Functions 2
A.Y. 2024/2025
Learning objectives
Function I and II are two strictly related courses which, together, focus on the fundamental mechanisms of body functions. Both courses are organized around the central theme of homeostasis, i.e. how the body maintains the constancy of the internal environment needed for all cells and organs to function properly despite continuously changing external and internal demands.
By combining Physiology and Anatomy, Functions II provides students the functional organization of the nervous system in its somatic and autonomic components, the main principles of the endocrine function, the interplay between endocrine system and nervous system within the Hypothalamic-Hypophyseal axis, main endocrine glands and their role in homeostasis together with their specific functions related to non strictly homeostatic functions as reproduction and growth. The course will also address the skeletal and smooth muscle and the mechanisms adopted by the human body to maintain the homeostasis of the thermal regulation and within the complex biological response to stress and the general entrainment of the body functions with the environment within the circadian rhythmicity.
As a preliminary step, membrane potential and its determinants, synaptic communications, skeletal and smooth muscle contraction will be discussed in Functions I module.
Specifically Functions II Anatomy and Physiology will be integrated to address the anatomo-functional organization of the sensory system from receptor along the ascending pathway to the higher centers, the modulation of the sensory information and motor systems organization and their interplay on the somatic and on the autonomic division of the nervous system, the special senses,
The anatomo-functional organization of spinal cord, brain stem. Thalamus, Hypothalamus and Cortex (archi, paleo and neo cortex)
During the course, the topics of the lectures will be reinforced and expanded by practical activities, problem-based learning, problem-based tutorials and seminars.
By combining Physiology and Anatomy, Functions II provides students the functional organization of the nervous system in its somatic and autonomic components, the main principles of the endocrine function, the interplay between endocrine system and nervous system within the Hypothalamic-Hypophyseal axis, main endocrine glands and their role in homeostasis together with their specific functions related to non strictly homeostatic functions as reproduction and growth. The course will also address the skeletal and smooth muscle and the mechanisms adopted by the human body to maintain the homeostasis of the thermal regulation and within the complex biological response to stress and the general entrainment of the body functions with the environment within the circadian rhythmicity.
As a preliminary step, membrane potential and its determinants, synaptic communications, skeletal and smooth muscle contraction will be discussed in Functions I module.
Specifically Functions II Anatomy and Physiology will be integrated to address the anatomo-functional organization of the sensory system from receptor along the ascending pathway to the higher centers, the modulation of the sensory information and motor systems organization and their interplay on the somatic and on the autonomic division of the nervous system, the special senses,
The anatomo-functional organization of spinal cord, brain stem. Thalamus, Hypothalamus and Cortex (archi, paleo and neo cortex)
During the course, the topics of the lectures will be reinforced and expanded by practical activities, problem-based learning, problem-based tutorials and seminars.
Expected learning outcomes
At the end of the course students are expected to achieve knowledge on the interaction and communication at the cellular, tissue, organ and system level in the organization of adaptive responses, on the anatomo-functional properties of the neural circuits subserving neurological functions and the interplay between nervous and endocrine system with the organs and systems to assure homeostasis
At the end of the course the students are expected to achieve knowledge on:
- the structure, metabolism and function of the nervous system and of the endocrine system and specifically:
- antomo-functional organization of the autonomic nervous system (successivamente definit come vegetative, quale usiamo?)
-anatomo-functional organization of the endocrine system
- anatomo-functional organization of the somatic nervous system
- anatomo-functional organization of the special senses
- computational analysis of the sensory information subserving the emergence of sensation, perception, motor control, body schema
- different degree of complexity of movement from reflex to voluntary movement
- anatomo-functional substrates of dexterity and phono-articulation
- sensorimotor integration in motor control
- associative cortices and cognitive functions
- anatomo-functional substrates of emotions
- anatomo-functional organization of the spinal cord, brain stem, diencephalon, telencephalon
- entrainment of the body functions with environment: circadian rhythms
- the dynamic integration of organs into apparatuses and the general functional control mechanisms in physiological conditions: thermal regulation and biological response to stress.
- Homeostasis of the interstitial fluid of the nervous system
- The changing brain: development, aging and plasticity
At the end of the course the students are expected to achieve knowledge on:
- the structure, metabolism and function of the nervous system and of the endocrine system and specifically:
- antomo-functional organization of the autonomic nervous system (successivamente definit come vegetative, quale usiamo?)
-anatomo-functional organization of the endocrine system
- anatomo-functional organization of the somatic nervous system
- anatomo-functional organization of the special senses
- computational analysis of the sensory information subserving the emergence of sensation, perception, motor control, body schema
- different degree of complexity of movement from reflex to voluntary movement
- anatomo-functional substrates of dexterity and phono-articulation
- sensorimotor integration in motor control
- associative cortices and cognitive functions
- anatomo-functional substrates of emotions
- anatomo-functional organization of the spinal cord, brain stem, diencephalon, telencephalon
- entrainment of the body functions with environment: circadian rhythms
- the dynamic integration of organs into apparatuses and the general functional control mechanisms in physiological conditions: thermal regulation and biological response to stress.
- Homeostasis of the interstitial fluid of the nervous system
- The changing brain: development, aging and plasticity
Lesson period: Second semester
Assessment methods: Esame
Assessment result: voto verbalizzato in trentesimi
Single course
This course cannot be attended as a single course. Please check our list of single courses to find the ones available for enrolment.
Course syllabus and organization
Single session
Responsible
Prerequisites for admission
Anatomy and Biochemistry requested for the admission to Functions II exam.
To understand the contents of FNC course, students must have the background knowledge acquired in Fundamentals of basic sciences, Cells, molecules and genes, Histology, Anatomy and Biochemistry courses.
To understand the contents of FNC course, students must have the background knowledge acquired in Fundamentals of basic sciences, Cells, molecules and genes, Histology, Anatomy and Biochemistry courses.
Assessment methods and Criteria
Student assessments is be based on a written test and on an oral exam.
The written tests (True or False statements) do not provide a mark, but simply allow students to take the oral exams, if passed (75% of correct answers). Once passed, the written test is kept valid.
The written test and the oral exams can be taken in different dates. The oral exam has two parts, one testing Neuroanatomy and one testing Physiology (all topics) , which should be passed in the same round.
The final mark will be given by the average of the oral exams marks, weighted by the number of credits of each module.
Registration to the exam through SIFA is mandatory.
The written tests (True or False statements) do not provide a mark, but simply allow students to take the oral exams, if passed (75% of correct answers). Once passed, the written test is kept valid.
The written test and the oral exams can be taken in different dates. The oral exam has two parts, one testing Neuroanatomy and one testing Physiology (all topics) , which should be passed in the same round.
The final mark will be given by the average of the oral exams marks, weighted by the number of credits of each module.
Registration to the exam through SIFA is mandatory.
Physiology
Course syllabus
LEARNING OBJECTIVES
DESCRIPTION:
Functions II course is devoted to understand the mechanisms adopted by the human body in order to perceive and adapt to the challenges induced by the interactions with the external environment. To this aim lectures will be focused on the nervous and the endocrine systems illustrating, in details, how these constantly interacting systems coordinate and regulate tissue and organ functions, in order to build up adaptation responses, from the most simple and involuntary reflex reactions to the most complex and behavioral motivational and emotional responses.
In order to optimize the interdisciplinary integration some of the topic will be presented with interdisciplinary lecture involving more than one discipline.
Prerequisite to this course is the knowledge of the mechanisms underlying the membrane excitability and communication between excitable cells discussed I Functions I course.
TOPIC 1 CONCEPT OF HOMEOSTASIS
Internal environment and the cell. Maintenance of the homeostasis and the role of endocrine and nervous system in Homeostasis
TOPIC 2: NERVOUS SYSTEM: DETECTION AND COMPUTATION OF THE RELEVANT STIMULI FROM EXTERNAL AND INTERNAL ENVIRONMENT
2a- The Somatosensory system: detection with stimuli interacting with body surface
Lectures will focus on the somatosensory system highlighting: 1) Functional basis of the receptors function in sensory transduction; 2) anatomy and functional properties of the sensory receptors belonging to the afferent somatosensory pathways; 3) distinction among the different sensory modalities and sensory fibers; 4) anatomo-functional description of the 4 main somatosensory modalities (touch, pain, thermal, proprioception); 5) processing of information in the different stations of the ascending pathways through the relay nuclei (projecting neurons, thalamus and cortex); 6) cortical organization of the sensory afferent information; 7) perceptual aspects and psychophysics of the sensory activation; 8) the relationships of the spinal somatosensory system with the trigeminal system.
2b- Special senses: monitoring the environment proximal and distal to the body
Lectures will focus on the special senses devoted to vision, hearing, balance, taste and smell. For each special sense lectures will discuss: 1) the underlying physical principles; 2) type of energy transduced and molecular mechanisms underlying energy transduction; 3) the anatomy of the peripheral sensory organ, the nerve/s conveying information, the central pathways to the cortex; 4) functional properties of the receptors, how the sensory information is processed along the entire pathways and the perceptual aspect related to the activation of the cortex.
2c- Interoception (the hidden sense): detection of major organs activity and body internal state.
Lectures will focus on interoceptive mechanisms highlighting: 1) Type of receptors in the viscera from which originates afferent signals; 2) processing of information in the different stations of the ascending interoceptive pathways through the relay nuclei (projecting neurons in the spinal cord, brainstem, thalamus and cortex); 3) cortical organization of the interoceptive afferent information.
TOPIC 3. THE NERVOUS SYSTEM: HOMEOSTATIC RESPONSES NEED HUMAN MOTION TO INTERACT WITH THE ENVIRONMENT
TOPIC 3a. The muscle and neural control of force recruitment
Lectures will focus on: 1) the structure of the skeletal muscle; 2) the biochemical processes underlying muscle contraction and force production; 3) motor units properties and the perfect match or the properties of the spinal motoneurons driving the muscle units; 4) the neural mechanism controlling force production; 5) Exercise and Incremental exercise test;
TOPIC 3b. Increasing complexity of human motion: reflexes and automatisms
Following an introduction on the hierarchical organization of the motor system, lectures will focus on the functions exerted by the spinal cord and specifically: reflexes and automatisms with particular regard to locomotion, its neural control and its biomechanical substrate.
TOPIC 3c. Increasing complexity of human motion: control of voluntary movement.
Lectures will focus on the anatomo-functional organization of the descending pathways controlling the voluntary movements and in particular on: 1) descending systems for the brainstem (tecto-, reticulo-, vestibulo-, rubro-spinal systems), their anatomy and functional properties and interaction with spinal motoneurons; 2) the corticospinal system, its anatomy and functional properties subserving the voluntary movement with specific regard to the acquisition of the human hand dexterity; 3) the corticobulbar tract and its control on brainstem descending systems and on cranial motor nuclei; 4) the extrapyramidal systems assisting corticospinal system in motor control: cerebellum and basal ganglia, their structure and function and interplay with motor descending pathways in motor control, their involvement in non-motor functions; 5) the prehension circuits as perfect example of sensorimotor integration needed for movement control.
TOPIC 3d. Increasing complexity of human motion: supporting voluntary movement
Lectures will focus on the neural mechanisms controlling posture, the main sensory systems involved and the main reflexes subserving postural control and specifically: 1) spinal control of posture; 2) visual control of posture; 3) vestibular control of posture; 5) vestibular reflexes contributing posture (vestibulo-ocular and vestibulo-spinal); 6) ocular movements and their involvement in movement control.
TOPIC 4 HOMEOSTASIS NEEDS TO MONITOR THE INTERNAL ENVIRONMENT AND CORRECT FOR DEVIATIONS FROM THE EXPECTATIONS
TOPIC 4a: The autonomic nervous system
Lectures will focus on 1) the general anatomo-functional organization of the autonomic (visceromotor) nervous system and its differences with somatic (somatomotor) nervous system; 2) historical aspects; 3) the different branches of the vegetative system (sympathetic, parasympathetic and enteric systems); 4) anatomo-functional criteria distinguishing the sympathetic and parasympathetic systems; 5) Central integration of vegetative functions; 6) examples of vegetative-mediated behaviors controlling cardiovascular, bladder and the gastrointestinal activities.
Topic 4b The Insular lobe (The hidden lobe)
The insular cortex is a wide region located within the later sulcus enclosing a posterior to anterior functional organization. Functional organization of the posterior insular cortex: integration between vestibular, acoustic and high-order somatosensory information. Functional organization of central insular cortex: integration of vegetative interoceptive afferents and its role as gustatory cortex. Functional organization of anterior insular cortex: controlling visceromotor output.
Topic 4c: The limbic system and emotions: a safety device?
Evolutionary models of emotions. Neural basis of emotional experience. Emotional disorders
TOPIC 4d: Blood-brain interactions and autonomic nervous system
Lectures will focus on the complex exchanges between the nervous tissue and the blood through the interstitial fluid and the cerebrospinal fluid. The vascularization of the brain, the blood-brain and blood-cerebrospinal fluid barriers will be discussed and the brain metabolism analyzed in details.
TOPIC 5: OVERVIEW OF THE ANATOMOFUNCTIONAL ORGANIZATION OF THE NERVOUS SYSTEMS
TOPIC 5a: From spinal cord to the cortex
Lectures will focus on the functional organization of the spinal cord white and grey matter, the brainstem, the dienchephalon, the anatomo-functional subdivision of the neocortex.
TOPIC6: HUMAN NEOCORTEX GOES BEYOND HOMEOSTHASIS: THE COGNITIVE FUNCTIONS
TOPIC6a: Evolution of the neocortex from unimodal to polymodal and
associative areas. Hemispheric dominance.
TOPIC6b: Neural basis of Visual Perception
TOPIC6c: Neural basis of Memory
TOPIC6d: Neural basis of Attention and Cognitive control
TOPIC6e. Neural basis of Language
TOPIC6f: Pathology of cognitive functions: principles of Neuropsychology.
TOPIC 7. HOMEOSTASIS NEEDS A WIRELESS SYSTEM FOR A LONG-TERM CONTROL
TOPIC 7a: The functional organization of the endocrine system: hormones
Organization of the endocrine system will be followed by lectures focusing on: 1) general concepts of hormones, their chemical classes and functions; control of endocrine function
TOPIC 7b: the interplay between brain and endocrine system through the hypothalamic-hypophysial axis;
TOPIC 7c: glands under pituitary control, the detailed analysis of the anterior and posterior pituitary systems and hormones; the anatomy and functions of the endocrine glands under pituitary control;
TOPIC 7d: glands independent from the pituitary control; the anatomy and functions of the endocrine glands under pituitary control;
TOPIC 7f: brain/endocrine interplay supporting growth and reproduction.
TOPIC 8: HOMEOSTASIS MAINTAINED WHEN WE SHAPE BODY FUNCTIONS ON THE ENVIRONMENTAL CHANGES
TOPIC 8a: Circadian rhythms and behavioral homeostatic responses
Lectures will focus on the higher level of organization of homeostatic responses, meaning the motivational states driving the instinctual behavior and the temporal organization of the physiological function driven by the suprachiasmatic nucleus in charge of timing the body functions to the changes of the environment assuring a perfect feedforward homeostatic control.
