Study guide / Studiegids

Department of Physiology
Departement Fisiologie
FLG 212 Circulatory physiology / Sirkulatoriese
fisiologie

2016

Copyright reserved / Kopiereg voorbehou

TABLE OF CONTENTS

TIME TABLE............................................................................................................................................... 1
LOGISTICS ................................................................................................................................................ 2
Official communications ...................................................................................... 2
Study materials .................................................................................................. 2
Assessments and contribution to final mark ........................................................... 3
Promotion ......................................................................................................... 4
Sub-minimum for admission to the examination ...................................................... 4
Absence from examination .................................................................................. 5
Plagiarism ......................................................................................................... 5
STUDY COMPONENT ......................................................................................... 6
STUDY UNITS ............................................................................................................................................ 7
SYLLABUS THEME 1: BODY WATER ...................................................................................................... 7
SYLLABUS THEME 2: HAEMATOLOGY AND AN INTRODUCTION TO IMMUNOLOGY AND
DEFENCE SYSTEMS ................................................................................................................................ 7
SYLLABUS THEME 3: CARDIOVASCULAR PHYSIOLOGY .................................................................... 12

LOGISTICS
Lecturer:

Office:

Tel. nr:

E-mail address:

Guardian

Dr M v Rooy

BMS 9-12 (Prinshof)

012 319-2423

mia.vanrooy@up.ac.za

Lecturer

Dr M Coetzee

BMS 9-23 (Prinshof)

012 319-2445

magdalena.coetzee@up.ac.za

Tutor

Ms D Fraser

073 101 1128

desiree.fraser@gmail.com

Administrative personnel

Office:

Tel. nr:

E-mail address:

Ms MS Botha

NW 1 2-1.2

012 420 4482

maryna.botha@up.ac.za

Official communications
The official notice board is situated at the entrance of level 2, NS1 building, west wing. Some
communications may be made via the Click UP. It is the students responsibility to verify any changes
and additional information regarding for example the lecturing schedule, test-, and exam venues posted
on click UP or the official notice board. Students test mark and test memos will be posted on the notice
board. Students are kindly requested not to leave Pretoria for the holidays until they know they do not
have a supplementary examination.
Appointments can be made with the lecturers by personal arrangement during working hours.
Lecture information
Fridays

08:30 10:20 (2 lectures)

Venue: Louw Hall

14:30 17:20

Venue: See ClickUP

Practicals
Thursday

Study materials
Prescribed text book:
Dee Unglaub Silverthorn
Human Physiology, an integrated approach. (6th edition)
Where necessary the following book will be utilised, but relevant information will be included
in the lecturers

BJ Meyer, DH van Papendorp, HS Meij en M Viljoen

Human Physiology (3nd Revised edition), Juta & Co., 2002

Assessments and contribution to final mark

Theory:
Test 1 + Test 2
=
80%
Practicals:
=
20%
Semester mark
=
100%
Examination: written paper
=
100%
Final mark:
=
(Semester mark + Examination mark)/2
Test dates - Will be available on UP Portal
Examination dates - Will be available on UP Portal
If a student fails to attend a practical or class test, or does not submit an assignment due to
medical reasons he/she needs to submit a medical certificate to the department administrator (ONLY
Ms Botha) within 72 hours.
o If no medical certificate is submitted to the department administrator (ONLY Ms Botha) within
72 hours, the student will receive zero for that specific assessment.
o If a medical certificate is submitted to the department administrator (ONLY Ms Botha) within 72
hours that specific assessment will not be taken in consideration for the calculation of the
module mark.
Criteria for a valid medical certificate
If the doctor has seen the student on the day of, or on the previous day of the test.
Consultations on the day after the test/examination, or a certificate based on hear-say will be
considered invalid. Medical certificates will be accepted as valid after consultation with the parties
involved and in consultation with the medical officer. Students are reminded that, issuing of a false
medical certificate may result in the name of the medical practitioner being removed from the medical
register. Tampering with a medical certificate will be brought to the attention of the disciplinary
committee and may result in expulsion.
Please take note:
1. Attendance of all practicals is compulsory.
2. If a student misses more than one of the above mentioned assessments he/she will not be
allowed to write the examination of the specific module.
Semester tests
If a student fails to write a semester test due to medical reasons he/she needs to submit a medical
certificate to the department administrator (ONLY Ms Botha) within 72 hours.
If no medical certificate is submitted to the department administrator (ONLY Ms Botha) within 72
hours, the student will receive zero for the semester test.
o If a medical certificate is submitted to the department administrator (ONLY Ms Botha) within 72
hours, no module mark will be calculated. In such a case, the students exam mark will be used
as his/her final mark (Thus, a student needs to obtain a minimum of 50% in the exam to pass
the module).
o Please take note: Submission of a forged medical certificate is a criminal offence!
NB! If a student misses both semester tests he/she will not be allowed to write the examination of
the specific module.
VERY IMPORTANT:
Sick tests are no longer offered for physiology modules.
Submission of a forged medical certificate or affidavit is a criminal offence!

