FLG 212 Study Guide

8/18/2019 FLG 212 Study Guide

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Study guide / Studiegids

Department of Physiology

Departement Fisiologie

FLG 212 – Circulatory physiology / Sirkulatoriesefisiologie

2016

© Copyright reserved / © Kopiereg voorbehou


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TABLE OF CONTENTS

TIME TABLE ............................................................................................................................................... 1

LOGISTICS ................................................................................................................................................ 2

Official communications ........ .......... ......... .......... ......... .......... ......... .......... ......... .. 2

Study materials .......... ......... .......... .......... ......... .......... .......... ......... .......... ......... .. 2

Assessments and contribution to final mark ...... ........ ........ ........ ...... ........ ........ ....... 3

Promotion ......... ......... .......... ......... .......... ......... .......... ......... .......... ......... .......... . 4

Sub-minimum for admission to the examination .... .... .... .... .... .... .... .... .... .... .... .... .... .. 4

Absence from examination ............ ........ ........ ...... ........ ........ ........ ........ ...... ........ .. 5

Plagiarism ......... ......... .......... ......... .......... ......... .......... ......... .......... ......... .......... . 5

STUDY COMPONENT .......... .......... ......... .......... .......... ......... .......... ......... .......... .. 6

STUDY UNITS ............................................................................................................................................ 7

SYLLABUS THEME 1: BODY WATER ...................................................................................................... 7

SYLLABUS THEME 2: HAEMATOLOGY AND AN INTRODUCTION TO IMMUNOLOGY ANDDEFENCE SYSTEMS ................................................................................................................................ 7

SYLLABUS THEME 3: CARDIOVASCULAR PHYSIOLOGY .................................................................... 12


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LOG ISTICS

Lecturer: Office: Tel. nr: E-mail address:

Guardian Dr M v Rooy BMS 9-12 (Prinshof) 012 319-2423 [email protected]

Lecturer Dr M Coetzee BMS 9-23 (Prinshof) 012 319-2445 [email protected]

Tutor Ms D Fraser 073 101 1128 [email protected]

Administrative personnel Office: Tel. nr: E-mail address:

Ms MS Botha NW 1 2-1.2 012 420 4482 [email protected]

O f fi c i a l c o m m u n i c a t io n s

The official notice board is situated at the entrance of level 2, NS1 building, west wing. Some

communications may be made via the Click UP. It is the student’s responsibility to verify any changes

and additional information regarding for example the lecturing schedule, test-, and exam venues posted

on click UP or the official notice board. Students’ test mark and test memo’s will be posted on the notice

board. Students are kindly requested not to leave Pretoria for the holidays until they know they do not

have a supplementary examination.

Appointments can be made with the lecturers by personal arrangement during working hours.

Le c t u re i n fo r m a t io n

Fridays 08:30 – 10:20 (2 lectures) Venue: Louw Hall

Pra c t ic a l s

Thursday 14:30 – 17:20 Venue: See ClickUP

St u d y m a t e r ia l s

Prescribed text book:

Dee Unglaub SilverthornHuman Physiology, an integrated approach. (6th edition)

Where necessary the following book will be utilised, but relevant information will be includedin the lecturers

BJ Meyer, DH van Papendorp, HS Meij en M ViljoenHuman Physiology (3nd Revised edition), Juta & Co., 2002


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A s se s sm e n t s a n d c o n t ri b u t i o n t o f in a l m a rk

Theory: Test 1 + Test 2 = 80%Practicals: = 20%Semester mark = 100%

Examination: written paper = 100%Final mark: = (Semester mark + Examination mark)/2

Test dates - Will be available on UP PortalExamination dates - Will be available on UP Portal

If a student fails to attend a practical or class test, or does not submit an assignment due tomedical reasons he/she needs to submit a medical certificate to the department administrator (ONLY Ms Botha) within 72 hours.

o If no medical certificate is submitted to the department administrator (ONLY Ms Botha) within72 hours, the student will receive zero for that specific assessment.

o If a medical certificate is submitted to the department administrator (ONLY Ms Botha) within 72hours that specific assessment will not be taken in consideration for the calculation of themodule mark.

