUP DISCUSSIONS (SDSs): 48 HOURS
- CLINICALLY ORIENTED LABORATORY PRACTICES: 4 HOURS
- COMPUTER LABORATORIES: 2 HOURS
- CLINICAL CORRELATIONS: 8 HOURS
- 3 CUMULATIVE PARTIAL EXAMS: 7.0 HOURS
- 1 FINAL EXAM (NBMS PHYSIOLOGY SHELF EXAM): 2.5 HOURS
- Cell Membrane Transport
- Muscle Physiology
- Cardiovascular Physiology
- Respiratory Physiology
- Renal Physiology
- Acid-Base Physiology
- Thermoregulatory Physiology
- Gastrointestinal Physiology
- Exercise Physiology
- Endocrine Physiology
This course will offer the basic physiological knowledge necessary to understand the essential facts and concepts of human physiology, in order to be able to make clinical judgments based on a strong and rational scientific foundation. Clinical contexts are used thorough the course in all the areas to make the students aware of the importance of physiology in their future medical practice. The course runs from January 8 to March 10, 2008 with more than half of the time dedicated to active learning activities in the form of small group discussions, laboratories and student directed discussions.
MAIN OBJECTIVES:
1. Describe the movement of molecules across the cell membrane and its regulation. 2. Explain the morphological and functional characteristics of skeletal, cardiac and smooth muscle. 3. Learn the main functions of the heart and blood vessels and the regulation and integrative actions of the cardiovascular system. 4. Describe the organization and function of the respiratory system. 5. Learn the structural- functional relation of the renal system and its integrative function with other organ systems. 6. Describe the organization and function of the gastrointestinal system. 7. Describe the organization and function of the endocrine system and its integrative function with other organ systems.
RECOMMENDED BOOKS
Cardiovascular Physiology, Berne and Levy 8th edition, 2001 (Mosby)
Medical Physiology. Rhoades R.A. and Tanner G.A. Eds. 2 nd Ed. Lippincott Williams and Wilkins. Philadelphia, 2003.
Respiratory Physiology, The Essentials, West, 7th edition, 2006 (Williams and Wilkins)
Endocrine Physiology, Porterfield, 2nd edition, 2000 (Mosby)
Gastrointestinal Physiology, Johnson, 6th edition, 2000 (Mosby)
Good Reference: Physiology, Costanzo, 2001 (Saunders)
Another Good Reference: Physiology, Berne & Levy,5th edition 2004 (Mosby)
TOTAL LECTURE HOURS: 70
ACTIVE LEARNING ACTIVITIES: 76 HOURS
EXAMS: 9.5 HOURS
TOTAL COURSE HOURS: 146
COURSE COORDINATOR:
Maria José Crespo Ph.D. (OFFICE A-667) (mcrespo@rcm.upr.edu)
COURSE FACULTY:
Nelson Escobales Ph.D. (NEA) Professor & Chair
Maria J. Crespo Ph.D. (MJC) Professor & Course Coordinator
Guido E. Santacana Ph.D. (GES) Professor
Walter I. Silva Ph.D. ( WIS) Professor
Anabell Segarra Ph.D. (AS) Professor
Jorge Miranda Ph.D. (JM) Associate Professor
Carlos Jimenez-Rivera Ph.D. (CJ) Associate Professor
Carlos Torres Ph.D. (CT) Assistant Professor
Walter R. Frontera M.D., Ph.D. (WF) Professor & Dean
COLLABORATING FACULTY:
Melvin Bonilla M.D. (MB) Assistant Professor Dept. Medicine
Phillip Specht Ph.D. (PS) Associate Professor, Dept. of Pharmacology
Josefina Romaguera M.D. Professor, Dept. of Medicine
Donald Dexter M.D.