TOPIC 8b: Sleep and awake state
TOPIC 8b: Maintenance of body temperature and biological response to stress
EXPECTED LEARNING OUTCOMES
TOPIC 1 CONCEPT OF HOMEOSTASIS
The main concept of homeostasis; the concept of internal environment; interplay between external and internal environment through adaptive responses; the needed interplay among the different systems and organs to maintaining the stability of the main parameters of the internal environment assuring the cells life; the main mechanisms of homeostasis control; the different level of complexity of adaptive responses from reflexes to complex behavioral responses.
TOPIC 2: NERVOUS SYSTEM: DETECTION AND COMPUTATION OF THE RELEVANT STIMULI FROM EXTERNAL AND INTERNAL ENVIRONMENT
General features of afferent (sensory) pathways. Sensory modalities and sensory fibers classification. Structure and location of sensory receptors in relation to the transduction of different forms of energy, the location of sensory ganglia and the description of primary sensory neurons.
Somatosensory system
Medial and lateral division of the dorsal root as the origin of ascending pathways in the spinal cord: the conscious and unconscious pathways. Pathways of the anterolateral system: pain, touch and temperature. Dorsal column pathway: conscious proprioception and discriminative touch. Trigeminal pathway: information from the head. Pathways to the cerebellum: the non-conscious pathways of somatosensory information. Routes of visceral sensory information. Thalamic nuclei classification in relation to their target. Primary, secondary and higher-order somatosensory cortical areas. Overview: course and anatomic structures involved in the dorsal column pathway; course and anatomic structures involved in the anterolateral system; course and anatomic structures involved in the trigeminal pathway; course and anatomic structures involved in the solitary tract.
SENSE OF TOUCH. Receptive field, functional properties of fast and slow adapting mechanoreceptors in the skin. Processing of afferents through the dorsal column system to the sensory cortices. Cell properties and the functional organization of the primary sensory cortex. Mechanisms underlying the ability of coding of spatial characteristic of objects. Main psychophysical laws.
TEMPERATURE AND NOCICEPTION. Functional and adaptation properties of the thermal warm and cold receptors. Processing of thermal afferents through the anterolateral system to the sensory cortices. Functional properties of the specific, polymodal and silent nociceptors. Mechanisms underlying pain: acute vs slow pain, afferents processing in the dorsal horn and mechanisms underlying sensitization and hyperalgesia. Major ascending pathways mediating specific and diffuse pain, autonomic, endocrinal and emotional reactions. Non-opioid and opioid central mechanisms controlling pain.
PROPRIOCEPTION. limb position sense and kinesthesia. Functional and adaptation properties of joint receptors and the central coding of the angular excursion. Muscle spindles structure: afferent and efferent innervations; functional and adaptation properties. Golgi tendon organs' functional and adaptation properties of the and their afferent innervations. Role of the skin receptors as proprioceptors. Processing of proprioceptive information through ascending systems and the body schema representation in parietal cortex. Integration between somatosensory (tactile and proprioceptive) and visual modalities in the posterior parietal cortex. Mechanisms of somatosensory prediction in the posterior parietal lobe and their functional implication for feedforward control of movement.
Special senses.
SOUND: Wave pulses, periodic waves, sinusoidal waves. Main properties of waves (wavelength, amplitude, phase, velocity, frequency, polarization, energy, intensity). Fourier analysis for the decomposition of an arbitrary wave into sinusoidal components.
Define sound waves and their propagation. Basics of sound waves (speed of sound, intensity and other properties). Standing sound waves Doppler effect. Ultrasound waves. The ear as a physical instrument: functional role of the outer ear as acoustic filter. Standing waves. Functional role of the middle ear as mechanical transformer. Functional role of inner ear as spectrum analyzer. Anatomical overview of the three compartments of the ear: external, middle and inner. Structures of the middle ear relevant to sound transduction. Structure of the acoustic labyrinth: the cochlea and anatomy of acoustic pathway. Functional circuitry of acoustic signals. Function of the external ear. Function of the middle ear and reflexes. Function of the inner ear: cochlear mechano-electrical transduction. Neural processing of auditory input.
VISION (recall principle of phototransduction in FUNCTIONS I). Light: rays, waves or particles? Refraction, reflection and transmission. Lenses, image formation and magnification. Effects of the ray nature of light on vision: the eye as a compound lens. The eye as the "perfect" performance-limited detector: the retina and its "pixels". Effects of the wave nature of light on vision: diffraction and aberrations. Effects of the particle nature of light on vision: counting single photons. Organization of the eyeball: layers, chambers, dioptric devices. Extraocular muscles. Physiology of the lens of the eye, accommodation and common vision disorders. The inversion of the visual field in the retinal image.
Organization of the retina: a piece of brain in the periphery. Explain why the visible region of the sun spectrum works for vision. Role of rods and cones in the foveal and peripheral retina. Mechanisms underlying dark and light adaptation. Functional properties of the ganglion and bipolar cells: the center-surround organization of receptive fields. Neural processing of visual inputs: functional models in primary visual cortex. The "computational" differences between the foveal and the peripheral vision.
Course of the optic nerve, optic chiasm and its surrounding. Course of optic pathways and the anatomic structures involved in pupillary reflex. Medial and lateral component of the optic tract. Neuroanatomy of pathway of the lateral optic tract to the visual cortex: anatomy of the lateral geniculate body, optic radiation and visual cortex. Overview of transcortical pathways fed by visual cortex: visuomotor transformation and objects-face and space recognition. Mechanisms underlying color vision.
EQUILIBRIUM The vestibular labyrinth and vestibular pathways. Medial longitudinal fasciculus. Functional circuitry of vestibular signals. Receptors in the vestibular labyrinth: functional properties in mechano- electrical transduction. Movements eliciting complex pattern of vestibular stimulation: the macular system and the semicircular canals system.
TASTE AND OLFACTION Neuroanatomy of gustative and olfactory systems: anatomical structures and pathways. Odorants and how chemical stimuli are perceived and transformed. Molecular structure of olfactory receptors and associated signal transduction mechanisms. Signal transduction for odorants and processing of information in the olfactory system. Taste stimuli, taste receptors and signal transduction for perception of different tastes. Hormonal modulation of taste and interconnections between taste and smell. Regulatory mechanisms of taste information at peripheral taste organs. Functional interaction between taste and olfactory pathway in perception.
Interoception
Functional organization of the sensory domain of the autonomic nervous system: properties of the mechanoreceptors and chemosensory receptors innervating viscera and modalities of visceral perception. Visceral reflexes: slow and rapid visceral responses. Modulation of the sensory input form the internal environment and organs in their ascending system. Trager structures and central modulation. Nociception and visceral pain.
TOPIC 3: THE NERVOUS SYSTEM: HOMEOSTATIC RESPONSES NEED HUMAN MOTION TO INTERACT WITH THE ENVIRONMENT
Skeletal Muscle excitation. Neuromuscular junction, the end plate potential, the striate muscle action potential and the current-to-frequency coding. Muscle contraction. Chemical composition of skeletal muscle and its peculiarities. Structure and properties of key sarcomere proteins, their molecular arrangements and functional properties. Neuronal signals to skeletal muscle, the sliding filament model of muscle contraction, and the molecular mechanisms underlying muscle relaxation. Integration of skeletal muscle contraction and metabolism, and coordinated regulation. Role of myoglobin, phosphocreatine and glycogen metabolism during exercise. Key molecules and metabolic integrations in aerobic and anaerobic exercise. Role of muscle proteins in glucose homeostasis.
Neural control of force. The Motor Unit: innervation ratio in different muscles. Classification of three types of motor units and based on the functional properties of different muscular fibers. The motoneurons properties: synaptic current to frequency coding: the rate match. Neural mechanisms controlling muscular force: recruitment order of motor units, the size principle and tetanic activation. Role of agonist and antagonist muscles at joint level, the coordinated work of different muscles on skeletal joints and the role of muscles in determining joint stiffness.
Exercise. Cardiovascular and respiratory responses to physical exercise. Anaerobic threshold, respiratory compensation point and their measurement. The incremental exercise test as a diagnostic tool.
Overview of the hierarchical organization of motor system.
General concept of reflex. Reflex arc components: somatic and visceral reflexes in spinal cord/brain stem. Main spinal reflexes in adults and in neonates.
Locomotion. Spinal automatism: general neural network underlying automatic functions. Phases of human locomotion: sequence of muscle contraction required for stepping. Spinal rhythm generating system, the neural control of locomotion and the processes active in learning locomotion. Locomotion. Total work during human terrestrial locomotion partitioned in internal and external work. External work measured using a force platform. The inverted pendulum mechanism for walking and the bouncing ball mechanism for running. Mechanisms decreasing the energy requirements for walking and running.
Brain stem descending pathways and corticospinal system. Neuroanatomy of the descending pathways: the medial and lateral system. Origin and course of the pyramidal tract. Location of the primary and secondary motor areas. Structural features of the motor cortex. Pathways from the reticular formation, red nucleus, tectum and vestibular nuclei. Course and anatomic structures involved in the corticospinal tract. Course and the anatomic structures involved in the corticonuclear tract. Course and the anatomic structures involved in the tectospinal and reticulospinal tracts. Course and the anatomic structures involved in the rubrospinal and vestibulospinal tracts. Functional properties acquired during evolution by the cerebral cortex and the corticospinal tract. Role exerted by the brain stem descending pathways on spinal cord. Corticospinal influences on spinal cord machinery for movement control. Illustrate the relation between the sensation and movement and the descending control of afferent inputs to sensory cortex. Output functions of the motor cortices: primary, premotor and supplementary motor cortices. Cortical circuits underlying sensorimotor transformation: reaching and grasping.
Cerebellum. Anatomo-functional organization of the cerebellum into different regions. Origin of sensory inputs to cerebellum. Cerebellar output pathways. Content of the cerebellar peduncles. Microcircuitry of the cerebellar cortex. Course and anatomic structures involved in the spinocerebellar tract. Course and anatomic structures involved in the pontocerebellar and olivocerebellar tracts. Functional properties of the basic cerebellar circuit module: the simple spikes and complex spikes. Role exerted by the Spinocerebellum on body and limb movements: interaction with the vestibular system and with the spinal cord. Role exerted by the Cerebrocerebellum on the cortical motor program: interaction with the cortex.
Functional role of the afferents from the Inferior olive and the role of cerebellum in motor learning. Involvement of cerebellum in postural tone control.
Basal ganglia. Structures belonging to the basal ganglia circuitry. Inputs to the basal ganglia, outputs from the basal ganglia and intrinsic connections. Circuitry involving the corpus striatum. Course of the pallidofugal fibers and circuitry involving the substantia nigra. General outline of the four parallel channels passing through the basal ganglia. Functional properties of the basal ganglia-thalamocortical circuitry. Skeletomotor, the oculomotor, the prefrontal and the limbic circuit. Role of the basal ganglia in cognition, mood and non-motor behaviour.
Supporting voluntary movement
Ocular movements. Main mechanisms of gaze control: the mechanisms for gaze stabilization and the mechanisms for gaze shifting. Gaze stabilization mechanisms: the vestibulo-system and the optocinetc system. Gaze shifting mechanisms: the saccadic system and the smooth pursuit system. Vergence movements and the Hering's law of equal innervation.
Posture and its biomechanical constraints. Different components of the postural control: spinal, vestibular and visual components. Spinal mechanisms acting in postural control and the main role of the stretch reflex. Vestibular mechanisms acting in postural control: the vestibulospinal and tonic neck reflexes. Visual action in postural control: closed vs opened eyes, lateral shift of retinal images and optocinetic nistagmus.
TOPIC 4: HOMEOSTASIS NEEDS TO MONITOR THE INTERNAL ENVIRONMENT AND CORRECT FOR DEVIATIONS FROM THE EXPECTATIONS
The autonomous nervous system. General anatomo-functional organization of the vegetative (visceromotor) nervous system and its differences with somatic (somatomotor) nervous system; Organization of the autonomous nervous system in sub-systems and their functional roles (sympathetic, parasympathetic and enteric systems); anatomo-functional criteria distinguishing the sympathetic and parasympathetic systems; integration of vegetative functions and vegetative-mediated behaviors controlling cardiovascular, bladder and the gastrointestinal activities. The insular cortex is a wide region located within the later sulcus enclosing a posterior to anterior functional organization. Functional organization of the posterior insular cortex: integration between vestibular, acoustic and high-order somatosensory information. Functional organization of central insular cortex: integration of vegetative interoceptive afferents and its role as gustatory cortex. Functional organization of anterior insular cortex: controlling visceromotor output. The limbic system and its role as a hub of the neural network subserving emotions. Definition of emotional experiences. Basic emotions model. The Emotional Brain Circuitry. Emotional Regulation and Cognitive Reappraisal. Brain Regions Involved in Emotion Regulation. Emotional Memories. Rewards and Motivation. Emotional Disorders. Vascularization of the brain. Circle of Willis: anterior and posterior circulation. Course and territory of supply of the three main cerebral arteries and revise main functional areas of the cerebral cortex. Most important penetrating vessels and their territory of supply. The vascular supply to the brainstem and revise internal structure. Superficial and deep venous drainage of the cerebral hemispheres. Dura meningeal venous sinuses. Anastomoses between intra and extra-cranial circulations.
BBB and BCFB. Structure and functions of Blood- Brain Barrier. Blood and Cerebrospinal fluid (CSF) Barrier. Cerebrospinal Fluid: amount, composition, production, circulation, reabsorption and functions. Structural and functional relationships between the intracranial compartments and blood-brain and blood-CSF barriers. Interplay between the two barriers.
TOPIC 5: OVERVIEW OF THE ANATOMOFUNCTIONAL ORGANIZATION OF THE NERVOUS SYSTEMS
Anatomo-functional subdivision and internal organization of the spinal cord white and grey matter, the brain stem, the dienchephalon (Thalamus and Hypothalamus), the anatomo-functional subdivision of the neocortex. Anatomo-functional organization of the connecting systems and tracts: Association, Commissural and Projecting tracts.
TOPIC 6: HUMAN NEOCORTEX GOES BEYOND HOMEOSTHASIS: THE COGNITIVE FUNCTIONS AND HEMISPHERIC DOMINANCE
Functional organization of the different cortical areas: unimodal, polymodal or secondary areas and associative areas. Evolutionary development of the neocortex, from unimodal areas to its development into polymodal and associative regions. Contribution of neocortex
development to cognitive functions. Neural Basis of Visual Perception. From basic feature encoding to object identification. Ventral and
Dorsal pathways of visual perception. Pathology of Visual perception. Neural Basis of Memory. Neural processes involved in memory formation, storage, and retrieval. Distinction from Declarative and Procedural memory. Role of Hippocampus and neocortex. Standard model of memory. Multiple traces model of memory. Role of schemas in memory consolidation. Neural Basis of Attention and Cognitive Control. Cognitive model of attention. Neural basis of visuospatial attention. Working memory and inhibitory control. Pathology of Attentive
processes. Neural basis of language. Principles of neuropsychology and neuropsychological assessment. Difference and communication between the two hemispheres. Concept of hemispheric dominance in the human brain.