Criteria for a valid medical certificateIf the doctor has seen the student on the day of, or on the previous day of the test.Consultations on the day after the test/examination, or a certificate based on hear-say will beconsidered invalid. Medical certificates will be accepted as valid after consultation with the partiesinvolved and in consultation with the medical officer. Students are reminded that, issuing of a falsemedical certificate may result in the name of the medical practitioner being removed from the medicalregister. Tampering with a medical certificate will be brought to the attention of the disciplinary

committee and may result in expulsion.

Please take note:1. Attendance of all practicals is compulsory.2. If a student misses more than one of the above mentioned assessments he/she will not be

allowed to write the examination of the specific module.

Semester testsIf a student fails to write a semester test due to medical reasons he/she needs to submit a medicalcertificate to the department administrator (ONLY Ms Botha) within 72 hours.If no medical certificate is submitted to the department administrator (ONLY Ms Botha) within 72

hours, the student will receive zero for the semester test.o If a medical certificate is submitted to the department administrator (ONLY Ms Botha) within 72

hours, no module mark will be calculated. In such a case, the student’s exam mark will be usedas his/her final mark (Thus, a student needs to obtain a minimum of 50% in the exam to passthe module).

o Please take note: Submission of a forged medical certificate is a criminal offence!NB! If a student misses both semester tests he/she will not be allowed to write the examination ofthe specific module.

VERY IMPORTANT:Sick tests are no longer offered for physiology modules.

Submission of a forged medical certificate or affidavit is a criminal offence!


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Promotion

A student can only promote if he/she:o Obtains a module mark of 65% or more.o Obtains60% or more for each semester test.o Attended and completed all assessment opportunities (semester tests, class tests,

assignments, practical classes, etc.). Thus a student may not promote if he/she fails tocomplete any one of the assessment opportunities, irrespective of the reason (with or withoutthe submission of a medical certificate) (continued on next page).

o Is going to enroll for 300-level Physiology subjects during the following year. If the student isnot enrolling for any third year Physiology subjects during the following year, he/she cannotpromote and has to write the examination. (See the official statement below, as stipulated in theUniversity’s General Regulations, 2009)

General Regulations 2009

Promotion to a subsequent year of study and promotion in a module.

Students who have reached the required standard in a module as stipulated in G10.3 (b),

may

be

promoted,

in

accordance

with

authorised

faculty

regulations,

to

the

next

semester

or level in a module without writing the prescribed examination, provided that a student

receives credit for such promoted modules only if study in those modules is concluded by

successfully completing a prescribed examination

If a student promotes his/her module mark will be used as his/her final mark.

Sub-minimum for admission to the examination:

A semester mark of 40% or higher for a semester mark is required for admission to the examination.

Examples:

Minimum requirement Example Outcome

Semester mark ≥ 40%Semester mark 0-39%

NOT admitted to examinationFAIL module

Semester mark 40-100% Admitted to examination

In order to pass this module:A final mark of 50% or higher AND an examination mark of 40% or higher must be obtained.

Examples:

Minimum requirements Example Outcome

Final mark ≥ 50%AND

Examination mark ≥ 40%

Final mark 0-39% FAIL

Final mark 40-49% Admitted to supplementary

examination

Final mark 50-100%Examination mark 0-39%

Admitted to supplementaryexamination

Final mark 50-100%

Examination mark 40-100% PASS


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Absence from the examination

If a student is absent from the examination, the student has to apply for a sick or special examination atFaculty Administration on the Ground Floor, Agricultural Sciences Building within 3 working days of theoriginal examination date (thus medical certificates have to be handed in at Administration of theFaculty of Natural and Agricultural Sciences and not at the Department of Physiology).

Pl a g i a r i sm

“Plagiarism refers to the appropriation of the work or ideas of others. Plagiarism is both unethical andillegal and may be regarded as a criminal offence in terms of the Copyright Act 98 of 1978. TheUniversity of Pretoria places a high premium on its academic standards and subscribes to a valuesystem that requires strong action against plagiarism. For more information, seehttp://upetd.up.ac.za/authors/create/plagiarism.htm.”