Promotion
A student can only promote if he/she:
o Obtains a module mark of 65% or more.
o Obtains 60% or more for each semester test.
o Attended and completed all assessment opportunities (semester tests, class tests,
assignments, practical classes, etc.). Thus a student may not promote if he/she fails to
complete any one of the assessment opportunities, irrespective of the reason (with or without
the submission of a medical certificate) (continued on next page).
o Is going to enroll for 300-level Physiology subjects during the following year. If the student is
not enrolling for any third year Physiology subjects during the following year, he/she cannot
promote and has to write the examination. (See the official statement below, as stipulated in the
Universitys General Regulations, 2009)
General Regulations 2009
Promotion to a subsequent year of study and promotion in a module.
Students who have reached the required standard in a module as stipulated in G10.3 (b),
may be promoted, in accordance with authorised faculty regulations, to the next semester
or level in a module without writing the prescribed examination, provided that a student
receives credit for such promoted modules only if study in those modules is concluded by
successfully completing a prescribed examination
If a student promotes his/her module mark will be used as his/her final mark.
Sub-minimum for admission to the examination:
A semester mark of 40% or higher for a semester mark is required for admission to the examination.
Examples:
Minimum requirement
Semester mark 40%

Example
Semester mark 0-39%
Semester mark 40-100%

Outcome
NOT admitted to examination
FAIL module
Admitted to examination

In order to pass this module:

A final mark of 50% or higher AND an examination mark of 40% or higher must be obtained.
Examples:
Minimum requirements

Final mark 50%

AND
Examination mark 40%

Example
Final mark 0-39%
Final mark 40-49%
Final mark 50-100%
Examination mark 0-39%
Final mark 50-100%
Examination mark 40-100%

Outcome
FAIL
Admitted to supplementary
examination
Admitted to supplementary
examination
PASS

Absence from the examination

If a student is absent from the examination, the student has to apply for a sick or special examination at
Faculty Administration on the Ground Floor, Agricultural Sciences Building within 3 working days of the
original examination date (thus medical certificates have to be handed in at Administration of the
Faculty of Natural and Agricultural Sciences and not at the Department of Physiology).
Plagiarism
Plagiarism refers to the appropriation of the work or ideas of others. Plagiarism is both unethical and
illegal and may be regarded as a criminal offence in terms of the Copyright Act 98 of 1978. The
University of Pretoria places a high premium on its academic standards and subscribes to a value
system that requires strong action against plagiarism. For more information, see
http://upetd.up.ac.za/authors/create/plagiarism.htm.