TOPIC 6: HOMEOSTASIS NEEDS A WIRELESS SYSTEM FOR A LONG-TERM CONTROL
Hormones. Hormones based on their chemical nature, mechanism of action, nature of action, effects on target cells. Transport of hormones in blood, their distribution, inactivation and clearance. Time course of hormone secretion: pulsatile vs episodic secretion. Feedback/feedforward mechanisms underlying hormonal secretion. Hypothalamus-hypophyseal axis. Hypothalamus and Posterior Pituitary gland as a neuroendocrine unit. Describe the Hypothalamus and Anterior Pituitary gland as a functional unit: the hypothalamus-hypophyseal portal system. Hypothalamic releasing and inhibiting hormones acting on the anterior pituitary gland. Mechanism underlying control of hormonal secretion. Action of the nervous and endocrine system in controlling body functions.
Anterior hypophysis hormones. Mechanism underlying control of Thyroid Gland trophism and hormonal secretion. Biological effect of Thyroid Hormones. Mechanism underlying control of Adrenal Gland trophism and hormonal secretion. Biological effect of adrenal gland hormones.
Growth. Complementary action of Thyroid and Adrenal gland hormones. Tissutal and metabolic events underlying physiological Growth. Factors affecting growth, the growth curves and growth rate at different ages. Events occurring in the skeletal growth. Growth Hormone production, its direct and indirect action by means of somatomedine and the regulation of GH secretion: role of GHRH, Somatostatin and IGFs. Role of the "permissive hormones" in growth: thyroid hormones, cortisol, insulin and gonadal hormones.
Reproduction. Hormonal control of male reproduction: maturation of male seminal cells and role of LH, FSH and testosterone in spermatogenesis. Functional properties of the male reproductive tract and of the accessory sex glands. Hormonal control of female reproduction: role of FSH, LH and ovarian estrogen and progesterone on the ovarian cycle and on the events occurring in the menstrual cycle. Feedback control of the hypothalamus-hypophysis-gonads axis on male and female, the puberty and GnRH activity. Physiological features of menopause. Principal pregnancy, parturition and post-pregnancy events.
TOPIC 7: HOMEOSTASIS MAINTAINED WHEN WE SHAPE BODY FUNCTIONS ON THE ENVIRONMENTAL CHANGES
Circadian rhythms. Circadian rhythms and nervous structure underlying them. Functional properties of the clock proteins and of the pineal gland (melatonin). Role of the suprachiasmatic nucleus in synchronization of biological rhythms with external environmental cues.
Hypothalamus. Functional partition of hypothalamus and its "driving" role of the hypothalamus in controlling the autonomic system. Introduction to the "driving" role of the hypothalamus in integrating endocrinal and autonomic functions with behaviour. Motivational states and their neural control.
EEG recording. Principle of EEG recording and EEG analysis. Correlation between the main cortical waves and the behavioral state. Free running recording vs evoked potentials and event related potentials.
Sleep. Classification of sleep and awake state based on the main physiological parameters Correlation of EEG-EMG and EOG and different sleep stages. Neural network underlying asleep vs awake state.
Internal core temperature. Balance between heat input and output to maintain body core temperature. Principles of heat exchange: radiation, conduction, convection and evaporation. "Sweating" as a regulated evaporative process. "Shivering" as primary involuntary mechanism of heat production. Role of blood flow in thermal regulation. Concept of "set point" and the role of the hypothalamus in thermal control. Fever vs Hyperthermia.
Definition of stress response and stressors. Pattern of reactions evoked by stressants. Role of sympathetic nervous system in stress. Role of hypothalamus-hypophysis-adrenal gland system in stress. Role of blood pressure in sustaining the stress response. Role of the hypothalamus in coordinating the response. Psychosocial stressors.
DESCRIPTION:
Functions II course is devoted to understand the mechanisms adopted by the human body in order to perceive and adapt to the challenges induced by the interactions with the external environment. To this aim lectures will be focused on the nervous and the endocrine systems illustrating, in details, how these constantly interacting systems coordinate and regulate tissue and organ functions, in order to build up adaptation responses, from the most simple and involuntary reflex reactions to the most complex and behavioral motivational and emotional responses.
In order to optimize the interdisciplinary integration some of the topic will be presented with interdisciplinary lecture involving more than one discipline.
Prerequisite to this course is the knowledge of the mechanisms underlying the membrane excitability and communication between excitable cells discussed I Functions I course.
TOPIC 1 CONCEPT OF HOMEOSTASIS
Internal environment and the cell. Maintenance of the homeostasis and the role of endocrine and nervous system in Homeostasis
TOPIC 2: NERVOUS SYSTEM: DETECTION AND COMPUTATION OF THE RELEVANT STIMULI FROM EXTERNAL AND INTERNAL ENVIRONMENT
2a- The Somatosensory system: detection with stimuli interacting with body surface
Lectures will focus on the somatosensory system highlighting: 1) Functional basis of the receptors function in sensory transduction; 2) anatomy and functional properties of the sensory receptors belonging to the afferent somatosensory pathways; 3) distinction among the different sensory modalities and sensory fibers; 4) anatomo-functional description of the 4 main somatosensory modalities (touch, pain, thermal, proprioception); 5) processing of information in the different stations of the ascending pathways through the relay nuclei (projecting neurons, thalamus and cortex); 6) cortical organization of the sensory afferent information; 7) perceptual aspects and psychophysics of the sensory activation; 8) the relationships of the spinal somatosensory system with the trigeminal system.
2b- Special senses: monitoring the environment proximal and distal to the body
Lectures will focus on the special senses devoted to vision, hearing, balance, taste and smell. For each special sense lectures will discuss: 1) the underlying physical principles; 2) type of energy transduced and molecular mechanisms underlying energy transduction; 3) the anatomy of the peripheral sensory organ, the nerve/s conveying information, the central pathways to the cortex; 4) functional properties of the receptors, how the sensory information is processed along the entire pathways and the perceptual aspect related to the activation of the cortex.
2c- Interoception (the hidden sense): detection of major organs activity and body internal state.
Lectures will focus on interoceptive mechanisms highlighting: 1) Type of receptors in the viscera from which originates afferent signals; 2) processing of information in the different stations of the ascending interoceptive pathways through the relay nuclei (projecting neurons in the spinal cord, brainstem, thalamus and cortex); 3) cortical organization of the interoceptive afferent information.
TOPIC 3. THE NERVOUS SYSTEM: HOMEOSTATIC RESPONSES NEED HUMAN MOTION TO INTERACT WITH THE ENVIRONMENT
TOPIC 3a. The muscle and neural control of force recruitment
Lectures will focus on: 1) the structure of the skeletal muscle; 2) the biochemical processes underlying muscle contraction and force production; 3) motor units properties and the perfect match or the properties of the spinal motoneurons driving the muscle units; 4) the neural mechanism controlling force production; 5) Exercise and Incremental exercise test;
TOPIC 3b. Increasing complexity of human motion: reflexes and automatisms
Following an introduction on the hierarchical organization of the motor system, lectures will focus on the functions exerted by the spinal cord and specifically: reflexes and automatisms with particular regard to locomotion, its neural control and its biomechanical substrate.
TOPIC 3c. Increasing complexity of human motion: control of voluntary movement.
Lectures will focus on the anatomo-functional organization of the descending pathways controlling the voluntary movements and in particular on: 1) descending systems for the brainstem (tecto-, reticulo-, vestibulo-, rubro-spinal systems), their anatomy and functional properties and interaction with spinal motoneurons; 2) the corticospinal system, its anatomy and functional properties subserving the voluntary movement with specific regard to the acquisition of the human hand dexterity; 3) the corticobulbar tract and its control on brainstem descending systems and on cranial motor nuclei; 4) the extrapyramidal systems assisting corticospinal system in motor control: cerebellum and basal ganglia, their structure and function and interplay with motor descending pathways in motor control, their involvement in non-motor functions; 5) the prehension circuits as perfect example of sensorimotor integration needed for movement control.
TOPIC 3d. Increasing complexity of human motion: supporting voluntary movement
Lectures will focus on the neural mechanisms controlling posture, the main sensory systems involved and the main reflexes subserving postural control and specifically: 1) spinal control of posture; 2) visual control of posture; 3) vestibular control of posture; 5) vestibular reflexes contributing posture (vestibulo-ocular and vestibulo-spinal); 6) ocular movements and their involvement in movement control.
TOPIC 4 HOMEOSTASIS NEEDS TO MONITOR THE INTERNAL ENVIRONMENT AND CORRECT FOR DEVIATIONS FROM THE EXPECTATIONS
TOPIC 4a: The autonomic nervous system
Lectures will focus on 1) the general anatomo-functional organization of the autonomic (visceromotor) nervous system and its differences with somatic (somatomotor) nervous system; 2) historical aspects; 3) the different branches of the vegetative system (sympathetic, parasympathetic and enteric systems); 4) anatomo-functional criteria distinguishing the sympathetic and parasympathetic systems; 5) Central integration of vegetative functions; 6) examples of vegetative-mediated behaviors controlling cardiovascular, bladder and the gastrointestinal activities.
Topic 4b The Insular lobe (The hidden lobe)
The insular cortex is a wide region located within the later sulcus enclosing a posterior to anterior functional organization. Functional organization of the posterior insular cortex: integration between vestibular, acoustic and high-order somatosensory information. Functional organization of central insular cortex: integration of vegetative interoceptive afferents and its role as gustatory cortex. Functional organization of anterior insular cortex: controlling visceromotor output.
Topic 4c: The limbic system and emotions: a safety device?
Evolutionary models of emotions. Neural basis of emotional experience. Emotional disorders
TOPIC 4d: Blood-brain interactions and autonomic nervous system
Lectures will focus on the complex exchanges between the nervous tissue and the blood through the interstitial fluid and the cerebrospinal fluid. The vascularization of the brain, the blood-brain and blood-cerebrospinal fluid barriers will be discussed and the brain metabolism analyzed in details.
TOPIC 5: OVERVIEW OF THE ANATOMOFUNCTIONAL ORGANIZATION OF THE NERVOUS SYSTEMS
TOPIC 5a: From spinal cord to the cortex
Lectures will focus on the functional organization of the spinal cord white and grey matter, the brainstem, the dienchephalon, the anatomo-functional subdivision of the neocortex.
TOPIC6: HUMAN NEOCORTEX GOES BEYOND HOMEOSTHASIS: THE COGNITIVE FUNCTIONS
TOPIC6a: Evolution of the neocortex from unimodal to polymodal and
associative areas. Hemispheric dominance.
TOPIC6b: Neural basis of Visual Perception
TOPIC6c: Neural basis of Memory
TOPIC6d: Neural basis of Attention and Cognitive control
TOPIC6e. Neural basis of Language
TOPIC6f: Pathology of cognitive functions: principles of Neuropsychology.
TOPIC 7. HOMEOSTASIS NEEDS A WIRELESS SYSTEM FOR A LONG-TERM CONTROL
TOPIC 7a: The functional organization of the endocrine system: hormones
Organization of the endocrine system will be followed by lectures focusing on: 1) general concepts of hormones, their chemical classes and functions; control of endocrine function
TOPIC 7b: the interplay between brain and endocrine system through the hypothalamic-hypophysial axis;
TOPIC 7c: glands under pituitary control, the detailed analysis of the anterior and posterior pituitary systems and hormones; the anatomy and functions of the endocrine glands under pituitary control;
TOPIC 7d: glands independent from the pituitary control; the anatomy and functions of the endocrine glands under pituitary control;
TOPIC 7f: brain/endocrine interplay supporting growth and reproduction.
TOPIC 8: HOMEOSTASIS MAINTAINED WHEN WE SHAPE BODY FUNCTIONS ON THE ENVIRONMENTAL CHANGES
TOPIC 8a: Circadian rhythms and behavioral homeostatic responses
Lectures will focus on the higher level of organization of homeostatic responses, meaning the motivational states driving the instinctual behavior and the temporal organization of the physiological function driven by the suprachiasmatic nucleus in charge of timing the body functions to the changes of the environment assuring a perfect feedforward homeostatic control.
TOPIC 8b: Sleep and awake state
TOPIC 8b: Maintenance of body temperature and biological response to stress
EXPECTED LEARNING OUTCOMES
TOPIC 1 CONCEPT OF HOMEOSTASIS
The main concept of homeostasis; the concept of internal environment; interplay between external and internal environment through adaptive responses; the needed interplay among the different systems and organs to maintaining the stability of the main parameters of the internal environment assuring the cells life; the main mechanisms of homeostasis control; the different level of complexity of adaptive responses from reflexes to complex behavioral responses.
TOPIC 2: NERVOUS SYSTEM: DETECTION AND COMPUTATION OF THE RELEVANT STIMULI FROM EXTERNAL AND INTERNAL ENVIRONMENT
General features of afferent (sensory) pathways. Sensory modalities and sensory fibers classification. Structure and location of sensory receptors in relation to the transduction of different forms of energy, the location of sensory ganglia and the description of primary sensory neurons.
Somatosensory system
Medial and lateral division of the dorsal root as the origin of ascending pathways in the spinal cord: the conscious and unconscious pathways. Pathways of the anterolateral system: pain, touch and temperature. Dorsal column pathway: conscious proprioception and discriminative touch. Trigeminal pathway: information from the head. Pathways to the cerebellum: the non-conscious pathways of somatosensory information. Routes of visceral sensory information. Thalamic nuclei classification in relation to their target. Primary, secondary and higher-order somatosensory cortical areas. Overview: course and anatomic structures involved in the dorsal column pathway; course and anatomic structures involved in the anterolateral system; course and anatomic structures involved in the trigeminal pathway; course and anatomic structures involved in the solitary tract.
SENSE OF TOUCH. Receptive field, functional properties of fast and slow adapting mechanoreceptors in the skin. Processing of afferents through the dorsal column system to the sensory cortices. Cell properties and the functional organization of the primary sensory cortex. Mechanisms underlying the ability of coding of spatial characteristic of objects. Main psychophysical laws.
TEMPERATURE AND NOCICEPTION. Functional and adaptation properties of the thermal warm and cold receptors. Processing of thermal afferents through the anterolateral system to the sensory cortices. Functional properties of the specific, polymodal and silent nociceptors. Mechanisms underlying pain: acute vs slow pain, afferents processing in the dorsal horn and mechanisms underlying sensitization and hyperalgesia. Major ascending pathways mediating specific and diffuse pain, autonomic, endocrinal and emotional reactions. Non-opioid and opioid central mechanisms controlling pain.