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STUDY C O M PO NENT

The statements used to define the outcomes determine the level (higher-lower) of thinking skills challenged by

the outcome. The characterisation of the levels is given in the table below. Bloom's Taxonomy of Educational

Objectives (Bloom BS and Krathwohl DR, Taxonomy of educational objectives. Handbook 1. Cognitive domain,

Addison-Wesley, 1984)

Level of cognition Definition Typical action verbs Skills demonstrated

1. Knowledge Remembering

previously

learned

information

Arrange, define, describe, identify,

label, list, match, name, outline, show,

label, collect, examine, tabulate, quote

Observe and recall information

Knowledge of dates, events, places

Knowledge of major ideas

Mastery of subject matter

2. Comprehension Understanding

the meaning of

information

Classify, discuss, estimate, explain,

give example(s), identify, predict,

report, review, select, summarise,interpret, ‘in your own words’, contrast,

predict, associate, distinguish,

estimate, differentiate

Understand information

Grasp meaning

Translate knowledge into newcontext

Interpret facts, compare, contrast

Order, group, infer causes

Predict consequences

3. Application Using the

information

appropriately in

different

situations

Apply, calculate, demonstrate,

illustrate, interpret, modify, predict,

prepare, produce, solve, use,

manipulate, put into practice, calculate,

examine, relate, change, classify

Use information

Use methods, concepts andtheories in new situations

Solve problems using requiredskills or knowledge

4. Analysis Breaking downthe information

into the

component parts

and seeing the

relationships

Analyze, appraise, calculate, compare,criticise, derive, differentiate, choose,

distinguish, examine, subdivide,

organise, deduce separate, order,

connect, infer, divide

Seeing patterns Organisation of parts

Recognition of hidden meanings

Identification of components

5. Synthesis Putting the

component parts

together to form

new products

and ideas

Assemble, compose, construct, create,

design, determine, develop, devise,

formulate, propose, synthesise, plan,

discuss, support combine, integrate,

modify, rearrange, substitute, design,

invent, what if? prepare, generalise,

rewrite

Use old ideas to create new ones

Generalise from given facts

Relate knowledge from severalareas

Predict, draw conclusions

6. Evaluation Making

judgements of

an idea, theory,

opinion, etc,

based on criteria

Appraise, assess, compare, conclude,defend, determine, evaluate, judge, justify, optimise, predict, criticise,assess, decide, rank, grade, test,measure, recommend, convince,select, judge, explain, discriminate,support, summarise

Compare and discriminatebetween ideas

Assess value of theories,presentations

Make choices based on reasonedargument

Verify value of evidence

Recognise subjectivity


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STUDY UNITS

M O DULE FLG 21 2 : C IRC ULA TO RY PHYSIO LO G Y 21 2

SYLLABUS THEMES:

1. BODY WATER2. HAEMATOLOGY AND DEFENCE SYSTEMS3. CARDIOVASCULAR PHYSIOLOGY AND THE LYMPHATIC SYSTEM

SYLLABUS THEME 1: BODY WATER

Study unit 1.1: Occurrence and functions of body water

Learning objectives:

Students should be able to describe the:o Water content and distribution of water in the bodyo Functions and importance of water in the bodyo Concept of water balance

Sources: Meyer p 3.1-3.2; Silverthorn p 131-132, 659-660.

Study unit 1.2: Pathophysiology


o Students should obtain a basic knowledge of the causes, symptoms and treatment ofdehydration and overhydration.

Meyer p 3.3-3.4

SYLLABUS THEME 2: HAEMATOLOGY AND AN INTRO DUCTION TO IMMUNOLO GY

AND DEFENCE SYSTEMS

SYLLABUS THEME OBJECTIVES: To understand the central role of blood in normal bodyhomeostasis and functioning, and to study the essential functions of the individual components ofblood, i.e., of plasma, red blood cells, white blood cells and platelets.