STUDY COMPONENT
The statements used to define the outcomes determine the level (higher-lower) of thinking skills challenged by
the outcome. The characterisation of the levels is given in the table below. Bloom's Taxonomy of Educational
Objectives (Bloom BS and Krathwohl DR, Taxonomy of educational objectives. Handbook 1. Cognitive domain,
Addison-Wesley, 1984)
Level of cognition

Definition

Typical action verbs

Skills demonstrated

1. Knowledge

Remembering
previously
learned
information

Arrange, define, describe, identify, Observe and recall information

label, list, match, name, outline, show, Knowledge of dates, events, places
Knowledge of major ideas
label, collect, examine, tabulate, quote
Mastery of subject matter

2. Comprehension

Understanding
the meaning of
information

Classify, discuss, estimate, explain,

give example(s), identify, predict,
report, review, select, summarise,
interpret, in your own words, contrast,
predict,
associate,
distinguish,
estimate, differentiate

3. Application

Using the
information
appropriately in
different
situations

Apply,
calculate,
demonstrate,
illustrate, interpret, modify, predict,
prepare,
produce,
solve,
use,
manipulate, put into practice, calculate,
examine, relate, change, classify

Use information
Use methods, concepts and
theories in new situations
Solve problems using required
skills or knowledge

4. Analysis

Breaking down
the information
into the
component parts
and seeing the
relationships

Analyze, appraise, calculate, compare,

criticise, derive, differentiate, choose,
distinguish,
examine,
subdivide,
organise, deduce separate, order,
connect, infer, divide

Seeing patterns
Organisation of parts
Recognition of hidden meanings
Identification of components

5. Synthesis

Putting the
component parts
together to form
new products
and ideas

Assemble, compose, construct, create,

design, determine, develop, devise,
formulate, propose, synthesise, plan,
discuss, support combine, integrate,
modify, rearrange, substitute, design,
invent, what if? prepare, generalise,
rewrite

Use old ideas to create new ones

Generalise from given facts
Relate knowledge from several
areas
Predict, draw conclusions

Making
judgements of
an idea, theory,
opinion, etc,
based on criteria

Appraise, assess, compare, conclude,

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

6. Evaluation

Understand information
Grasp meaning
Translate knowledge into new
context
Interpret facts, compare, contrast
Order, group, infer causes
Predict consequences

Compare
and
discriminate
between ideas
Assess value of theories,
presentations
Make choices based on reasoned
argument
Verify value of evidence
Recognise subjectivity

STUDY UNITS
MODULE FLG 212: CIRCULATORY PHYSIOLOGY 212
SYLLABUS THEMES:
1.
2.
3.

BODY WATER
HAEMATOLOGY AND DEFENCE SYSTEMS
CARDIOVASCULAR PHYSIOLOGY AND THE LYMPHATIC SYSTEM

SYLLABUS THEME 1:
Study unit 1.1:

BODY WATER

Occurrence and functions of body water

Learning objectives:
Students should be able to describe the:
o Water content and distribution of water in the body
o Functions and importance of water in the body
o Concept of water balance
Sources: Meyer p 3.1-3.2; Silverthorn p 131-132, 659-660.
Study unit 1.2:

Pathophysiology

Learning objectives:
o Students should obtain a basic knowledge of the causes, symptoms and treatment of
dehydration and overhydration.
Meyer p 3.3-3.4
SYLLABUS THEME 2: HAEMATOLOGY AND AN INTRODUCTION TO IMMUNOLOGY
AND DEFENCE SYSTEMS
SYLLABUS THEME OBJECTIVES: To understand the central role of blood in normal body
homeostasis and functioning, and to study the essential functions of the individual components of
blood, i.e., of plasma, red blood cells, white blood cells and platelets.
STUDY UNITS
2.1. Whole blood
2.2. Plasma
2.3. Haemopoiesis
2.4. Red blood cells (RBC)
2.5. Blood groups
2.6. Blood platelets and haemostasis
2.7. White blood cells (WBC) and an introduction to immunology

Study unit 2.1:

Whole blood

Study Unit Themes

2.1.1

Composition

Learning objectives:
o Students should be able to list the various components of blood as well as the normal
concentrations and volumes of it.
Source: Silverthorn p 545-551
2.1.2

Functions of blood

Learning objectives:
o Students should be able to list the functions and describe the importance of blood in normal
body homeostasis.
Sources: Meyer 12.1; Silverthorn p 545-547.
2.1.3