PROPRIOCEPTION. limb position sense and kinesthesia. Functional and adaptation properties of joint receptors and the central coding of the angular excursion. Muscle spindles structure: afferent and efferent innervations; functional and adaptation properties. Golgi tendon organs' functional and adaptation properties of the and their afferent innervations. Role of the skin receptors as proprioceptors. Processing of proprioceptive information through ascending systems and the body schema representation in parietal cortex. Integration between somatosensory (tactile and proprioceptive) and visual modalities in the posterior parietal cortex. Mechanisms of somatosensory prediction in the posterior parietal lobe and their functional implication for feedforward control of movement.
Special senses.
SOUND: Wave pulses, periodic waves, sinusoidal waves. Main properties of waves (wavelength, amplitude, phase, velocity, frequency, polarization, energy, intensity). Fourier analysis for the decomposition of an arbitrary wave into sinusoidal components.
Define sound waves and their propagation. Basics of sound waves (speed of sound, intensity and other properties). Standing sound waves Doppler effect. Ultrasound waves. The ear as a physical instrument: functional role of the outer ear as acoustic filter. Standing waves. Functional role of the middle ear as mechanical transformer. Functional role of inner ear as spectrum analyzer. Anatomical overview of the three compartments of the ear: external, middle and inner. Structures of the middle ear relevant to sound transduction. Structure of the acoustic labyrinth: the cochlea and anatomy of acoustic pathway. Functional circuitry of acoustic signals. Function of the external ear. Function of the middle ear and reflexes. Function of the inner ear: cochlear mechano-electrical transduction. Neural processing of auditory input.
VISION (recall principle of phototransduction in FUNCTIONS I). Light: rays, waves or particles? Refraction, reflection and transmission. Lenses, image formation and magnification. Effects of the ray nature of light on vision: the eye as a compound lens. The eye as the "perfect" performance-limited detector: the retina and its "pixels". Effects of the wave nature of light on vision: diffraction and aberrations. Effects of the particle nature of light on vision: counting single photons. Organization of the eyeball: layers, chambers, dioptric devices. Extraocular muscles. Physiology of the lens of the eye, accommodation and common vision disorders. The inversion of the visual field in the retinal image.
Organization of the retina: a piece of brain in the periphery. Explain why the visible region of the sun spectrum works for vision. Role of rods and cones in the foveal and peripheral retina. Mechanisms underlying dark and light adaptation. Functional properties of the ganglion and bipolar cells: the center-surround organization of receptive fields. Neural processing of visual inputs: functional models in primary visual cortex. The "computational" differences between the foveal and the peripheral vision.
Course of the optic nerve, optic chiasm and its surrounding. Course of optic pathways and the anatomic structures involved in pupillary reflex. Medial and lateral component of the optic tract. Neuroanatomy of pathway of the lateral optic tract to the visual cortex: anatomy of the lateral geniculate body, optic radiation and visual cortex. Overview of transcortical pathways fed by visual cortex: visuomotor transformation and objects-face and space recognition. Mechanisms underlying color vision.
EQUILIBRIUM The vestibular labyrinth and vestibular pathways. Medial longitudinal fasciculus. Functional circuitry of vestibular signals. Receptors in the vestibular labyrinth: functional properties in mechano- electrical transduction. Movements eliciting complex pattern of vestibular stimulation: the macular system and the semicircular canals system.
TASTE AND OLFACTION Neuroanatomy of gustative and olfactory systems: anatomical structures and pathways. Odorants and how chemical stimuli are perceived and transformed. Molecular structure of olfactory receptors and associated signal transduction mechanisms. Signal transduction for odorants and processing of information in the olfactory system. Taste stimuli, taste receptors and signal transduction for perception of different tastes. Hormonal modulation of taste and interconnections between taste and smell. Regulatory mechanisms of taste information at peripheral taste organs. Functional interaction between taste and olfactory pathway in perception.
Interoception
Functional organization of the sensory domain of the autonomic nervous system: properties of the mechanoreceptors and chemosensory receptors innervating viscera and modalities of visceral perception. Visceral reflexes: slow and rapid visceral responses. Modulation of the sensory input form the internal environment and organs in their ascending system. Trager structures and central modulation. Nociception and visceral pain.
TOPIC 3: THE NERVOUS SYSTEM: HOMEOSTATIC RESPONSES NEED HUMAN MOTION TO INTERACT WITH THE ENVIRONMENT
Skeletal Muscle excitation. Neuromuscular junction, the end plate potential, the striate muscle action potential and the current-to-frequency coding. Muscle contraction. Chemical composition of skeletal muscle and its peculiarities. Structure and properties of key sarcomere proteins, their molecular arrangements and functional properties. Neuronal signals to skeletal muscle, the sliding filament model of muscle contraction, and the molecular mechanisms underlying muscle relaxation. Integration of skeletal muscle contraction and metabolism, and coordinated regulation. Role of myoglobin, phosphocreatine and glycogen metabolism during exercise. Key molecules and metabolic integrations in aerobic and anaerobic exercise. Role of muscle proteins in glucose homeostasis.
Neural control of force. The Motor Unit: innervation ratio in different muscles. Classification of three types of motor units and based on the functional properties of different muscular fibers. The motoneurons properties: synaptic current to frequency coding: the rate match. Neural mechanisms controlling muscular force: recruitment order of motor units, the size principle and tetanic activation. Role of agonist and antagonist muscles at joint level, the coordinated work of different muscles on skeletal joints and the role of muscles in determining joint stiffness.
Exercise. Cardiovascular and respiratory responses to physical exercise. Anaerobic threshold, respiratory compensation point and their measurement. The incremental exercise test as a diagnostic tool.
Overview of the hierarchical organization of motor system.
General concept of reflex. Reflex arc components: somatic and visceral reflexes in spinal cord/brain stem. Main spinal reflexes in adults and in neonates.
Locomotion. Spinal automatism: general neural network underlying automatic functions. Phases of human locomotion: sequence of muscle contraction required for stepping. Spinal rhythm generating system, the neural control of locomotion and the processes active in learning locomotion. Locomotion. Total work during human terrestrial locomotion partitioned in internal and external work. External work measured using a force platform. The inverted pendulum mechanism for walking and the bouncing ball mechanism for running. Mechanisms decreasing the energy requirements for walking and running.
Brain stem descending pathways and corticospinal system. Neuroanatomy of the descending pathways: the medial and lateral system. Origin and course of the pyramidal tract. Location of the primary and secondary motor areas. Structural features of the motor cortex. Pathways from the reticular formation, red nucleus, tectum and vestibular nuclei. Course and anatomic structures involved in the corticospinal tract. Course and the anatomic structures involved in the corticonuclear tract. Course and the anatomic structures involved in the tectospinal and reticulospinal tracts. Course and the anatomic structures involved in the rubrospinal and vestibulospinal tracts. Functional properties acquired during evolution by the cerebral cortex and the corticospinal tract. Role exerted by the brain stem descending pathways on spinal cord. Corticospinal influences on spinal cord machinery for movement control. Illustrate the relation between the sensation and movement and the descending control of afferent inputs to sensory cortex. Output functions of the motor cortices: primary, premotor and supplementary motor cortices. Cortical circuits underlying sensorimotor transformation: reaching and grasping.
Cerebellum. Anatomo-functional organization of the cerebellum into different regions. Origin of sensory inputs to cerebellum. Cerebellar output pathways. Content of the cerebellar peduncles. Microcircuitry of the cerebellar cortex. Course and anatomic structures involved in the spinocerebellar tract. Course and anatomic structures involved in the pontocerebellar and olivocerebellar tracts. Functional properties of the basic cerebellar circuit module: the simple spikes and complex spikes. Role exerted by the Spinocerebellum on body and limb movements: interaction with the vestibular system and with the spinal cord. Role exerted by the Cerebrocerebellum on the cortical motor program: interaction with the cortex.
Functional role of the afferents from the Inferior olive and the role of cerebellum in motor learning. Involvement of cerebellum in postural tone control.
Basal ganglia. Structures belonging to the basal ganglia circuitry. Inputs to the basal ganglia, outputs from the basal ganglia and intrinsic connections. Circuitry involving the corpus striatum. Course of the pallidofugal fibers and circuitry involving the substantia nigra. General outline of the four parallel channels passing through the basal ganglia. Functional properties of the basal ganglia-thalamocortical circuitry. Skeletomotor, the oculomotor, the prefrontal and the limbic circuit. Role of the basal ganglia in cognition, mood and non-motor behaviour.
Supporting voluntary movement
Ocular movements. Main mechanisms of gaze control: the mechanisms for gaze stabilization and the mechanisms for gaze shifting. Gaze stabilization mechanisms: the vestibulo-system and the optocinetc system. Gaze shifting mechanisms: the saccadic system and the smooth pursuit system. Vergence movements and the Hering's law of equal innervation.
Posture and its biomechanical constraints. Different components of the postural control: spinal, vestibular and visual components. Spinal mechanisms acting in postural control and the main role of the stretch reflex. Vestibular mechanisms acting in postural control: the vestibulospinal and tonic neck reflexes. Visual action in postural control: closed vs opened eyes, lateral shift of retinal images and optocinetic nistagmus.
TOPIC 4: HOMEOSTASIS NEEDS TO MONITOR THE INTERNAL ENVIRONMENT AND CORRECT FOR DEVIATIONS FROM THE EXPECTATIONS
The autonomous nervous system. General anatomo-functional organization of the vegetative (visceromotor) nervous system and its differences with somatic (somatomotor) nervous system; Organization of the autonomous nervous system in sub-systems and their functional roles (sympathetic, parasympathetic and enteric systems); anatomo-functional criteria distinguishing the sympathetic and parasympathetic systems; integration of vegetative functions and vegetative-mediated behaviors controlling cardiovascular, bladder and the gastrointestinal activities. The insular cortex is a wide region located within the later sulcus enclosing a posterior to anterior functional organization. Functional organization of the posterior insular cortex: integration between vestibular, acoustic and high-order somatosensory information. Functional organization of central insular cortex: integration of vegetative interoceptive afferents and its role as gustatory cortex. Functional organization of anterior insular cortex: controlling visceromotor output. The limbic system and its role as a hub of the neural network subserving emotions. Definition of emotional experiences. Basic emotions model. The Emotional Brain Circuitry. Emotional Regulation and Cognitive Reappraisal. Brain Regions Involved in Emotion Regulation. Emotional Memories. Rewards and Motivation. Emotional Disorders. Vascularization of the brain. Circle of Willis: anterior and posterior circulation. Course and territory of supply of the three main cerebral arteries and revise main functional areas of the cerebral cortex. Most important penetrating vessels and their territory of supply. The vascular supply to the brainstem and revise internal structure. Superficial and deep venous drainage of the cerebral hemispheres. Dura meningeal venous sinuses. Anastomoses between intra and extra-cranial circulations.
BBB and BCFB. Structure and functions of Blood- Brain Barrier. Blood and Cerebrospinal fluid (CSF) Barrier. Cerebrospinal Fluid: amount, composition, production, circulation, reabsorption and functions. Structural and functional relationships between the intracranial compartments and blood-brain and blood-CSF barriers. Interplay between the two barriers.
TOPIC 5: OVERVIEW OF THE ANATOMOFUNCTIONAL ORGANIZATION OF THE NERVOUS SYSTEMS
Anatomo-functional subdivision and internal organization of the spinal cord white and grey matter, the brain stem, the dienchephalon (Thalamus and Hypothalamus), the anatomo-functional subdivision of the neocortex. Anatomo-functional organization of the connecting systems and tracts: Association, Commissural and Projecting tracts.
TOPIC 6: HUMAN NEOCORTEX GOES BEYOND HOMEOSTHASIS: THE COGNITIVE FUNCTIONS AND HEMISPHERIC DOMINANCE
Functional organization of the different cortical areas: unimodal, polymodal or secondary areas and associative areas. Evolutionary development of the neocortex, from unimodal areas to its development into polymodal and associative regions. Contribution of neocortex
development to cognitive functions. Neural Basis of Visual Perception. From basic feature encoding to object identification. Ventral and
Dorsal pathways of visual perception. Pathology of Visual perception. Neural Basis of Memory. Neural processes involved in memory formation, storage, and retrieval. Distinction from Declarative and Procedural memory. Role of Hippocampus and neocortex. Standard model of memory. Multiple traces model of memory. Role of schemas in memory consolidation. Neural Basis of Attention and Cognitive Control. Cognitive model of attention. Neural basis of visuospatial attention. Working memory and inhibitory control. Pathology of Attentive
processes. Neural basis of language. Principles of neuropsychology and neuropsychological assessment. Difference and communication between the two hemispheres. Concept of hemispheric dominance in the human brain.
TOPIC 6: HOMEOSTASIS NEEDS A WIRELESS SYSTEM FOR A LONG-TERM CONTROL
Hormones. Hormones based on their chemical nature, mechanism of action, nature of action, effects on target cells. Transport of hormones in blood, their distribution, inactivation and clearance. Time course of hormone secretion: pulsatile vs episodic secretion. Feedback/feedforward mechanisms underlying hormonal secretion. Hypothalamus-hypophyseal axis. Hypothalamus and Posterior Pituitary gland as a neuroendocrine unit. Describe the Hypothalamus and Anterior Pituitary gland as a functional unit: the hypothalamus-hypophyseal portal system. Hypothalamic releasing and inhibiting hormones acting on the anterior pituitary gland. Mechanism underlying control of hormonal secretion. Action of the nervous and endocrine system in controlling body functions.
Anterior hypophysis hormones. Mechanism underlying control of Thyroid Gland trophism and hormonal secretion. Biological effect of Thyroid Hormones. Mechanism underlying control of Adrenal Gland trophism and hormonal secretion. Biological effect of adrenal gland hormones.
Growth. Complementary action of Thyroid and Adrenal gland hormones. Tissutal and metabolic events underlying physiological Growth. Factors affecting growth, the growth curves and growth rate at different ages. Events occurring in the skeletal growth. Growth Hormone production, its direct and indirect action by means of somatomedine and the regulation of GH secretion: role of GHRH, Somatostatin and IGFs. Role of the "permissive hormones" in growth: thyroid hormones, cortisol, insulin and gonadal hormones.
Reproduction. Hormonal control of male reproduction: maturation of male seminal cells and role of LH, FSH and testosterone in spermatogenesis. Functional properties of the male reproductive tract and of the accessory sex glands. Hormonal control of female reproduction: role of FSH, LH and ovarian estrogen and progesterone on the ovarian cycle and on the events occurring in the menstrual cycle. Feedback control of the hypothalamus-hypophysis-gonads axis on male and female, the puberty and GnRH activity. Physiological features of menopause. Principal pregnancy, parturition and post-pregnancy events.
TOPIC 7: HOMEOSTASIS MAINTAINED WHEN WE SHAPE BODY FUNCTIONS ON THE ENVIRONMENTAL CHANGES
Circadian rhythms. Circadian rhythms and nervous structure underlying them. Functional properties of the clock proteins and of the pineal gland (melatonin). Role of the suprachiasmatic nucleus in synchronization of biological rhythms with external environmental cues.