STUDY UNITS

2.1. Whole blood2.2. Plasma2.3. Haemopoiesis2.4. Red blood cells (RBC)2.5. Blood groups2.6. Blood platelets and haemostasis2.7. White blood cells (WBC) and an introduction to immunology


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Study unit 2.1: Whole blood

Study Unit Themes

2.1.1 Composition

Learning objectives: o Students should be able to list the various components of blood as well as the normal

concentrations and volumes of it.

Source: Silverthorn p 545-551

2.1.2 Functions of blood


o Students should be able to list the functions and describe the importance of blood in normal

body homeostasis.

Sources: Meyer 12.1; Silverthorn p 545-547.

2.1.3 General characteristic and related analyses


o At the end of this unit students should be able to define:

The relative density of blood, plasma and cells

Red cell aggregation

Sedimentation rate Haematocrit

Viscosity

Source: Meyer p 12.1-12.3

Study unit 2.2: Plasma

Study Unit Themes

2.2.1 Composition


o Students should know the inorganic as well as the organic composition and volume of plasmaSources: Meyer p 12.6 (table); Silverthorn p 545-547

2.2.2 Functions

Learning objectives: o Students should know the origin and functions of plasma components as well as the effects of

deficiencies.

Source: Meyer 12.3 – 12.5; Silverthorn p 545-547


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Study unit 2.3: Haemopoiesis (Production of blood cells)


Students should be able to:o Describe the ontogenic phases

o Describe the various stages of erythropoiesis, leukopoiesis and thrombopoiesiso Identify the factors that influence haemopoiesis and explain the role of each

Source Meyer p 12.6 – 12.7, 12.23-24; Silverthorn p 547-551

Study unit 2.4: Red blood cells (RBC)

Study Unit Themes

2.4.1 Red blood cells - General

Learning objectives: At the end of this study unit theme the students should be able to:

o Describe the production and characteristics of the RBCo Give values for the normal red blood cell count and to describe physiological and pathological

variationso Describe the morphology of the RBC in terms of MCV, MCH, MCHC - including pathological

variations (Red blood cell profile) (FLG 212 Practical study guide)o Demonstrate a basic knowledge on haemoglobin which would allow them to describe the

structure

the functional arranging of the various structural components

abnormalities in biosynthesis or structureo Describe the functions of the red blood cell (Meyer p12.22-12.23)o Give a basic account of the metabolic activities of red blood cells (Meyer p 12.24)o Describe the importance of iron balance for erythropoiesis

Sources: Meyer 12.24 - 12.30; Silverthorn p 551-557

2.4.2 Lifespan of red blood cells


Students should be able to:

o Describe the factors which influence erythropoiesiso Describe the normal RBC lifespano List the causes of haemolysis and explain haemoglobin breakdown (Meyer fig 12.5)

Sources: Meyer p 12.23-12.25; Silverthorn p 554-557

2.4.3 Abnormalities of the erythron


Students should be able to:o Describe polycythaemia as well as the causes of it

o Define anaemia as well as its diagnostic characteristicso Classify anaemia on the basis of both morphology and aetiology


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o Describe the causes and consequences of the deficiency states of Fe++, Vit B12 and folic acid

Sources: Meyer p 12.26-12.27, 12.23-12.24; Silverthorn p 556-557

After completion of the practical course in haematology, the students should be able to:

o Calculate the red cell indices (red blood cell profile) by making use of the relevant formulae andblood values

o Make a diagnosis and suggest possible causes by referring to relevant information obtained inthe haematology course

Study unit 2.5: Blood groups


After completion of this study unit the students should be able to:o Define the ABO and the Rh blood group systems and to describe the characteristic differences

between the two systems

o Explain the clinical implications of the two blood group systems with special reference to bloodtransfusions and erythroblastosis foetalis

o Handle problem solving exercises with regard to blood groups, donors and recipients