General characteristic and related analyses

Learning objectives:
o At the end of this unit students should be able to define:
The relative density of blood, plasma and cells
Red cell aggregation
Sedimentation rate
Haematocrit
Viscosity
Source: Meyer p 12.1-12.3
Study unit 2.2:

Plasma

Study Unit Themes

2.2.1

Composition

Learning objectives:
o Students should know the inorganic as well as the organic composition and volume of plasma
Sources: Meyer p 12.6 (table); Silverthorn p 545-547
2.2.2

Functions

Learning objectives:
o Students should know the origin and functions of plasma components as well as the effects of
deficiencies.
Source: Meyer 12.3 12.5; Silverthorn p 545-547

Study unit 2.3:

Haemopoiesis (Production of blood cells)

Learning objectives:
Students should be able to:
o Describe the ontogenic phases
o Describe the various stages of erythropoiesis, leukopoiesis and thrombopoiesis
o Identify the factors that influence haemopoiesis and explain the role of each
Source

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

Study unit 2.4:

Red blood cells (RBC)

Study Unit Themes

2.4.1

Red blood cells - General

Learning objectives:
At the end of this study unit theme the students should be able to:
o Describe the production and characteristics of the RBC
o Give values for the normal red blood cell count and to describe physiological and pathological
variations
o Describe the morphology of the RBC in terms of MCV, MCH, MCHC - including pathological
variations (Red blood cell profile) (FLG 212 Practical study guide)
o Demonstrate a basic knowledge on haemoglobin which would allow them to describe the
structure
the functional arranging of the various structural components
abnormalities in biosynthesis or structure
o Describe the functions of the red blood cell (Meyer p12.22-12.23)
o Give a basic account of the metabolic activities of red blood cells (Meyer p 12.24)
o Describe the importance of iron balance for erythropoiesis
Sources: Meyer 12.24 - 12.30; Silverthorn p 551-557
2.4.2

Lifespan of red blood cells

Learning objectives:
Students should be able to:
o Describe the factors which influence erythropoiesis
o Describe the normal RBC lifespan
o List the causes of haemolysis and explain haemoglobin breakdown (Meyer fig 12.5)
Sources: Meyer p 12.23-12.25; Silverthorn p 554-557
2.4.3

Abnormalities of the erythron

Learning objectives:
Students should be able to:
o Describe polycythaemia as well as the causes of it
o Define anaemia as well as its diagnostic characteristics
o Classify anaemia on the basis of both morphology and aetiology

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

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

After completion of the practical course in haematology, the students should be able to:
o Calculate the red cell indices (red blood cell profile) by making use of the relevant formulae and
blood values
o Make a diagnosis and suggest possible causes by referring to relevant information obtained in
the haematology course
Study unit 2.5:

Blood groups

Learning objectives:
After completion of this study unit the students should be able to:
o Define the ABO and the Rh blood group systems and to describe the characteristic differences
between the two systems
o Explain the clinical implications of the two blood group systems with special reference to blood
transfusions and erythroblastosis foetalis
o Handle problem solving exercises with regard to blood groups, donors and recipients
Sources:

Meyer 12.28-12.31; Silverthorn p 825-827

Study unit 2.6:

Blood platelets and haemostasis

Study Unit Themes

2.6.1

Blood platelets

Learning objectives:
Students should be able to:
o Define normal and abnormal platelet counts
o Describe the structure of platelets and to relate structure to function
o Describe the role of platelets in haemostasis
Sources: Silverthorn p 557-565
2.6.2

Haemostasis

Learning objectives:
After completion of this study students should be able to:
o Describe the reactions which follow upon damage to a blood vessel chronologically
o Describe the clotting cascade
o Explain the causes of clotting abnormalities
o Describe fibrinolysis
Source : Silverthorn p 557-565

10

Study unit 2.7:

White blood cells (WBC) and an introduction to immunology

Study Unit Themes

2.7.1

White blood cells

Learning objectives:
After completion of this study unit the students should have a basic knowledge of white blood cells and
be able to:
o Identify and classify the different leukocytes on the basis of their morphological characteristics
o Explain the contribution of each type to the defence system
o List their concentrations, recognise abnormal values and explain the consequences of
abnormal WBC counts in general.
Source :