Hypothalamus. Functional partition of hypothalamus and its "driving" role of the hypothalamus in controlling the autonomic system. Introduction to the "driving" role of the hypothalamus in integrating endocrinal and autonomic functions with behaviour. Motivational states and their neural control.
EEG recording. Principle of EEG recording and EEG analysis. Correlation between the main cortical waves and the behavioral state. Free running recording vs evoked potentials and event related potentials.
Sleep. Classification of sleep and awake state based on the main physiological parameters Correlation of EEG-EMG and EOG and different sleep stages. Neural network underlying asleep vs awake state.
Internal core temperature. Balance between heat input and output to maintain body core temperature. Principles of heat exchange: radiation, conduction, convection and evaporation. "Sweating" as a regulated evaporative process. "Shivering" as primary involuntary mechanism of heat production. Role of blood flow in thermal regulation. Concept of "set point" and the role of the hypothalamus in thermal control. Fever vs Hyperthermia.
Definition of stress response and stressors. Pattern of reactions evoked by stressants. Role of sympathetic nervous system in stress. Role of hypothalamus-hypophysis-adrenal gland system in stress. Role of blood pressure in sustaining the stress response. Role of the hypothalamus in coordinating the response. Psychosocial stressors.
Teaching methods
Synchronous learning: lectures, video conferences, problem-based learning and tutorials, case studies and practical activities. Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Teaching Resources
PHYSIOLOGY
· D Purves, GJ Augustine, D Fitzpatric, WC Hall, AS LaMantia, JO McNamara, LE White, NEUROSCIENCE (5th ed) Sinauer 2012. · E Kandel, T Jessell, J Schwartz, S Siegelbaum, AJ Hudspeth, PRINCIPLES OF NEURAL SCIENCE (5th ed) McGraw Hill 2012. SUPPLEMENTAL LEARNING MATERIAL: Additional material, in particular to online content, will be made available during the course
· D Purves, GJ Augustine, D Fitzpatric, WC Hall, AS LaMantia, JO McNamara, LE White, NEUROSCIENCE (5th ed) Sinauer 2012. · E Kandel, T Jessell, J Schwartz, S Siegelbaum, AJ Hudspeth, PRINCIPLES OF NEURAL SCIENCE (5th ed) McGraw Hill 2012. SUPPLEMENTAL LEARNING MATERIAL: Additional material, in particular to online content, will be made available during the course
Anatomy
Course syllabus
LEARNING OBJECTIVES
DESCRIPTION:
Functions II course is devoted to understand the mechanisms adopted by the human body in order to perceive and adapt to the challenges induced by the interactions with the external environment. To this aim lectures will be focused on the nervous and the endocrine systems illustrating, in details, how these constantly interacting systems coordinate and regulate tissue and organ functions, in order to build up adaptation responses, from the most simple and involuntary reflex reactions to the most complex and behavioral motivational and emotional responses.
In order to optimize the interdisciplinary integration some of the topic will be presented with interdisciplinary lecture involving more than one discipline.
Prerequisite to this course is the knowledge of the mechanisms underlying the membrane excitability and communication between excitable cells discussed I Functions I course.
TOPIC 1 CONCEPT OF HOMEOSTASIS
Internal environment and the cell. Maintenance of the homeostasis and the role of endocrine and nervous system in Homeostasis
TOPIC 2: NERVOUS SYSTEM: DETECTION AND COMPUTATION OF THE RELEVANT STIMULI FROM EXTERNAL AND INTERNAL ENVIRONMENT
2a- The Somatosensory system: detection with stimuli interacting with body surface
Lectures will focus on the somatosensory system highlighting: 1) Functional basis of the receptors function in sensory transduction; 2) anatomy and functional properties of the sensory receptors belonging to the afferent somatosensory pathways; 3) distinction among the different sensory modalities and sensory fibers; 4) anatomo-functional description of the 4 main somatosensory modalities (touch, pain, thermal, proprioception); 5) processing of information in the different stations of the ascending pathways through the relay nuclei (projecting neurons, thalamus and cortex); 6) cortical organization of the sensory afferent information; 7) perceptual aspects and psychophysics of the sensory activation; 8) the relationships of the spinal somatosensory system with the trigeminal system.
2b- Special senses: monitoring the environment proximal and distal to the body
Lectures will focus on the special senses devoted to vision, hearing, balance, taste and smell. For each special sense lectures will discuss: 1) the underlying physical principles; 2) type of energy transduced and molecular mechanisms underlying energy transduction; 3) the anatomy of the peripheral sensory organ, the nerve/s conveying information, the central pathways to the cortex; 4) functional properties of the receptors, how the sensory information is processed along the entire pathways and the perceptual aspect related to the activation of the cortex.
2c- Interoception (the hidden sense): detection of major organs activity and body internal state.
Lectures will focus on interoceptive mechanisms highlighting: 1) Type of receptors in the viscera from which originates afferent signals; 2) processing of information in the different stations of the ascending interoceptive pathways through the relay nuclei (projecting neurons in the spinal cord, brainstem, thalamus and cortex); 3) cortical organization of the interoceptive afferent information.
TOPIC 3. THE NERVOUS SYSTEM: HOMEOSTATIC RESPONSES NEED HUMAN MOTION TO INTERACT WITH THE ENVIRONMENT
TOPIC 3a. The muscle and neural control of force recruitment
Lectures will focus on: 1) the structure of the skeletal muscle; 2) the biochemical processes underlying muscle contraction and force production; 3) motor units properties and the perfect match or the properties of the spinal motoneurons driving the muscle units; 4) the neural mechanism controlling force production; 5) Exercise and Incremental exercise test;
TOPIC 3b. Increasing complexity of human motion: reflexes and automatisms
Following an introduction on the hierarchical organization of the motor system, lectures will focus on the functions exerted by the spinal cord and specifically: reflexes and automatisms with particular regard to locomotion, its neural control and its biomechanical substrate.
TOPIC 3c. Increasing complexity of human motion: control of voluntary movement.
Lectures will focus on the anatomo-functional organization of the descending pathways controlling the voluntary movements and in particular on: 1) descending systems for the brainstem (tecto-, reticulo-, vestibulo-, rubro-spinal systems), their anatomy and functional properties and interaction with spinal motoneurons; 2) the corticospinal system, its anatomy and functional properties subserving the voluntary movement with specific regard to the acquisition of the human hand dexterity; 3) the corticobulbar tract and its control on brainstem descending systems and on cranial motor nuclei; 4) the extrapyramidal systems assisting corticospinal system in motor control: cerebellum and basal ganglia, their structure and function and interplay with motor descending pathways in motor control, their involvement in non-motor functions; 5) the prehension circuits as perfect example of sensorimotor integration needed for movement control.
TOPIC 3d. Increasing complexity of human motion: supporting voluntary movement
Lectures will focus on the neural mechanisms controlling posture, the main sensory systems involved and the main reflexes subserving postural control and specifically: 1) spinal control of posture; 2) visual control of posture; 3) vestibular control of posture; 5) vestibular reflexes contributing posture (vestibulo-ocular and vestibulo-spinal); 6) ocular movements and their involvement in movement control.
TOPIC 4 HOMEOSTASIS NEEDS TO MONITOR THE INTERNAL ENVIRONMENT AND CORRECT FOR DEVIATIONS FROM THE EXPECTATIONS
TOPIC 4a: The autonomic nervous system
Lectures will focus on 1) the general anatomo-functional organization of the autonomic (visceromotor) nervous system and its differences with somatic (somatomotor) nervous system; 2) historical aspects; 3) the different branches of the vegetative system (sympathetic, parasympathetic and enteric systems); 4) anatomo-functional criteria distinguishing the sympathetic and parasympathetic systems; 5) Central integration of vegetative functions; 6) examples of vegetative-mediated behaviors controlling cardiovascular, bladder and the gastrointestinal activities.
Topic 4b The Insular lobe (The hidden lobe)
The insular cortex is a wide region located within the later sulcus enclosing a posterior to anterior functional organization. Functional organization of the posterior insular cortex: integration between vestibular, acoustic and high-order somatosensory information. Functional organization of central insular cortex: integration of vegetative interoceptive afferents and its role as gustatory cortex. Functional organization of anterior insular cortex: controlling visceromotor output.
Topic 4c: The limbic system and emotions: a safety device?
Evolutionary models of emotions. Neural basis of emotional experience. Emotional disorders
TOPIC 4d: Blood-brain interactions and autonomic nervous system
Lectures will focus on the complex exchanges between the nervous tissue and the blood through the interstitial fluid and the cerebrospinal fluid. The vascularization of the brain, the blood-brain and blood-cerebrospinal fluid barriers will be discussed and the brain metabolism analyzed in details.
TOPIC 5: OVERVIEW OF THE ANATOMOFUNCTIONAL ORGANIZATION OF THE NERVOUS SYSTEMS
TOPIC 5a: From spinal cord to the cortex
Lectures will focus on the functional organization of the spinal cord white and grey matter, the brainstem, the dienchephalon, the anatomo-functional subdivision of the neocortex.
TOPIC6: HUMAN NEOCORTEX GOES BEYOND HOMEOSTHASIS: THE COGNITIVE FUNCTIONS
TOPIC6a: Evolution of the neocortex from unimodal to polymodal and
associative areas. Hemispheric dominance.
TOPIC6b: Neural basis of Visual Perception
TOPIC6c: Neural basis of Memory
TOPIC6d: Neural basis of Attention and Cognitive control
TOPIC6e. Neural basis of Language
TOPIC6f: Pathology of cognitive functions: principles of Neuropsychology.
TOPIC 7. HOMEOSTASIS NEEDS A WIRELESS SYSTEM FOR A LONG-TERM CONTROL
TOPIC 7a: The functional organization of the endocrine system: hormones
Organization of the endocrine system will be followed by lectures focusing on: 1) general concepts of hormones, their chemical classes and functions; control of endocrine function
TOPIC 7b: the interplay between brain and endocrine system through the hypothalamic-hypophysial axis;
TOPIC 7c: glands under pituitary control, the detailed analysis of the anterior and posterior pituitary systems and hormones; the anatomy and functions of the endocrine glands under pituitary control;
TOPIC 7d: glands independent from the pituitary control; the anatomy and functions of the endocrine glands under pituitary control;
TOPIC 7f: brain/endocrine interplay supporting growth and reproduction.
TOPIC 8: HOMEOSTASIS MAINTAINED WHEN WE SHAPE BODY FUNCTIONS ON THE ENVIRONMENTAL CHANGES
TOPIC 8a: Circadian rhythms and behavioral homeostatic responses
Lectures will focus on the higher level of organization of homeostatic responses, meaning the motivational states driving the instinctual behavior and the temporal organization of the physiological function driven by the suprachiasmatic nucleus in charge of timing the body functions to the changes of the environment assuring a perfect feedforward homeostatic control.
TOPIC 8b: Sleep and awake state
TOPIC 8b: Maintenance of body temperature and biological response to stress
EXPECTED LEARNING OUTCOMES
TOPIC 1 CONCEPT OF HOMEOSTASIS
The main concept of homeostasis; the concept of internal environment; interplay between external and internal environment through adaptive responses; the needed interplay among the different systems and organs to maintaining the stability of the main parameters of the internal environment assuring the cells life; the main mechanisms of homeostasis control; the different level of complexity of adaptive responses from reflexes to complex behavioral responses.
TOPIC 2: NERVOUS SYSTEM: DETECTION AND COMPUTATION OF THE RELEVANT STIMULI FROM EXTERNAL AND INTERNAL ENVIRONMENT
General features of afferent (sensory) pathways. Sensory modalities and sensory fibers classification. Structure and location of sensory receptors in relation to the transduction of different forms of energy, the location of sensory ganglia and the description of primary sensory neurons.
Somatosensory system
Medial and lateral division of the dorsal root as the origin of ascending pathways in the spinal cord: the conscious and unconscious pathways. Pathways of the anterolateral system: pain, touch and temperature. Dorsal column pathway: conscious proprioception and discriminative touch. Trigeminal pathway: information from the head. Pathways to the cerebellum: the non-conscious pathways of somatosensory information. Routes of visceral sensory information. Thalamic nuclei classification in relation to their target. Primary, secondary and higher-order somatosensory cortical areas. Overview: course and anatomic structures involved in the dorsal column pathway; course and anatomic structures involved in the anterolateral system; course and anatomic structures involved in the trigeminal pathway; course and anatomic structures involved in the solitary tract.
SENSE OF TOUCH. Receptive field, functional properties of fast and slow adapting mechanoreceptors in the skin. Processing of afferents through the dorsal column system to the sensory cortices. Cell properties and the functional organization of the primary sensory cortex. Mechanisms underlying the ability of coding of spatial characteristic of objects. Main psychophysical laws.
TEMPERATURE AND NOCICEPTION. Functional and adaptation properties of the thermal warm and cold receptors. Processing of thermal afferents through the anterolateral system to the sensory cortices. Functional properties of the specific, polymodal and silent nociceptors. Mechanisms underlying pain: acute vs slow pain, afferents processing in the dorsal horn and mechanisms underlying sensitization and hyperalgesia. Major ascending pathways mediating specific and diffuse pain, autonomic, endocrinal and emotional reactions. Non-opioid and opioid central mechanisms controlling pain.
PROPRIOCEPTION. limb position sense and kinesthesia. Functional and adaptation properties of joint receptors and the central coding of the angular excursion. Muscle spindles structure: afferent and efferent innervations; functional and adaptation properties. Golgi tendon organs' functional and adaptation properties of the and their afferent innervations. Role of the skin receptors as proprioceptors. Processing of proprioceptive information through ascending systems and the body schema representation in parietal cortex. Integration between somatosensory (tactile and proprioceptive) and visual modalities in the posterior parietal cortex. Mechanisms of somatosensory prediction in the posterior parietal lobe and their functional implication for feedforward control of movement.
Special senses.
SOUND: Wave pulses, periodic waves, sinusoidal waves. Main properties of waves (wavelength, amplitude, phase, velocity, frequency, polarization, energy, intensity). Fourier analysis for the decomposition of an arbitrary wave into sinusoidal components.
Define sound waves and their propagation. Basics of sound waves (speed of sound, intensity and other properties). Standing sound waves Doppler effect. Ultrasound waves. The ear as a physical instrument: functional role of the outer ear as acoustic filter. Standing waves. Functional role of the middle ear as mechanical transformer. Functional role of inner ear as spectrum analyzer. Anatomical overview of the three compartments of the ear: external, middle and inner. Structures of the middle ear relevant to sound transduction. Structure of the acoustic labyrinth: the cochlea and anatomy of acoustic pathway. Functional circuitry of acoustic signals. Function of the external ear. Function of the middle ear and reflexes. Function of the inner ear: cochlear mechano-electrical transduction. Neural processing of auditory input.