Sources: Meyer 12.28-12.31; Silverthorn p 825-827

Study unit 2.6: Blood platelets and haemostasis

Study Unit Themes

2.6.1 Blood platelets


Students should be able to:o Define normal and abnormal platelet countso Describe the structure of platelets and to relate structure to functiono Describe the role of platelets in haemostasis

Sources: Silverthorn p 557-565

2.6.2 Haemostasis


After completion of this study students should be able to:o Describe the reactions which follow upon damage to a blood vessel chronologicallyo Describe the clotting cascadeo Explain the causes of clotting abnormalitieso Describe fibrinolysis

Source : Silverthorn p 557-565


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Study unit 2.7: White blood cells (WBC) and an introduction to immunology

Study Unit Themes

2.7.1 White blood cells

Learning objectives: After completion of this study unit the students should have a basic knowledge of white blood cells andbe able to:o Identify and classify the different leukocytes on the basis of their morphological characteristicso Explain the contribution of each type to the defence systemo List their concentrations, recognise abnormal values and explain the consequences of

abnormal WBC counts in general.

Source : Silverthorn p 547-549, 804-825

Study Unit Themes

2.7.2 Defence mechanisms


Students should be able to distinguish between non-specific (general) and specific defencemechanisms.

2.7.3 Non-specific defence mechanisms (innate immunity)

Learning objectives

Students should be able too explain the different mechanisms involved in non-specific defence


2.7.4 Specific immunity (acquired immunity)


Students should have the basic knowledge which would enable them to:o Define and describe the characteristics of an immune reactiono

Distinguish between and give the characteristics of a secondary and a primary immunereactiono Distinguish between active and passive immunity and explain the reactions which can be

elicited either naturally or artificiallyo Define the term antigeno Give an annotated sketch of a basic immunoglobino Classify immunoglobulins and to name the characteristics of each classo Describe the functions of the antibodieso Define and describe cellular and humoral immunityo Describe the cause and onset of the allergic reaction



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SYLLABUS THEME 3: CARDIOVASCULAR PHYSIOLOGY

SYLLABUS THEME GOAL: To become conversant with the physiological anatomy, the controlmechanisms, the mechanisms of action and the functions of the cardiovascular system.

STUDY UNITS

3.1. Overview of the cardiovascular system3.2. Mechanisms and forces involved in blood flow3.3. The heart3.4. The heart as a pump3.5. The blood vessels3.6. Blood pressure3.7. Resistance in arterioles3.8. Distribution of blood in the tissues3.9. Cardiovascular control centre

3.10. Exchange at capillaries3.11. Lymphatic system

Study unit 3.1: Overview of the cardiovascular system

Study Unit Theme

1.1.1 Transport of substances by the cardiovascular system


Students must know the substances that are transported by the cardiovascular system and why they

are important.

3.1.2 Components of the cardiovascular system


Students must know the:o The components of the cardiovascular systemo Difference between arteries and veinso Functions of the chambers of the hearto Be able to distinguish between the pulmonary and systemic circulation and special

arrangements in the circulation.

Source: Silverthorn pp. 462-466

Study unit 3.2: Mechanism and forces involved in blood flow

Study Unit Theme

3.2.1 Pressure


Students should be able to describe:o Pressure in the cardiovascular systemo Effect of distance and contraction of the heart on pressure


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o Driving pressureo The importance of a pressure gradient with regards to blood flow

3.2.2 Resistance

Learning objectives:Students must be able to explain:o Resistanceo The relationship between resistance and flowo Factors affecting resistanceo The difference between flow rate and velocity of flowo Relationship between velocity of flow, flow rate and cross-sectional area


Study unit 3.3: The heart

Study Unit Theme

3.3.1 Anatomy of the heart


Students should know and be able to describe:o The layers of the hearto Pathway of blood flow through the hearto Heart valves, positions and function

3.3.2 Contraction of cardiac muscle cells


Students should be able to distinguish between autorythmic and contractile cells.