Silverthorn p 547-549, 804-825

Study Unit Themes

2.7.2

Defence mechanisms

Learning objectives:
Students should be able to distinguish between non-specific (general) and specific defence
mechanisms.
2.7.3

Non-specific defence mechanisms (innate immunity)

Learning objectives
Students should be able to
o explain the different mechanisms involved in non-specific defence
Source: Silverthorn p 811-814
2.7.4

Specific immunity (acquired immunity)

Learning objectives:
Students should have the basic knowledge which would enable them to:
o Define and describe the characteristics of an immune reaction
o Distinguish between and give the characteristics of a secondary and a primary immune
reaction
o Distinguish between active and passive immunity and explain the reactions which can be
elicited either naturally or artificially
o Define the term antigen
o Give an annotated sketch of a basic immunoglobin
o Classify immunoglobulins and to name the characteristics of each class
o Describe the functions of the antibodies
o Define and describe cellular and humoral immunity
o Describe the cause and onset of the allergic reaction
Source: Silverthorn p 814-825

11

SYLLABUS THEME 3: CARDIOVASCULAR PHYSIOLOGY

SYLLABUS THEME GOAL: To become conversant with the physiological anatomy, the control
mechanisms, the mechanisms of action and the functions of the cardiovascular system.
STUDY UNITS
3.1.
Overview of the cardiovascular system
3.2.
Mechanisms and forces involved in blood flow
3.3.
The heart
3.4.
The heart as a pump
3.5.
The blood vessels
3.6.
Blood pressure
3.7.
Resistance in arterioles
3.8.
Distribution of blood in the tissues
3.9.
Cardiovascular control centre
3.10. Exchange at capillaries
3.11. Lymphatic system
Study unit 3.1:

Overview of the cardiovascular system

Study Unit Theme

1.1.1

Transport of substances by the cardiovascular system

Learning objectives:
Students must know the substances that are transported by the cardiovascular system and why they
are important.
3.1.2

Components of the cardiovascular system

Learning objectives:
Students must know the:
o The components of the cardiovascular system
o Difference between arteries and veins
o Functions of the chambers of the heart
o Be able to distinguish between the pulmonary and systemic circulation and special
arrangements in the circulation.
Source: Silverthorn pp. 462-466
Study unit 3.2:

Mechanism and forces involved in blood flow

Study Unit Theme

3.2.1

Pressure

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

12

o
o
3.2.2

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

Learning objectives:
Students must be able to explain:
o Resistance
o The relationship between resistance and flow
o Factors affecting resistance
o The difference between flow rate and velocity of flow
o Relationship between velocity of flow, flow rate and cross-sectional area
Source: Silverthorn pp. 466-471
Study unit 3.3:

The heart

Study Unit Theme

3.3.1

Anatomy of the heart

Learning objectives:
Students should know and be able to describe:
o The layers of the heart
o Pathway of blood flow through the heart
o Heart valves, positions and function
3.3.2

Contraction of cardiac muscle cells

Learning objectives:
Students should be able to distinguish between autorythmic and contractile cells.
3.3.3

Cardiac contractile cell excitation-contraction coupling

Learning objectives:
Students should be able to describe the process of EC coupling as well as the grading of cardiac
muscle cells
3.3.4 Myocardial action potentials
Learning objectives:
Students must be able to recognise and describe the different phases of action potentials in myocardial
contractile and myocardial autorythmic cells.
Source: Silverthorn pp. 471-482

13

Study unit 3.4:

The heart as a pump

Study Unit Themes

3.4.1

Conducting system of the heart

Learning objectives:
Students should be able to describe the pathway of the electrical conduction system through the heart
as well as the importance of each structure.
3.4.2

Cardiac cycle and electrocardiogram (ECG)

Learning objectives:
Students should be able to:
o Recognise the different waves on an ECG and how they correspond to each event in the
cardiac cycle
o Describe each phase of the cardiac cycle
o Interpret the pressure-volume curve
o Distinguish between end-diastolic volume and end-systolic volume
3.4.3