VISION (recall principle of phototransduction in FUNCTIONS I). Light: rays, waves or particles? Refraction, reflection and transmission. Lenses, image formation and magnification. Effects of the ray nature of light on vision: the eye as a compound lens. The eye as the "perfect" performance-limited detector: the retina and its "pixels". Effects of the wave nature of light on vision: diffraction and aberrations. Effects of the particle nature of light on vision: counting single photons. Organization of the eyeball: layers, chambers, dioptric devices. Extraocular muscles. Physiology of the lens of the eye, accommodation and common vision disorders. The inversion of the visual field in the retinal image.
Organization of the retina: a piece of brain in the periphery. Explain why the visible region of the sun spectrum works for vision. Role of rods and cones in the foveal and peripheral retina. Mechanisms underlying dark and light adaptation. Functional properties of the ganglion and bipolar cells: the center-surround organization of receptive fields. Neural processing of visual inputs: functional models in primary visual cortex. The "computational" differences between the foveal and the peripheral vision.
Course of the optic nerve, optic chiasm and its surrounding. Course of optic pathways and the anatomic structures involved in pupillary reflex. Medial and lateral component of the optic tract. Neuroanatomy of pathway of the lateral optic tract to the visual cortex: anatomy of the lateral geniculate body, optic radiation and visual cortex. Overview of transcortical pathways fed by visual cortex: visuomotor transformation and objects-face and space recognition. Mechanisms underlying color vision.
EQUILIBRIUM The vestibular labyrinth and vestibular pathways. Medial longitudinal fasciculus. Functional circuitry of vestibular signals. Receptors in the vestibular labyrinth: functional properties in mechano- electrical transduction. Movements eliciting complex pattern of vestibular stimulation: the macular system and the semicircular canals system.
TASTE AND OLFACTION Neuroanatomy of gustative and olfactory systems: anatomical structures and pathways. Odorants and how chemical stimuli are perceived and transformed. Molecular structure of olfactory receptors and associated signal transduction mechanisms. Signal transduction for odorants and processing of information in the olfactory system. Taste stimuli, taste receptors and signal transduction for perception of different tastes. Hormonal modulation of taste and interconnections between taste and smell. Regulatory mechanisms of taste information at peripheral taste organs. Functional interaction between taste and olfactory pathway in perception.
Interoception
Functional organization of the sensory domain of the autonomic nervous system: properties of the mechanoreceptors and chemosensory receptors innervating viscera and modalities of visceral perception. Visceral reflexes: slow and rapid visceral responses. Modulation of the sensory input form the internal environment and organs in their ascending system. Trager structures and central modulation. Nociception and visceral pain.
TOPIC 3: THE NERVOUS SYSTEM: HOMEOSTATIC RESPONSES NEED HUMAN MOTION TO INTERACT WITH THE ENVIRONMENT
Skeletal Muscle excitation. Neuromuscular junction, the end plate potential, the striate muscle action potential and the current-to-frequency coding. Muscle contraction. Chemical composition of skeletal muscle and its peculiarities. Structure and properties of key sarcomere proteins, their molecular arrangements and functional properties. Neuronal signals to skeletal muscle, the sliding filament model of muscle contraction, and the molecular mechanisms underlying muscle relaxation. Integration of skeletal muscle contraction and metabolism, and coordinated regulation. Role of myoglobin, phosphocreatine and glycogen metabolism during exercise. Key molecules and metabolic integrations in aerobic and anaerobic exercise. Role of muscle proteins in glucose homeostasis.
Neural control of force. The Motor Unit: innervation ratio in different muscles. Classification of three types of motor units and based on the functional properties of different muscular fibers. The motoneurons properties: synaptic current to frequency coding: the rate match. Neural mechanisms controlling muscular force: recruitment order of motor units, the size principle and tetanic activation. Role of agonist and antagonist muscles at joint level, the coordinated work of different muscles on skeletal joints and the role of muscles in determining joint stiffness.
Exercise. Cardiovascular and respiratory responses to physical exercise. Anaerobic threshold, respiratory compensation point and their measurement. The incremental exercise test as a diagnostic tool.
Overview of the hierarchical organization of motor system.
General concept of reflex. Reflex arc components: somatic and visceral reflexes in spinal cord/brain stem. Main spinal reflexes in adults and in neonates.
Locomotion. Spinal automatism: general neural network underlying automatic functions. Phases of human locomotion: sequence of muscle contraction required for stepping. Spinal rhythm generating system, the neural control of locomotion and the processes active in learning locomotion. Locomotion. Total work during human terrestrial locomotion partitioned in internal and external work. External work measured using a force platform. The inverted pendulum mechanism for walking and the bouncing ball mechanism for running. Mechanisms decreasing the energy requirements for walking and running.
Brain stem descending pathways and corticospinal system. Neuroanatomy of the descending pathways: the medial and lateral system. Origin and course of the pyramidal tract. Location of the primary and secondary motor areas. Structural features of the motor cortex. Pathways from the reticular formation, red nucleus, tectum and vestibular nuclei. Course and anatomic structures involved in the corticospinal tract. Course and the anatomic structures involved in the corticonuclear tract. Course and the anatomic structures involved in the tectospinal and reticulospinal tracts. Course and the anatomic structures involved in the rubrospinal and vestibulospinal tracts. Functional properties acquired during evolution by the cerebral cortex and the corticospinal tract. Role exerted by the brain stem descending pathways on spinal cord. Corticospinal influences on spinal cord machinery for movement control. Illustrate the relation between the sensation and movement and the descending control of afferent inputs to sensory cortex. Output functions of the motor cortices: primary, premotor and supplementary motor cortices. Cortical circuits underlying sensorimotor transformation: reaching and grasping.
Cerebellum. Anatomo-functional organization of the cerebellum into different regions. Origin of sensory inputs to cerebellum. Cerebellar output pathways. Content of the cerebellar peduncles. Microcircuitry of the cerebellar cortex. Course and anatomic structures involved in the spinocerebellar tract. Course and anatomic structures involved in the pontocerebellar and olivocerebellar tracts. Functional properties of the basic cerebellar circuit module: the simple spikes and complex spikes. Role exerted by the Spinocerebellum on body and limb movements: interaction with the vestibular system and with the spinal cord. Role exerted by the Cerebrocerebellum on the cortical motor program: interaction with the cortex.
Functional role of the afferents from the Inferior olive and the role of cerebellum in motor learning. Involvement of cerebellum in postural tone control.
Basal ganglia. Structures belonging to the basal ganglia circuitry. Inputs to the basal ganglia, outputs from the basal ganglia and intrinsic connections. Circuitry involving the corpus striatum. Course of the pallidofugal fibers and circuitry involving the substantia nigra. General outline of the four parallel channels passing through the basal ganglia. Functional properties of the basal ganglia-thalamocortical circuitry. Skeletomotor, the oculomotor, the prefrontal and the limbic circuit. Role of the basal ganglia in cognition, mood and non-motor behaviour.
Supporting voluntary movement
Ocular movements. Main mechanisms of gaze control: the mechanisms for gaze stabilization and the mechanisms for gaze shifting. Gaze stabilization mechanisms: the vestibulo-system and the optocinetc system. Gaze shifting mechanisms: the saccadic system and the smooth pursuit system. Vergence movements and the Hering's law of equal innervation.
Posture and its biomechanical constraints. Different components of the postural control: spinal, vestibular and visual components. Spinal mechanisms acting in postural control and the main role of the stretch reflex. Vestibular mechanisms acting in postural control: the vestibulospinal and tonic neck reflexes. Visual action in postural control: closed vs opened eyes, lateral shift of retinal images and optocinetic nistagmus.
TOPIC 4: HOMEOSTASIS NEEDS TO MONITOR THE INTERNAL ENVIRONMENT AND CORRECT FOR DEVIATIONS FROM THE EXPECTATIONS
The autonomous nervous system. General anatomo-functional organization of the vegetative (visceromotor) nervous system and its differences with somatic (somatomotor) nervous system; Organization of the autonomous nervous system in sub-systems and their functional roles (sympathetic, parasympathetic and enteric systems); anatomo-functional criteria distinguishing the sympathetic and parasympathetic systems; integration of vegetative functions and vegetative-mediated behaviors controlling cardiovascular, bladder and the gastrointestinal activities. The insular cortex is a wide region located within the later sulcus enclosing a posterior to anterior functional organization. Functional organization of the posterior insular cortex: integration between vestibular, acoustic and high-order somatosensory information. Functional organization of central insular cortex: integration of vegetative interoceptive afferents and its role as gustatory cortex. Functional organization of anterior insular cortex: controlling visceromotor output. The limbic system and its role as a hub of the neural network subserving emotions. Definition of emotional experiences. Basic emotions model. The Emotional Brain Circuitry. Emotional Regulation and Cognitive Reappraisal. Brain Regions Involved in Emotion Regulation. Emotional Memories. Rewards and Motivation. Emotional Disorders. Vascularization of the brain. Circle of Willis: anterior and posterior circulation. Course and territory of supply of the three main cerebral arteries and revise main functional areas of the cerebral cortex. Most important penetrating vessels and their territory of supply. The vascular supply to the brainstem and revise internal structure. Superficial and deep venous drainage of the cerebral hemispheres. Dura meningeal venous sinuses. Anastomoses between intra and extra-cranial circulations.
BBB and BCFB. Structure and functions of Blood- Brain Barrier. Blood and Cerebrospinal fluid (CSF) Barrier. Cerebrospinal Fluid: amount, composition, production, circulation, reabsorption and functions. Structural and functional relationships between the intracranial compartments and blood-brain and blood-CSF barriers. Interplay between the two barriers.
TOPIC 5: OVERVIEW OF THE ANATOMOFUNCTIONAL ORGANIZATION OF THE NERVOUS SYSTEMS
Anatomo-functional subdivision and internal organization of the spinal cord white and grey matter, the brain stem, the dienchephalon (Thalamus and Hypothalamus), the anatomo-functional subdivision of the neocortex. Anatomo-functional organization of the connecting systems and tracts: Association, Commissural and Projecting tracts.
TOPIC 6: HUMAN NEOCORTEX GOES BEYOND HOMEOSTHASIS: THE COGNITIVE FUNCTIONS AND HEMISPHERIC DOMINANCE
Functional organization of the different cortical areas: unimodal, polymodal or secondary areas and associative areas. Evolutionary development of the neocortex, from unimodal areas to its development into polymodal and associative regions. Contribution of neocortex
development to cognitive functions. Neural Basis of Visual Perception. From basic feature encoding to object identification. Ventral and
Dorsal pathways of visual perception. Pathology of Visual perception. Neural Basis of Memory. Neural processes involved in memory formation, storage, and retrieval. Distinction from Declarative and Procedural memory. Role of Hippocampus and neocortex. Standard model of memory. Multiple traces model of memory. Role of schemas in memory consolidation. Neural Basis of Attention and Cognitive Control. Cognitive model of attention. Neural basis of visuospatial attention. Working memory and inhibitory control. Pathology of Attentive
processes. Neural basis of language. Principles of neuropsychology and neuropsychological assessment. Difference and communication between the two hemispheres. Concept of hemispheric dominance in the human brain.
TOPIC 6: HOMEOSTASIS NEEDS A WIRELESS SYSTEM FOR A LONG-TERM CONTROL
Hormones. Hormones based on their chemical nature, mechanism of action, nature of action, effects on target cells. Transport of hormones in blood, their distribution, inactivation and clearance. Time course of hormone secretion: pulsatile vs episodic secretion. Feedback/feedforward mechanisms underlying hormonal secretion. Hypothalamus-hypophyseal axis. Hypothalamus and Posterior Pituitary gland as a neuroendocrine unit. Describe the Hypothalamus and Anterior Pituitary gland as a functional unit: the hypothalamus-hypophyseal portal system. Hypothalamic releasing and inhibiting hormones acting on the anterior pituitary gland. Mechanism underlying control of hormonal secretion. Action of the nervous and endocrine system in controlling body functions.
Anterior hypophysis hormones. Mechanism underlying control of Thyroid Gland trophism and hormonal secretion. Biological effect of Thyroid Hormones. Mechanism underlying control of Adrenal Gland trophism and hormonal secretion. Biological effect of adrenal gland hormones.
Growth. Complementary action of Thyroid and Adrenal gland hormones. Tissutal and metabolic events underlying physiological Growth. Factors affecting growth, the growth curves and growth rate at different ages. Events occurring in the skeletal growth. Growth Hormone production, its direct and indirect action by means of somatomedine and the regulation of GH secretion: role of GHRH, Somatostatin and IGFs. Role of the "permissive hormones" in growth: thyroid hormones, cortisol, insulin and gonadal hormones.
Reproduction. Hormonal control of male reproduction: maturation of male seminal cells and role of LH, FSH and testosterone in spermatogenesis. Functional properties of the male reproductive tract and of the accessory sex glands. Hormonal control of female reproduction: role of FSH, LH and ovarian estrogen and progesterone on the ovarian cycle and on the events occurring in the menstrual cycle. Feedback control of the hypothalamus-hypophysis-gonads axis on male and female, the puberty and GnRH activity. Physiological features of menopause. Principal pregnancy, parturition and post-pregnancy events.
TOPIC 7: HOMEOSTASIS MAINTAINED WHEN WE SHAPE BODY FUNCTIONS ON THE ENVIRONMENTAL CHANGES
Circadian rhythms. Circadian rhythms and nervous structure underlying them. Functional properties of the clock proteins and of the pineal gland (melatonin). Role of the suprachiasmatic nucleus in synchronization of biological rhythms with external environmental cues.
Hypothalamus. Functional partition of hypothalamus and its "driving" role of the hypothalamus in controlling the autonomic system. Introduction to the "driving" role of the hypothalamus in integrating endocrinal and autonomic functions with behaviour. Motivational states and their neural control.
EEG recording. Principle of EEG recording and EEG analysis. Correlation between the main cortical waves and the behavioral state. Free running recording vs evoked potentials and event related potentials.
Sleep. Classification of sleep and awake state based on the main physiological parameters Correlation of EEG-EMG and EOG and different sleep stages. Neural network underlying asleep vs awake state.
Internal core temperature. Balance between heat input and output to maintain body core temperature. Principles of heat exchange: radiation, conduction, convection and evaporation. "Sweating" as a regulated evaporative process. "Shivering" as primary involuntary mechanism of heat production. Role of blood flow in thermal regulation. Concept of "set point" and the role of the hypothalamus in thermal control. Fever vs Hyperthermia.
Definition of stress response and stressors. Pattern of reactions evoked by stressants. Role of sympathetic nervous system in stress. Role of hypothalamus-hypophysis-adrenal gland system in stress. Role of blood pressure in sustaining the stress response. Role of the hypothalamus in coordinating the response. Psychosocial stressors.