TEACHING ASSISTANTS
Raissa Menendez (Ph.D. Student)
Laurivette Mosquera (Ph.D. Student)
Jose Garcia (Ph.D. Student)
Jose M. Santiago (Ph.D. Student)
Lucy Arocho (Ph.D. Student)
Natasha Lugo (Ph.D. Student)
Odrik Rojas (Ph.D. Student)
Maria Velez (Ph.D. Student)
Jose Ramos (Ph.D. Student)
DETAILED COURSE SCHEDULE
Table of Contents:
WEEK 1
TUESDAY JANUARY 8
8:00-9:00am- Cell Membrane Physiology (NEA)
9:00-10:00am- Cell Membrane Physiology (NEA)
10:00-12:00 m- SDS: Cell Membrane Physiology (NEA)
MUSCLE PHYSIOLOGY AND AUTONOMIC SYSTEM
WEDNESDAY JANUARY 9
8:00-10:00am- Skeletal Muscle Mechanics (GES)
10:00-11:00am- SDS: Skeletal Muscle (GES)
THURSDAY JANUARY 10
8:00-9:00am- Autonomic System (CJ)
9:00-10:00am- Synaptic Integration (CJ)
10:00-12:00am- SDS: Special Senses (CJ)
FRIDAY JANUARY 11
8:00-10:00am- Introduction/ Heart Electrophysiology (GES) 10:00-12:00m- SDS The Microcirculation (GES)
WEEK 2
MONDAY JANUARY 14
HOLIDAY
TUESDAY JANUARY 15
8:00-9:00am- Heart Electrophysiology (GES)
9:00-10:00am- Fundamentals of the Electrocardiogram (GES)
10:00-12:00 m- Laboratory Practice (The Electrocardiogram and Blood Pressure) (Graduate Students)
WEDNESDAY JANUARY 16
8:00-9:00am- Heart Mechanics/The Cardiac Cycle (GES)
9:00-10:00am- Heart Mechanics/The Cardiac Cycle (GES)
10:00-12:00 m- Laboratory Practice (The Electrocardiogram and Blood Pressure) (Graduate Students)
THURSDAY JANUARY 17
8:00-9:00am- The Arterial System (GES)
9:00-10:00am- Cardiac Regulation (GES).
10:00-11:00am- Integrative Exercise in Cardiovascular Physiology (Staff)
11:00-12:00 SDS Coronary Circulation and Coagulation Cascade
FRIDAY JANUARY 18
8:00-10:00am- Coupling of the Heart and Blood Vessels (GES)
10:00-12:00 m-SGD Case Study in Cardiovascular Physiology (GES)
WEEK 3
MONDAY JANUARY 21
HOLIDAY Martin Luther King
TUESDAY JANUARY 22
8:00-9:00am Composition of the Air, Gas Pressure (MJC)
9:00-10:00am Pulmonary Mechanics (MC)
10:00-12:00 m- SDS Surface Tension and Surfactant (MJC)
Wednesday JANUARY 23
8:00-9:00am- Alveolar Ventilation (MC)
9:00-10:00- Oxygen Transport in Blood (MJC)
10:00-12:00 m- Laboratory-Pulmonary Volumes and Capacities/Pulmonary Mechanics (Graduate Students)
THURSDAY JANUARY 24
8:00-9:00am- Carbon Dioxide Transport in Blood (MJC)
9:00-10:00am- Regulation of Breathing (MJC)
10:00-11:00 m- Laboratory-Pulmonary Volumes and Capacities/Pulmonary Mechanics (Graduate Students)
FRIDAY JANUARY 25
8:00-9:00am- Shunts in the Pulmonary System (MJC)
9:00-10:00am- Ventilation/Perfusion Relations (MJC)
10:00-11:00am- Clinical Correlation
WEEK 4
MONDAY JANUARY 28
8:00-9:00am- Factors that Determine Pao 2 (MJC)
9:00-10:00am- Hypoxia (MJC)
10:00-12:00 m- SGD Case Study in Respiratory Physiology (Staff)
TUESDAY JANUARY 29
INDEPENDENT STUDY DAY
WEDNESDAY JANUARY 30
9:00-11:30 PARTIAL EXAMINATION I- 70 QUESTIONS
THURSDAY JANUARY 31
8:00-9:00am- The Nephron, GFR (NEA)
9:00-10:00am- Clearance (NEA)
10:00-12:00 m- SDS Body Fluids (NEA)
FRIDAY FEBRUARY 1
8:00-9:00am- Tubular Transport Mechanisms (NEA)
9:00-10:00am- Sodium and Water Balance (NEA)
10:00-11:00am- SDS Renal Hemodynamics (NEA)
WEEK 5
MONDAY FEBRUARY 4
8:00-9:00am- Sodium and Water Balance (NEA)
9:00-10:00am- Concentration and Dilution of Urine (NEA)
10:00-12:00 m- SDS Regulation of Sodium Balance (NEA)
TUESDAY FEBRUARY 5
8:00-9:00am- Concentration and Dilution of Urine (NEA)
9:00-10:00am- Role of the Kidneys in A/B Balance (NEA)
10:00-12:00 m- SDS Disturbances in Water Balance (NEA)
WEDNESDAY FEBRUARY 6
8:00-9:00am- Role of the Kidneys in A/B Balance (NEA)