3.3.3 Cardiac contractile cell excitation-contraction coupling


Students should be able to describe the process of EC coupling as well as the grading of cardiacmuscle cells

3.3.4 Myocardial action potentials


Students must be able to recognise and describe the different phases of action potentials in myocardialcontractile and myocardial autorythmic cells.



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Study unit 3.4: The heart as a pump

Study Unit Themes

3.4.1 Conducting system of the heart


Students should be able to describe the pathway of the electrical conduction system through the heartas well as the importance of each structure.

3.4.2 Cardiac cycle and electrocardiogram (ECG)


Students should be able to:o Recognise the different waves on an ECG and how they correspond to each event in the

cardiac cycle

o Describe each phase of the cardiac cycleo Interpret the pressure-volume curveo Distinguish between end-diastolic volume and end-systolic volume

3.4.3 Stroke volume and cardiac output


Students should be familiar with and be able to relate the:o Definition of stroke volume and cardiac output and their formulaeo Parasympathetic and sympathetic effect on heart rateo Factors that influence stroke volume and their effects on cardiac outputo Chemical and neural control of cardiac outputo Afterload


Study unit 3.5: The blood vessels

Study Unit Themes

3.5.1 Anatomy of the blood vessels


Students should be familiar with and be able to describe the different layers in each of the bloodvessels and their role in the function of the blood vessel.

3.5.2 Arteries and arterioles


Students should be able to describe the structure and characteristics of arteries, arterioles andmetarterioles


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3.5.3 Capillaries


Students should be able to describe the structure and characteristics of capillaries as well as thefunction of pericytes.

3.5.4 Venules and Veins


Students should be able to describe the structure and characteristics of venules and veins as well asthe importance of valves in the veins.

3.5.5 Angiogenesis


Students should be able to define angiogenesis and describe situations where angiogenesis occurs.


Study unit 3.6: Blood pressure

Study Unit Theme

3.6.1 Blood pressure in arteries and veins


Students should know and be able to describe:o The origin of blood pressure in the circulationo Causes of frictiono Pulse and pulse pressureo Pumps aiding venous return

3.6.2 Mean arterial pressure (MAP)


Students should know and be able to describe:o MAPo

The difference between hypertension and hypotension

3.6.3 Sphygmomanometry


Students should know and be able to describe the use of the sphygmomanometer in the measurementof blood pressure.


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3.6.4 Biophysical factors and MAP


Students should know and be able to describe:o Peripheral resistance

o The relationship between CO, peripheral resistance and MAPo As well as apply the effects on this relationship when changes in flow, distribution of blood and

total blood volume occuro Changes in blood volume


Study unit 3.7: Resistance in arterioles and blood pressure

Study Unit Theme

3.7.1 Poiseuilles’ Law


Students should be able to explain and apply the following:o The relationship between resistance in arterioles, length of the arteriole, viscosity of the fluid

and radius of the tubeo Control mechanisms of arteriolar resistance including myogenic autoregulationo Distribution of blood supplyo Effect of hormones and neurotransmitters on resistance


Study unit 3.8: Cardiovascular control centre

Study Unit Theme

3.8.1 Baroreceptor reflex


Students should be able to explain and apply the baroreceptor reflex and orthostatic hypertension.

3.8.2 Other receptors influencing cardiovascular functions


Students should be able to explain and apply the effect of other receptors on cardiovascular function.



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Study unit 3.9: Exchange at capillaries

Study Unit Theme

3.9.1 Efficiency of gas exchange


Students should be able to:o Describe the importance of cross-sectional area of capillaries on the efficiency of exchangeo Explain and differentiate between diffusion and transcytosis

3.9.2 Bulk flow


Students should be able to:o Describe bulk flow

o Compare absorption to filtrationo Explain hydrostatic and colloid osmotic pressure and the effect thereof on exchangeo Calculate net pressure


Study unit 3.10: Lymphatic system

Study Unit Theme

3.10.1 Lymphatic system


Students should know and be able to explain the following:o Functions of the lymphatic systemo Composition and origin of lympho Importance of filtered fluid being returned to the circulationo Oedema and factors causing oedema


Documents

FLG 212 Study Guide