DESCRIPTION:
Functions II course is devoted to understand the mechanisms adopted by the human body in order to perceive and adapt to the challenges induced by the interactions with the external environment. To this aim lectures will be focused on the nervous and the endocrine systems illustrating, in details, how these constantly interacting systems coordinate and regulate tissue and organ functions, in order to build up adaptation responses, from the most simple and involuntary reflex reactions to the most complex and behavioral motivational and emotional responses.
In order to optimize the interdisciplinary integration some of the topic will be presented with interdisciplinary lecture involving more than one discipline.
Prerequisite to this course is the knowledge of the mechanisms underlying the membrane excitability and communication between excitable cells discussed I Functions I course.
TOPIC 1 CONCEPT OF HOMEOSTASIS
Internal environment and the cell. Maintenance of the homeostasis and the role of endocrine and nervous system in Homeostasis
TOPIC 2: NERVOUS SYSTEM: DETECTION AND COMPUTATION OF THE RELEVANT STIMULI FROM EXTERNAL AND INTERNAL ENVIRONMENT
2a- The Somatosensory system: detection with stimuli interacting with body surface
Lectures will focus on the somatosensory system highlighting: 1) Functional basis of the receptors function in sensory transduction; 2) anatomy and functional properties of the sensory receptors belonging to the afferent somatosensory pathways; 3) distinction among the different sensory modalities and sensory fibers; 4) anatomo-functional description of the 4 main somatosensory modalities (touch, pain, thermal, proprioception); 5) processing of information in the different stations of the ascending pathways through the relay nuclei (projecting neurons, thalamus and cortex); 6) cortical organization of the sensory afferent information; 7) perceptual aspects and psychophysics of the sensory activation; 8) the relationships of the spinal somatosensory system with the trigeminal system.
2b- Special senses: monitoring the environment proximal and distal to the body
Lectures will focus on the special senses devoted to vision, hearing, balance, taste and smell. For each special sense lectures will discuss: 1) the underlying physical principles; 2) type of energy transduced and molecular mechanisms underlying energy transduction; 3) the anatomy of the peripheral sensory organ, the nerve/s conveying information, the central pathways to the cortex; 4) functional properties of the receptors, how the sensory information is processed along the entire pathways and the perceptual aspect related to the activation of the cortex.
2c- Interoception (the hidden sense): detection of major organs activity and body internal state.
Lectures will focus on interoceptive mechanisms highlighting: 1) Type of receptors in the viscera from which originates afferent signals; 2) processing of information in the different stations of the ascending interoceptive pathways through the relay nuclei (projecting neurons in the spinal cord, brainstem, thalamus and cortex); 3) cortical organization of the interoceptive afferent information.
TOPIC 3. THE NERVOUS SYSTEM: HOMEOSTATIC RESPONSES NEED HUMAN MOTION TO INTERACT WITH THE ENVIRONMENT
TOPIC 3a. The muscle and neural control of force recruitment
Lectures will focus on: 1) the structure of the skeletal muscle; 2) the biochemical processes underlying muscle contraction and force production; 3) motor units properties and the perfect match or the properties of the spinal motoneurons driving the muscle units; 4) the neural mechanism controlling force production; 5) Exercise and Incremental exercise test;
TOPIC 3b. Increasing complexity of human motion: reflexes and automatisms
Following an introduction on the hierarchical organization of the motor system, lectures will focus on the functions exerted by the spinal cord and specifically: reflexes and automatisms with particular regard to locomotion, its neural control and its biomechanical substrate.
TOPIC 3c. Increasing complexity of human motion: control of voluntary movement.
Lectures will focus on the anatomo-functional organization of the descending pathways controlling the voluntary movements and in particular on: 1) descending systems for the brainstem (tecto-, reticulo-, vestibulo-, rubro-spinal systems), their anatomy and functional properties and interaction with spinal motoneurons; 2) the corticospinal system, its anatomy and functional properties subserving the voluntary movement with specific regard to the acquisition of the human hand dexterity; 3) the corticobulbar tract and its control on brainstem descending systems and on cranial motor nuclei; 4) the extrapyramidal systems assisting corticospinal system in motor control: cerebellum and basal ganglia, their structure and function and interplay with motor descending pathways in motor control, their involvement in non-motor functions; 5) the prehension circuits as perfect example of sensorimotor integration needed for movement control.
TOPIC 3d. Increasing complexity of human motion: supporting voluntary movement
Lectures will focus on the neural mechanisms controlling posture, the main sensory systems involved and the main reflexes subserving postural control and specifically: 1) spinal control of posture; 2) visual control of posture; 3) vestibular control of posture; 5) vestibular reflexes contributing posture (vestibulo-ocular and vestibulo-spinal); 6) ocular movements and their involvement in movement control.
TOPIC 4 HOMEOSTASIS NEEDS TO MONITOR THE INTERNAL ENVIRONMENT AND CORRECT FOR DEVIATIONS FROM THE EXPECTATIONS
TOPIC 4a: The autonomic nervous system
Lectures will focus on 1) the general anatomo-functional organization of the autonomic (visceromotor) nervous system and its differences with somatic (somatomotor) nervous system; 2) historical aspects; 3) the different branches of the vegetative system (sympathetic, parasympathetic and enteric systems); 4) anatomo-functional criteria distinguishing the sympathetic and parasympathetic systems; 5) Central integration of vegetative functions; 6) examples of vegetative-mediated behaviors controlling cardiovascular, bladder and the gastrointestinal activities.
Topic 4b The Insular lobe (The hidden lobe)
The insular cortex is a wide region located within the later sulcus enclosing a posterior to anterior functional organization. Functional organization of the posterior insular cortex: integration between vestibular, acoustic and high-order somatosensory information. Functional organization of central insular cortex: integration of vegetative interoceptive afferents and its role as gustatory cortex. Functional organization of anterior insular cortex: controlling visceromotor output.
Topic 4c: The limbic system and emotions: a safety device?
Evolutionary models of emotions. Neural basis of emotional experience. Emotional disorders
TOPIC 4d: Blood-brain interactions and autonomic nervous system
Lectures will focus on the complex exchanges between the nervous tissue and the blood through the interstitial fluid and the cerebrospinal fluid. The vascularization of the brain, the blood-brain and blood-cerebrospinal fluid barriers will be discussed and the brain metabolism analyzed in details.
TOPIC 5: OVERVIEW OF THE ANATOMOFUNCTIONAL ORGANIZATION OF THE NERVOUS SYSTEMS
TOPIC 5a: From spinal cord to the cortex
Lectures will focus on the functional organization of the spinal cord white and grey matter, the brainstem, the dienchephalon, the anatomo-functional subdivision of the neocortex.
TOPIC6: HUMAN NEOCORTEX GOES BEYOND HOMEOSTHASIS: THE COGNITIVE FUNCTIONS
TOPIC6a: Evolution of the neocortex from unimodal to polymodal and
associative areas. Hemispheric dominance.
TOPIC6b: Neural basis of Visual Perception
TOPIC6c: Neural basis of Memory
TOPIC6d: Neural basis of Attention and Cognitive control
TOPIC6e. Neural basis of Language
TOPIC6f: Pathology of cognitive functions: principles of Neuropsychology.
TOPIC 7. HOMEOSTASIS NEEDS A WIRELESS SYSTEM FOR A LONG-TERM CONTROL
TOPIC 7a: The functional organization of the endocrine system: hormones
Organization of the endocrine system will be followed by lectures focusing on: 1) general concepts of hormones, their chemical classes and functions; control of endocrine function
TOPIC 7b: the interplay between brain and endocrine system through the hypothalamic-hypophysial axis;
TOPIC 7c: glands under pituitary control, the detailed analysis of the anterior and posterior pituitary systems and hormones; the anatomy and functions of the endocrine glands under pituitary control;
TOPIC 7d: glands independent from the pituitary control; the anatomy and functions of the endocrine glands under pituitary control;
TOPIC 7f: brain/endocrine interplay supporting growth and reproduction.
TOPIC 8: HOMEOSTASIS MAINTAINED WHEN WE SHAPE BODY FUNCTIONS ON THE ENVIRONMENTAL CHANGES
TOPIC 8a: Circadian rhythms and behavioral homeostatic responses
Lectures will focus on the higher level of organization of homeostatic responses, meaning the motivational states driving the instinctual behavior and the temporal organization of the physiological function driven by the suprachiasmatic nucleus in charge of timing the body functions to the changes of the environment assuring a perfect feedforward homeostatic control.
TOPIC 8b: Sleep and awake state
TOPIC 8b: Maintenance of body temperature and biological response to stress
EXPECTED LEARNING OUTCOMES
TOPIC 1 CONCEPT OF HOMEOSTASIS
The main concept of homeostasis; the concept of internal environment; interplay between external and internal environment through adaptive responses; the needed interplay among the different systems and organs to maintaining the stability of the main parameters of the internal environment assuring the cells life; the main mechanisms of homeostasis control; the different level of complexity of adaptive responses from reflexes to complex behavioral responses.
TOPIC 2: NERVOUS SYSTEM: DETECTION AND COMPUTATION OF THE RELEVANT STIMULI FROM EXTERNAL AND INTERNAL ENVIRONMENT
General features of afferent (sensory) pathways. Sensory modalities and sensory fibers classification. Structure and location of sensory receptors in relation to the transduction of different forms of energy, the location of sensory ganglia and the description of primary sensory neurons.
Somatosensory system
Medial and lateral division of the dorsal root as the origin of ascending pathways in the spinal cord: the conscious and unconscious pathways. Pathways of the anterolateral system: pain, touch and temperature. Dorsal column pathway: conscious proprioception and discriminative touch. Trigeminal pathway: information from the head. Pathways to the cerebellum: the non-conscious pathways of somatosensory information. Routes of visceral sensory information. Thalamic nuclei classification in relation to their target. Primary, secondary and higher-order somatosensory cortical areas. Overview: course and anatomic structures involved in the dorsal column pathway; course and anatomic structures involved in the anterolateral system; course and anatomic structures involved in the trigeminal pathway; course and anatomic structures involved in the solitary tract.
SENSE OF TOUCH. Receptive field, functional properties of fast and slow adapting mechanoreceptors in the skin. Processing of afferents through the dorsal column system to the sensory cortices. Cell properties and the functional organization of the primary sensory cortex. Mechanisms underlying the ability of coding of spatial characteristic of objects. Main psychophysical laws.
TEMPERATURE AND NOCICEPTION. Functional and adaptation properties of the thermal warm and cold receptors. Processing of thermal afferents through the anterolateral system to the sensory cortices. Functional properties of the specific, polymodal and silent nociceptors. Mechanisms underlying pain: acute vs slow pain, afferents processing in the dorsal horn and mechanisms underlying sensitization and hyperalgesia. Major ascending pathways mediating specific and diffuse pain, autonomic, endocrinal and emotional reactions. Non-opioid and opioid central mechanisms controlling pain.
PROPRIOCEPTION. limb position sense and kinesthesia. Functional and adaptation properties of joint receptors and the central coding of the angular excursion. Muscle spindles structure: afferent and efferent innervations; functional and adaptation properties. Golgi tendon organs' functional and adaptation properties of the and their afferent innervations. Role of the skin receptors as proprioceptors. Processing of proprioceptive information through ascending systems and the body schema representation in parietal cortex. Integration between somatosensory (tactile and proprioceptive) and visual modalities in the posterior parietal cortex. Mechanisms of somatosensory prediction in the posterior parietal lobe and their functional implication for feedforward control of movement.
Special senses.
SOUND: Wave pulses, periodic waves, sinusoidal waves. Main properties of waves (wavelength, amplitude, phase, velocity, frequency, polarization, energy, intensity). Fourier analysis for the decomposition of an arbitrary wave into sinusoidal components.
Define sound waves and their propagation. Basics of sound waves (speed of sound, intensity and other properties). Standing sound waves Doppler effect. Ultrasound waves. The ear as a physical instrument: functional role of the outer ear as acoustic filter. Standing waves. Functional role of the middle ear as mechanical transformer. Functional role of inner ear as spectrum analyzer. Anatomical overview of the three compartments of the ear: external, middle and inner. Structures of the middle ear relevant to sound transduction. Structure of the acoustic labyrinth: the cochlea and anatomy of acoustic pathway. Functional circuitry of acoustic signals. Function of the external ear. Function of the middle ear and reflexes. Function of the inner ear: cochlear mechano-electrical transduction. Neural processing of auditory input.
VISION (recall principle of phototransduction in FUNCTIONS I). Light: rays, waves or particles? Refraction, reflection and transmission. Lenses, image formation and magnification. Effects of the ray nature of light on vision: the eye as a compound lens. The eye as the "perfect" performance-limited detector: the retina and its "pixels". Effects of the wave nature of light on vision: diffraction and aberrations. Effects of the particle nature of light on vision: counting single photons. Organization of the eyeball: layers, chambers, dioptric devices. Extraocular muscles. Physiology of the lens of the eye, accommodation and common vision disorders. The inversion of the visual field in the retinal image.
Organization of the retina: a piece of brain in the periphery. Explain why the visible region of the sun spectrum works for vision. Role of rods and cones in the foveal and peripheral retina. Mechanisms underlying dark and light adaptation. Functional properties of the ganglion and bipolar cells: the center-surround organization of receptive fields. Neural processing of visual inputs: functional models in primary visual cortex. The "computational" differences between the foveal and the peripheral vision.
Course of the optic nerve, optic chiasm and its surrounding. Course of optic pathways and the anatomic structures involved in pupillary reflex. Medial and lateral component of the optic tract. Neuroanatomy of pathway of the lateral optic tract to the visual cortex: anatomy of the lateral geniculate body, optic radiation and visual cortex. Overview of transcortical pathways fed by visual cortex: visuomotor transformation and objects-face and space recognition. Mechanisms underlying color vision.
EQUILIBRIUM The vestibular labyrinth and vestibular pathways. Medial longitudinal fasciculus. Functional circuitry of vestibular signals. Receptors in the vestibular labyrinth: functional properties in mechano- electrical transduction. Movements eliciting complex pattern of vestibular stimulation: the macular system and the semicircular canals system.
TASTE AND OLFACTION Neuroanatomy of gustative and olfactory systems: anatomical structures and pathways. Odorants and how chemical stimuli are perceived and transformed. Molecular structure of olfactory receptors and associated signal transduction mechanisms. Signal transduction for odorants and processing of information in the olfactory system. Taste stimuli, taste receptors and signal transduction for perception of different tastes. Hormonal modulation of taste and interconnections between taste and smell. Regulatory mechanisms of taste information at peripheral taste organs. Functional interaction between taste and olfactory pathway in perception.
Interoception
Functional organization of the sensory domain of the autonomic nervous system: properties of the mechanoreceptors and chemosensory receptors innervating viscera and modalities of visceral perception. Visceral reflexes: slow and rapid visceral responses. Modulation of the sensory input form the internal environment and organs in their ascending system. Trager structures and central modulation. Nociception and visceral pain.