9:00-10:00 am-Potassium Balance (NEA)
10:00-11:00 m- Clinical Correlation
11:00-12:00 m- SDS Potassium Balance (NEA)
THURSDAY FEBRUARY 7
8:00-9:00am- Potassium Balance (NEA)
9:00-10:00 am-Diuretics (NEA)
10:00-12:00 m- SGD Renal Physiology Case Study (Staff)
THERMOREGULATION / ACID BASE PHYSIOLOGY
FRIDAY FEBRUARY 8
8:00-9:00am- Acid Base Balance (MJC)
9:00-10:00am- Acid Base Balance (MJC)
10:00-11:00 m- Acid Base SDS (MJC)
WEEK 6
MONDAY FEBRUARY 11
8:00-10:00am- Mechanisms of Heat Transfer & Thermoregulation (CJ)
10:00-12:00pm- SGD Acid Base Case Study (Staff)
TUESDAY FEBRUARY 12
8:00-9:00am- Chewing and Salivary Secretion ( WIS)
9:00-10:00am- Swallowing and Vomiting ( WIS)
10:00-12:00 m- SDS Nerve Regulation in the GI Tract ( WIS)
WEDNESDAY FEBRUARY 13
8:00-9:00am- Gastric Secretion ( WIS)
9:00-10:00am- Gastric Motility ( WIS)
10:00-11:00am- SDS Pancreatic Secretion and Small Intestine ( WIS)
THURSDAY FEBRUARY 14
8:00-9:00am- Absorption of Water and Electrolytes ( WIS)
9:00-10:00am- Digestion and Absorption of Carbohydrates ( WIS)
10:00-12:00 m- SGD Case Study GI
FRIDAY FEBRUARY 15
8:00-9:00am- Digestion and Absorption of Proteins ( WIS) 9:00-10:00am- Digestion and Absorption of Fats ( WIS)
10:00-11:00 m- Clinical Correlation
11:00-12:00 SDS Enterohepatic Circulation and Bile Acid Secretion ( WIS)
WEEK 7
MONDAY FEBRUARY 18
HOLIDAY George Washington
TUESDAY FEBRUARY 19
PHYSIOLOGY PARTIAL EXAMINATION II ( RENAL, A/B, GASTRO + CUMULATIVE)
9:00AM TO 11:30AM
WEDNESDAY FEBRUARY 20
8:00-10:00 am- Mechanisms of Hormone Action (JM)
10:00-12:00pm - SDS Mechanisms of Hormone Action (JM)
THURSDAY FEBRUARY 21
8:00-9:00am- Hypothalamus and Adenohypophysis (AS)
9:00-10:00am- Hypothalamus and Adenohypophysis/ Feedback Mechanisms (AS)
10:00-11:00am- SDS Hypothalamic/Hypophyseal Axis (AS)
FRIDAY FEBRUARY 22
8:00-9:00am- Growth Hormone and Growth Factors (AS)
9:00-10:00am- Neurohypophysis,Oxitocin and Vasopressin (AS)
10:00-11:00 m- Deficiencies in Pituitary Hormones (AS)
WEEK 8
MONDAY FEBRUARY 25
8:00-9:00am- Regulation of Thyroid Function (CT)
9:00-10:00am- Physiological Effects of Thyroid Hormones (CT)
10:00-12:00am- Clinical Correlation
TUESDAY FEBRUARY 26
8:00-10:00am- Adrenal Cortex/ Regulation and Physiology (AS)
10:00-12:00 m- Clinical Correlation
WEDNESDAY FEBRUARY 27
8:00-9:00am- Adrenal Medulla and Catecholamines (AS)
9:00-10:00am Calcium Homeostasis (CT)
10:00-12:00am- SGD Case Study in Endocrine Physiology (Staff)
THURSDAY FEBRUARY 28
8:00-10:00am- The Endocrine Pancreas (CT)
10:00-11:00 m- Clinical Correlation
11:00-12:00 m- SDS Endocrine Pancreas (CT)
FRIDAY FEBRUARY 29
8:00-10:00am- “Exercise: Energetics and Physiological Responses" (WF)
10:00-11:00am- Clinical Correlation (WF)
WEEK 9
ENDOCRINE PHYSIOLOGY (REPRODUCTIVE SYSTEM)
MONDAY MARCH 3
8:00-10:00am Male Reproductive System (AS)
10:00-11:00 m- Clinical Correlation
TUESDAY MARCH 4
8:00-10:00am Female Reproductive System (AS)
10:00-12:00 m- Clinical Correlation
WEDNESDAY MARCH 5
8:00- 9:00am- Sex differentiation (AS)
9:00-10:00am Puberty, Pregnancy, Lactation and Menopause (AS)
10:00-12:00am- Clinical Correlation
THURSDAY MARCH 6
INDEPENDENT STUDY DAY
FRIDAY MARCH 7
PHYSIOLOGY PARTIAL EXAMINATION III (ENDO + CUMULATIVE)
100 QUESTIONS 9:00AM TO 11:30AM
MONDAY MARCH 10
9:00AM - 11:30AM PHYSIOLOGY NBME SUBJECT EXAM
STUDENT EVALUATION
The students will be evaluated by means of 3 partial examinations (60% of the grade), their participation in the case studies (10% of the grade) and the final "NBME Shelf Exam" (30% of the grade).