Stroke volume and cardiac output

Learning objectives:
Students should be familiar with and be able to relate the:
o Definition of stroke volume and cardiac output and their formulae
o Parasympathetic and sympathetic effect on heart rate
o Factors that influence stroke volume and their effects on cardiac output
o Chemical and neural control of cardiac output
o Afterload
Source: Silverthorn pp. 483-501
Study unit 3.5: The blood vessels
Study Unit Themes
3.5.1

Anatomy of the blood vessels

Learning objectives:
Students should be familiar with and be able to describe the different layers in each of the blood
vessels and their role in the function of the blood vessel.
3.5.2

Arteries and arterioles

Learning objectives:
Students should be able to describe the structure and characteristics of arteries, arterioles and
metarterioles

14

3.5.3

Capillaries

Learning objectives:
Students should be able to describe the structure and characteristics of capillaries as well as the
function of pericytes.
3.5.4

Venules and Veins

Learning objectives:
Students should be able to describe the structure and characteristics of venules and veins as well as
the importance of valves in the veins.
3.5.5

Angiogenesis

Learning objectives:
Students should be able to define angiogenesis and describe situations where angiogenesis occurs.
Source: Silverthorn pp. 510-513
Study unit 3.6: Blood pressure
Study Unit Theme
3.6.1

Blood pressure in arteries and veins

Learning objectives:
Students should know and be able to describe:
o The origin of blood pressure in the circulation
o Causes of friction
o Pulse and pulse pressure
o Pumps aiding venous return
3.6.2

Mean arterial pressure (MAP)

Learning objectives:
Students should know and be able to describe:
o MAP
o The difference between hypertension and hypotension
3.6.3

Sphygmomanometry

Learning objectives:
Students should know and be able to describe the use of the sphygmomanometer in the measurement
of blood pressure.

15

3.6.4

Biophysical factors and MAP

Learning objectives:
Students should know and be able to describe:
o Peripheral resistance
o The relationship between CO, peripheral resistance and MAP
o As well as apply the effects on this relationship when changes in flow, distribution of blood and
total blood volume occur
o Changes in blood volume
Source: Silverthorn pp. 513-519
Study unit 3.7:

Resistance in arterioles and blood pressure

Study Unit Theme

3.7.1

Poiseuilles Law

Learning objectives:
Students should be able to explain and apply the following:
o The relationship between resistance in arterioles, length of the arteriole, viscosity of the fluid
and radius of the tube
o Control mechanisms of arteriolar resistance including myogenic autoregulation
o Distribution of blood supply
o Effect of hormones and neurotransmitters on resistance
Source: Silverthorn pp. 519-524
Study unit 3.8:

Cardiovascular control centre

Study Unit Theme

3.8.1

Baroreceptor reflex

Learning objectives:
Students should be able to explain and apply the baroreceptor reflex and orthostatic hypertension.
3.8.2

Other receptors influencing cardiovascular functions

Learning objectives:
Students should be able to explain and apply the effect of other receptors on cardiovascular function.
Source: Silverthorn pp. 524-528

16

Study unit 3.9:

Exchange at capillaries

Study Unit Theme

3.9.1

Efficiency of gas exchange

Learning objectives:
Students should be able to:
o Describe the importance of cross-sectional area of capillaries on the efficiency of exchange
o Explain and differentiate between diffusion and transcytosis
3.9.2

Bulk flow

Learning objectives:
Students should be able to:
o Describe bulk flow
o Compare absorption to filtration
o Explain hydrostatic and colloid osmotic pressure and the effect thereof on exchange
o Calculate net pressure
Source: Silverthorn pp. 528-531
Study unit 3.10:

Lymphatic system

Study Unit Theme

3.10.1 Lymphatic system
Learning objectives:
Students should know and be able to explain the following:
o Functions of the lymphatic system
o Composition and origin of lymph
o Importance of filtered fluid being returned to the circulation
o Oedema and factors causing oedema
Source: Silverthorn pp. 532-533

17