TOPIC 3: THE NERVOUS SYSTEM: HOMEOSTATIC RESPONSES NEED HUMAN MOTION TO INTERACT WITH THE ENVIRONMENT
Skeletal Muscle excitation. Neuromuscular junction, the end plate potential, the striate muscle action potential and the current-to-frequency coding. Muscle contraction. Chemical composition of skeletal muscle and its peculiarities. Structure and properties of key sarcomere proteins, their molecular arrangements and functional properties. Neuronal signals to skeletal muscle, the sliding filament model of muscle contraction, and the molecular mechanisms underlying muscle relaxation. Integration of skeletal muscle contraction and metabolism, and coordinated regulation. Role of myoglobin, phosphocreatine and glycogen metabolism during exercise. Key molecules and metabolic integrations in aerobic and anaerobic exercise. Role of muscle proteins in glucose homeostasis.
Neural control of force. The Motor Unit: innervation ratio in different muscles. Classification of three types of motor units and based on the functional properties of different muscular fibers. The motoneurons properties: synaptic current to frequency coding: the rate match. Neural mechanisms controlling muscular force: recruitment order of motor units, the size principle and tetanic activation. Role of agonist and antagonist muscles at joint level, the coordinated work of different muscles on skeletal joints and the role of muscles in determining joint stiffness.
Exercise. Cardiovascular and respiratory responses to physical exercise. Anaerobic threshold, respiratory compensation point and their measurement. The incremental exercise test as a diagnostic tool.
Overview of the hierarchical organization of motor system.
General concept of reflex. Reflex arc components: somatic and visceral reflexes in spinal cord/brain stem. Main spinal reflexes in adults and in neonates.
Locomotion. Spinal automatism: general neural network underlying automatic functions. Phases of human locomotion: sequence of muscle contraction required for stepping. Spinal rhythm generating system, the neural control of locomotion and the processes active in learning locomotion. Locomotion. Total work during human terrestrial locomotion partitioned in internal and external work. External work measured using a force platform. The inverted pendulum mechanism for walking and the bouncing ball mechanism for running. Mechanisms decreasing the energy requirements for walking and running.
Brain stem descending pathways and corticospinal system. Neuroanatomy of the descending pathways: the medial and lateral system. Origin and course of the pyramidal tract. Location of the primary and secondary motor areas. Structural features of the motor cortex. Pathways from the reticular formation, red nucleus, tectum and vestibular nuclei. Course and anatomic structures involved in the corticospinal tract. Course and the anatomic structures involved in the corticonuclear tract. Course and the anatomic structures involved in the tectospinal and reticulospinal tracts. Course and the anatomic structures involved in the rubrospinal and vestibulospinal tracts. Functional properties acquired during evolution by the cerebral cortex and the corticospinal tract. Role exerted by the brain stem descending pathways on spinal cord. Corticospinal influences on spinal cord machinery for movement control. Illustrate the relation between the sensation and movement and the descending control of afferent inputs to sensory cortex. Output functions of the motor cortices: primary, premotor and supplementary motor cortices. Cortical circuits underlying sensorimotor transformation: reaching and grasping.
Cerebellum. Anatomo-functional organization of the cerebellum into different regions. Origin of sensory inputs to cerebellum. Cerebellar output pathways. Content of the cerebellar peduncles. Microcircuitry of the cerebellar cortex. Course and anatomic structures involved in the spinocerebellar tract. Course and anatomic structures involved in the pontocerebellar and olivocerebellar tracts. Functional properties of the basic cerebellar circuit module: the simple spikes and complex spikes. Role exerted by the Spinocerebellum on body and limb movements: interaction with the vestibular system and with the spinal cord. Role exerted by the Cerebrocerebellum on the cortical motor program: interaction with the cortex.
Functional role of the afferents from the Inferior olive and the role of cerebellum in motor learning. Involvement of cerebellum in postural tone control.
Basal ganglia. Structures belonging to the basal ganglia circuitry. Inputs to the basal ganglia, outputs from the basal ganglia and intrinsic connections. Circuitry involving the corpus striatum. Course of the pallidofugal fibers and circuitry involving the substantia nigra. General outline of the four parallel channels passing through the basal ganglia. Functional properties of the basal ganglia-thalamocortical circuitry. Skeletomotor, the oculomotor, the prefrontal and the limbic circuit. Role of the basal ganglia in cognition, mood and non-motor behaviour.
Supporting voluntary movement
Ocular movements. Main mechanisms of gaze control: the mechanisms for gaze stabilization and the mechanisms for gaze shifting. Gaze stabilization mechanisms: the vestibulo-system and the optocinetc system. Gaze shifting mechanisms: the saccadic system and the smooth pursuit system. Vergence movements and the Hering's law of equal innervation.
Posture and its biomechanical constraints. Different components of the postural control: spinal, vestibular and visual components. Spinal mechanisms acting in postural control and the main role of the stretch reflex. Vestibular mechanisms acting in postural control: the vestibulospinal and tonic neck reflexes. Visual action in postural control: closed vs opened eyes, lateral shift of retinal images and optocinetic nistagmus.
TOPIC 4: HOMEOSTASIS NEEDS TO MONITOR THE INTERNAL ENVIRONMENT AND CORRECT FOR DEVIATIONS FROM THE EXPECTATIONS
The autonomous nervous system. General anatomo-functional organization of the vegetative (visceromotor) nervous system and its differences with somatic (somatomotor) nervous system; Organization of the autonomous nervous system in sub-systems and their functional roles (sympathetic, parasympathetic and enteric systems); anatomo-functional criteria distinguishing the sympathetic and parasympathetic systems; integration of vegetative functions and vegetative-mediated behaviors controlling cardiovascular, bladder and the gastrointestinal activities. The insular cortex is a wide region located within the later sulcus enclosing a posterior to anterior functional organization. Functional organization of the posterior insular cortex: integration between vestibular, acoustic and high-order somatosensory information. Functional organization of central insular cortex: integration of vegetative interoceptive afferents and its role as gustatory cortex. Functional organization of anterior insular cortex: controlling visceromotor output. The limbic system and its role as a hub of the neural network subserving emotions. Definition of emotional experiences. Basic emotions model. The Emotional Brain Circuitry. Emotional Regulation and Cognitive Reappraisal. Brain Regions Involved in Emotion Regulation. Emotional Memories. Rewards and Motivation. Emotional Disorders. Vascularization of the brain. Circle of Willis: anterior and posterior circulation. Course and territory of supply of the three main cerebral arteries and revise main functional areas of the cerebral cortex. Most important penetrating vessels and their territory of supply. The vascular supply to the brainstem and revise internal structure. Superficial and deep venous drainage of the cerebral hemispheres. Dura meningeal venous sinuses. Anastomoses between intra and extra-cranial circulations.
BBB and BCFB. Structure and functions of Blood- Brain Barrier. Blood and Cerebrospinal fluid (CSF) Barrier. Cerebrospinal Fluid: amount, composition, production, circulation, reabsorption and functions. Structural and functional relationships between the intracranial compartments and blood-brain and blood-CSF barriers. Interplay between the two barriers.
TOPIC 5: OVERVIEW OF THE ANATOMOFUNCTIONAL ORGANIZATION OF THE NERVOUS SYSTEMS
Anatomo-functional subdivision and internal organization of the spinal cord white and grey matter, the brain stem, the dienchephalon (Thalamus and Hypothalamus), the anatomo-functional subdivision of the neocortex. Anatomo-functional organization of the connecting systems and tracts: Association, Commissural and Projecting tracts.
TOPIC 6: HUMAN NEOCORTEX GOES BEYOND HOMEOSTHASIS: THE COGNITIVE FUNCTIONS AND HEMISPHERIC DOMINANCE
Functional organization of the different cortical areas: unimodal, polymodal or secondary areas and associative areas. Evolutionary development of the neocortex, from unimodal areas to its development into polymodal and associative regions. Contribution of neocortex
development to cognitive functions. Neural Basis of Visual Perception. From basic feature encoding to object identification. Ventral and
Dorsal pathways of visual perception. Pathology of Visual perception. Neural Basis of Memory. Neural processes involved in memory formation, storage, and retrieval. Distinction from Declarative and Procedural memory. Role of Hippocampus and neocortex. Standard model of memory. Multiple traces model of memory. Role of schemas in memory consolidation. Neural Basis of Attention and Cognitive Control. Cognitive model of attention. Neural basis of visuospatial attention. Working memory and inhibitory control. Pathology of Attentive
processes. Neural basis of language. Principles of neuropsychology and neuropsychological assessment. Difference and communication between the two hemispheres. Concept of hemispheric dominance in the human brain.
TOPIC 6: HOMEOSTASIS NEEDS A WIRELESS SYSTEM FOR A LONG-TERM CONTROL
Hormones. Hormones based on their chemical nature, mechanism of action, nature of action, effects on target cells. Transport of hormones in blood, their distribution, inactivation and clearance. Time course of hormone secretion: pulsatile vs episodic secretion. Feedback/feedforward mechanisms underlying hormonal secretion. Hypothalamus-hypophyseal axis. Hypothalamus and Posterior Pituitary gland as a neuroendocrine unit. Describe the Hypothalamus and Anterior Pituitary gland as a functional unit: the hypothalamus-hypophyseal portal system. Hypothalamic releasing and inhibiting hormones acting on the anterior pituitary gland. Mechanism underlying control of hormonal secretion. Action of the nervous and endocrine system in controlling body functions.
Anterior hypophysis hormones. Mechanism underlying control of Thyroid Gland trophism and hormonal secretion. Biological effect of Thyroid Hormones. Mechanism underlying control of Adrenal Gland trophism and hormonal secretion. Biological effect of adrenal gland hormones.
Growth. Complementary action of Thyroid and Adrenal gland hormones. Tissutal and metabolic events underlying physiological Growth. Factors affecting growth, the growth curves and growth rate at different ages. Events occurring in the skeletal growth. Growth Hormone production, its direct and indirect action by means of somatomedine and the regulation of GH secretion: role of GHRH, Somatostatin and IGFs. Role of the "permissive hormones" in growth: thyroid hormones, cortisol, insulin and gonadal hormones.
Reproduction. Hormonal control of male reproduction: maturation of male seminal cells and role of LH, FSH and testosterone in spermatogenesis. Functional properties of the male reproductive tract and of the accessory sex glands. Hormonal control of female reproduction: role of FSH, LH and ovarian estrogen and progesterone on the ovarian cycle and on the events occurring in the menstrual cycle. Feedback control of the hypothalamus-hypophysis-gonads axis on male and female, the puberty and GnRH activity. Physiological features of menopause. Principal pregnancy, parturition and post-pregnancy events.
TOPIC 7: HOMEOSTASIS MAINTAINED WHEN WE SHAPE BODY FUNCTIONS ON THE ENVIRONMENTAL CHANGES
Circadian rhythms. Circadian rhythms and nervous structure underlying them. Functional properties of the clock proteins and of the pineal gland (melatonin). Role of the suprachiasmatic nucleus in synchronization of biological rhythms with external environmental cues.
Hypothalamus. Functional partition of hypothalamus and its "driving" role of the hypothalamus in controlling the autonomic system. Introduction to the "driving" role of the hypothalamus in integrating endocrinal and autonomic functions with behaviour. Motivational states and their neural control.
EEG recording. Principle of EEG recording and EEG analysis. Correlation between the main cortical waves and the behavioral state. Free running recording vs evoked potentials and event related potentials.
Sleep. Classification of sleep and awake state based on the main physiological parameters Correlation of EEG-EMG and EOG and different sleep stages. Neural network underlying asleep vs awake state.
Internal core temperature. Balance between heat input and output to maintain body core temperature. Principles of heat exchange: radiation, conduction, convection and evaporation. "Sweating" as a regulated evaporative process. "Shivering" as primary involuntary mechanism of heat production. Role of blood flow in thermal regulation. Concept of "set point" and the role of the hypothalamus in thermal control. Fever vs Hyperthermia.
Definition of stress response and stressors. Pattern of reactions evoked by stressants. Role of sympathetic nervous system in stress. Role of hypothalamus-hypophysis-adrenal gland system in stress. Role of blood pressure in sustaining the stress response. Role of the hypothalamus in coordinating the response. Psychosocial stressors.
Teaching methods
Synchronous learning: lectures, video conferences, problem-based learning and tutorials, case studies and practical activities. Asynchronous learning: audio-video based (pre-recorded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Teaching Resources
ANATOMY
Beckstead RM. A SURVEY OF MEDICAL NEUROSCIENCE. Springer-Verlag, 1995. · Brodal P. THE CENTRAL NERVOUS SYSTEM. Oxford University Press; 5th ed, 2016. · Burt AM. TEXTBOOK OF NEUROANATOMY. Saunders, 1st ed, 1993. · Chusid JG. CORRELATIVE NEUROANATOMY & FUNCTIONAL NEUROLOGY. Appleton & Lange, 19th ed, 1986. · Haines DE. NEUROANATOMY IN CLINICAL CONTEXT: AN ATLAS OF STRUCTURES, SECTIONS, SYSTEMS, AND SYNDROMES. Wolters Kluver, 9th ed, 2014. · Parent A. CARPENTER'S HUMAN NEUROANATOMY. Lippincott Williams & Wilkins, 9th ed, 1996. SUPPLEMENTAL LEARNING MATERIAL: Additional material, in particular to online content, will be made available during the course.
Beckstead RM. A SURVEY OF MEDICAL NEUROSCIENCE. Springer-Verlag, 1995. · Brodal P. THE CENTRAL NERVOUS SYSTEM. Oxford University Press; 5th ed, 2016. · Burt AM. TEXTBOOK OF NEUROANATOMY. Saunders, 1st ed, 1993. · Chusid JG. CORRELATIVE NEUROANATOMY & FUNCTIONAL NEUROLOGY. Appleton & Lange, 19th ed, 1986. · Haines DE. NEUROANATOMY IN CLINICAL CONTEXT: AN ATLAS OF STRUCTURES, SECTIONS, SYSTEMS, AND SYNDROMES. Wolters Kluver, 9th ed, 2014. · Parent A. CARPENTER'S HUMAN NEUROANATOMY. Lippincott Williams & Wilkins, 9th ed, 1996. SUPPLEMENTAL LEARNING MATERIAL: Additional material, in particular to online content, will be made available during the course.
Anatomy
BIO/16 - HUMAN ANATOMY - University credits: 4
Lessons: 36 hours
: 12 hours
: 12 hours
Professor:
Dellavia Claudia Paola Bruna
Shifts:
Turno
Professor:
Dellavia Claudia Paola Bruna
Physiology
BIO/09 - PHYSIOLOGY - University credits: 8
Practicals: 16 hours
Lessons: 72 hours
: 12 hours
Lessons: 72 hours
: 12 hours
Shifts:
Group 1
Professor:
Fornia LucaGroup 2
Professor:
Fornia LucaProfessor(s)
Reception:
by prior appointment, arranged by e-mail
Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, sezione di Fisiologia, via L. Mangiagalli 32