EXAMS:
There will be 4 exams (3 partial 1 final). They will count as 90% of the final grade. Exams II and III are cumulative. This means that they will cover material from past examinations.
EXAM I
Counts as 15% of the final grade. Topics Covered: Membrane Physiology, Muscle Physiology, Cardiovascular Physiology, Respiratory Physiology.. Questions and Time: 70 multiple choice questions/ 2 hours
EXAM II (Cumulative)
Counts as 20% of the final grade. Topics Covered: Renal Physiology, Thermoregulation, Acid Base Physiology + approximately 20% of questions from topics of exam I. Questions and Time: 80 multiple choice questions/ 2.5hours
EXAM III (Cumulative)
Counts as 25% of the final grade. Topics Covered: Endocrine Physiology, Physiology of Reproduction + 40% of questions from topics of exam I and II. Questions and Time:100 multiple choice questions/ 2.5 hours
EXAM IV (NBME "SHELF" EXAM AND FINAL)
Counts as 30% of the final grade. Topics Covered: Comprehensive exam covering all topics of exams I, II and III. Questions and Time: Approximately 120 multiple choice questions/ 2.5 hours.
PARTICIPATION IN THE CASE STUDIES (SGDs) AND SELF DIRECTED STUDIES (SDSs)
Case studies are small group learning experiences in which basic physiological science is presented in a clinical context. They are carried out in groups of 10 to 12 students under the direction of a mentor. The cases allow students to see the relevance of the knowledge that they gain in class with the practice of medicine. There will be 6 cases during the 9 weeks duration of the physiology course. The evaluation of the case studies is carried out by each mentor who evaluates each student individually. Participation in the case studies is mandatory. The criteria used to evaluate the students in the case studies are as follows:
Evaluation by SGD Director: Each SGD director will evaluate individual students in these areas.
Presence and Alertness-- 25%
Preparation------------------25%
Evoked Participation------25%
Spontaneous Participation-25%
The total grade obtained from this evaluation will count as 50% of the SGD grade.
Each partial examination will contain five questions pertaining to the SGDs. These questions will also be evaluated separately and counted as 50% of the SGD grade. In other words, your SGD grade will be the sum of the SGD director subjective evaluation and the five exam questions objective evaluation.
The total grade obtained by the students in the case studies will count as 10% of the course final grade. Students who do not attend a case study will receive a grade of 0%(zero). If the student has a valid excuse for the absence, then he/she may be given the option of removing the zero grade by taking a written test pertaining to the specific case study or arranging a discussion of the case with the professor of the specific section. The grade assigned to the student in the specific case study will be the grade obtained in this test or the evaluation carried out by the professor plus the five questions on the test about the particular SGD. IMPORTANT:ATTENDANCE TO THE SGDs IS MANDATORY. ARRIVING 30 MINUTES AFTER THE START OF A CASE DISCUSSION WILL BE CONSIDERED AN ABSENCE. ABSENCE TO THREE OR MORE CASE STUDIES WITHOUT A VALID AND REASONABLE EXCUSE WILL BE CONSIDERED AS A FAILURE OR F IN THE WHOLE MPRI 7120 COURSE WITHOUT THE BENEFIT OF THE REPOSITION.
The SDSs are student directed activities designed to give the students the opportunity to work on their own and in small groups in specially designed active learning formats. The learning activities are based on prepared problems and reading material that the student must cover in a period of 1.5 hours. Another half hour is spent in the classroom with the professor in charge discussing the main aspects of the problem. The discussion with the professor is optional and depends on the professor in charge. The activity may or may not be case based depending on the specific aim that it wants to accomplish. The material covered in SDSs will not be covered in lectures but will be part of the examination and is the sole responsibility of the student to make sure that he has studied this material. It is in the student's best interest to utilize the 2 hours of active learning activities in the morning for the SDS when it is assigned. Failure to do so will only result in additional work for the independent study in the afternoons.
GRADE CALCULATION:
The final grade for the course will be calculated as follows:
(Exam I Score) x 0.15 + (Exam II Score) x 0.20 + (Exam III Score) x 0.25 + (Final "Shelf" Score) x 0.30 + (Case Studies Score) x 0.10 = Final Grade
THE PASSING GRADE FOR THE MEDICAL PHYSIOLOGY COURSE MPRI 7120 WILL BE 70%.
THE GRADE DISTRIBUTION WILL BE AS FOLLOWS:
90%-100% A
80%-89% B
70%-79% C
< 70% F
Reposition Exam : A DEPARTMENTAL COMPREHENSIVE EXAM will be administered to those students who score less than 70% at the end of the course. The exact date for this exam will be announced. In order to pass this reposition exam a student must score 70% or higher. THERE WILL BE NO ADJUSTMENTS APPLIED TO THE COMPREHENSIVE EXAM.
STUDENTS TAKING AND PASSING THE REPOSITION COMPREHENSIVE EXAM WILL BE GIVEN A MAXIMUM GRADE OF "C" IN THE COURSE.
AN ABSENCE TO ANY PARTIAL OR FINAL EXAM MUST BE ACCOMPANIED WITH AN APPROPRIATE JUSTIFICATION. UPON THE REVIEW OF THE JUSTIFICATION BY THE COURSE COORDINATOR AND ACCEPTANCE OF THE JUSTIFICATION, THE STUDENT WILL THEN BE ALLOWED TO TAKE A MAKEUP EXAM AT A DATE ARRANGED WITH THE COORDINATOR.
NO STUDENT WILL BE ALLOWED TO TAKE A PARTIAL OF FINAL EXAM IF THE STUDENT ARRIVES 30 MINUTES AFTER THE START OF THE EXAMINATION. LATE ARRIVAL TO AN EXAM DOES NOT MEAN THAT THE STUDENT WILL BE ALLOWED TO REMAIN EXTRA TIME TO FINISH THE EXAM. IN THIS CASE THE STUDENT WILL HAVE ONLY THE REMAINING ALLOTTED TIME FOR THE EXAMINATION AND THE EXAM WILL BE COLLECTED AT THE END OF THE ESTABLISHED EXAM PERIOD.
THE STUDENT WILL HAVE 5 WORKING DAYS AFTER EACH PARTIAL EXAMINATION TO DISCUSS THE EXAM QUESTIONS WITH THE PROFESSORS. ALLEGATIONS REGARDING EXAM QUESTIONS WILL NOT BE ACCEPTED AFTER THIS PERIOD. ALLEGATIONS OF EXAM QUESTIONS ARE TO BE DISCUSSED DIRECTLY WITH THE PROFESSOR IN CHARGE OF PREPARING THE SPECIFIC QUESTIONS. THERE WILL BE NO DISCUSSIONS OF EXAMINATIONS IN CLASS AND NO WRITTEN CHALLENGES.
REASONABLE ACCOMMODATION
STUDENTS WITH A HEALTH CONDITION OR SITUATION THAT, ACCORDING TO THE LAW, MAKES THEM ELIGIBLE FOR REASONABLE ACCOMMODATION HAVE THE RIGHT TO SUBMIT A WRITTEN APPLICATION TO THE PROFESSOR AND THE DEAN OF THEIR FACULTY, ACCORDING TO THE PROCEDURES ESTABLISHED IN THE DOCUMENT "SUBMITTAL PROCESS FOR REASONABLE ACCOMMODATION OF THE MEDICAL SCIENCES CAMPUS". A FREE COPY OF THIS DOCUMENT MAY BE OBTAINED AT THE OFFICE OF THE DEAN FOR STUDENTS AFFAIRS, SECOND FLOOR OF THE PHARMACY BUILDING; PHONE 787-758-2525 EXT. 5203. A COPY MAY ALSO BE OBTAINED AT THE OFFICE OF THE FACULTY DEANS AS WELL AS IN THE MSC WEB PAGE. THE APPLICATION DOES NOT EXEMPT STUDENTS FROM COMPLYING WITH THE ACADEMIC REQUIREMENTS PERTAINING TO THE PROGRAMS OF THE MEDICAL SCIENCES CAMPUS.
ETHICAL ISSUES:
Written examinations are the principal means utilized by the Department of Physiology to measure the student’s achievements in their educational experiences. It is our intention to guarantee that all students have an equal opportunity to demonstrate their academic achievement under the same circumstances; eliminating all possibility of unfair or unethical behavior. We trust our students in their commitment to honesty and professional ethics; should unethical behavior be observed, appropriate and very rigorous disciplinary measures will be taken.