ENTRY LEVEL
In bold:
Literature references to textbooks that will be used in the courses.
G = Guyton, 10th edition
A = Alberts, Molecular Biology of the Cell (this textbook is freely accessible online at
http://www.ncbi.nlm.nih.gov/books/bv.fcgi?call=bv.View..ShowTOC&rid=cell.TOC&depth=2
B = Braunwald's Heart Disease 6/7th edition or e-book
http://www.accessmedicine.com/content.aspx?aID=81992
Blood & Fluid Dynamics
CV 1. Describe the components of blood (cells, ions, proteins, platelets) giving their normal
values. Relate the three red blood cell concentration estimates, red blood cell count,
hematocrit, and hemoglobin concentration. (G. Ch 32)
CV 2. Identify the source, stimulus for formation, and function of the hormone erythropoietin.
Relate the rate of red blood cell synthesis to the normal red blood cell life span and the
percentage of immature reticulocytes in the blood. (G. Ch 32)
CV 3. Know how pressures arise from a hydrostatic column. Apply this to the choice of a
reference point for physiological pressure measurement. (G. Ch 14)
CV 4. Be able to differentiate between flow and velocity in terms of units and in terms of
concept. (G. Ch 14)
CV 5. Understand the relationship between pressure, flow, and resistance in the vasculature.
Relate this relationship to the (density of) arteries, arterioles, capillaries, venules, and veins.
Explain how blood flow to any organ is altered by changes in resistance to that organ. (G. Ch
14)
CV 6. Explain how Poiseuille’s Law relates resistance to flow. Use it to calculate changes in
resistance in a rigid tube as a model for a blood vessel. Discuss the assumptions of the
Poisseuille law and explain the deviations from Poiseuille’s law that occur in distensible blood
vessels. (G. Ch 14, p. 150)
CV 7. Understand the relationship between flow, velocity, and cross-sectional area and the
influence of vascular compliance. Apply this relationship to the various segments of the
circulation. (G. Ch 14)
CV 8. Define resistance and conductance. Understand the effects of adding resistance in
series vs. in parallel to total resistance. Apply this concept to the redistribution of flow from
the aorta to the tissues during exercise. (G. Ch 14)
CV 9. List the factors that shift laminar flow to turbulent flow. Describe the relationship
between velocity, viscosity, and audible events, such as murmurs and bruits. (G. Ch 14)
CV 10. Understand the principles of flow through collapsible tubes, the Starling resistor, and
what pressure gradient determines flow for different relative values of inflow, surrounding,
and outflow pressures. (G. Ch 15)
CV 11. Explain how hemodynamics in blood vessels, especially the microcirculation, deviates
from theory due to anomalous viscosity, distensibility, axial streaming, and critical closing
behaviour. (G. Ch 16)
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Arterial Pressure and the Circulation
CV 12. Describe the organization of the circulatory system and explain how the systemic and
pulmonary circulations are linked physically and physiologically. (G. Ch 14)
CV 13. Explain how the physical properties of the circulation (vessel size, wall thickness, wall
composition, compliance, elastic recoil, and blood viscosity) affect movement of blood and
delivery of nutrients. (G. Ch 14)
CV 14. Describe blood pressure measurement with a catheter and transducer and explain the
components of the blood pressure waveform. Contrast that with the indirect estimation of
blood pressure with a sphygmomanometer. Explain how each approach provides estimates of
systolic and diastolic pressures. Given systolic and diastolic blood pressures, calculate the
pulse pressure and the mean arterial pressure. (G. Ch 15)
CV 15. Describe how arterial systolic, diastolic, mean, and pulse pressure are affected by
changes in a) stroke volume, b) heart rate, c) arterial compliance, and d) total peripheral
resistance. (G. Ch 15)
CV 16. Contrast pressures and oxygen saturations in the arteries, arterioles, capillaries,
venules, and veins of both the systemic and pulmonary circulations. Repeat that process for
velocity of blood flow and cross-sectional area, and volume. (G. Ch 15)
CV 17. Identify the cell membrane receptors and second messenger systems mediating the
contraction of vascular smooth muscle by norepinephrine, angiotensin II, and vasopressin.
(G. Ch 18, 19)
CV 18. Identify the cell membrane receptors and second messenger systems mediating the
relaxation of vascular smooth muscle by nitric oxide, bradykinin, prostaglandins, and
histamine (G. Ch 17)
The Microcirculation and Lymphatics
CV 19. Explain how water and solutes traverse the capillary wall. Use Fick’s equation for
diffusion to identify the factors that will affect the diffusion-mediated delivery of nutrients
from the capillaries to the tissues. Define and give examples of diffusion-limited and flowlimited exchange. (G. Ch 16)
CV 20. Describe how changes in capillary surface area affect the capacity for fluid exchange.
(G. Ch 16)
CV 21. Define the Starling equation and discuss how each component influences fluid
movement across the capillary wall (G. Ch 16, p. 170).
CV 22. Describe the pathway for leukocyte migration across the microcirculation, including
expression of cellular adhesion molecules, and recognition sites in the vascular endothelial
cells. (G. Ch 33)
CV 23. Starting at the post-capillary venule, describe the process of angiogenesis, including
the stimulus that initiates new vessel growth. (A, use search function)
CV 24. Describe the Donnan effect and its importance in capillary dynamics. (G. Ch 25, p.
266)
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CV 25. Predict how altering pressure or resistance in pre- and post-capillary regions alters
capillary pressure and the consequence of this change on transmural fluid movement. (G. Ch
16)
CV 26. Using the components of the Starling equation, explain why fluid does not usually
accumulate in the interstitium of the lungs. (G. Ch 16)
CV 27. Describe how histamine alters the permeability of the post-capillary venules, and how
the loss of albumin into the interstitial space promotes localized edema. (G. Ch 16, 17)
CV 28. Describe the lymphatics, and explain how the structural characteristics of terminal
lymphatics allow the reabsorption of large compounds, such as proteins. (G. Ch 16)
CV 29. Contrast the structure of lymphatic capillaries and systemic capillaries, including the
significance of the smooth muscle in the walls of the lymphatic vessels. (G. Ch 16)
CV 30. Identify critical functions of the lymphatic system in fat absorption, interstitial fluid
reabsorption, and clearing large proteins from the interstitial spaces. (G. Ch 16)
CV 31. Diagram the relationship between interstitial pressure and lymph flow. Explain why
edema does not normally develop as interstitial pressure increases. (G. Ch 16)
CV 32. Explain how edema develops in response to: a) venous obstruction, b) lymphatic
obstruction, c) increased capillary permeability, d) heart failure, e) tissue injury or allergic
reaction, and f) malnutrition. (G. Ch 16)
CV 33. Explain how inflammatory cells adhere to the vessel wall, migrate into the vessel wall
and locate to certain regions in atherosclerotic vessels (Nature (2000) 407:233)
CV 34. Describe the effect of shear stress on local gene expression and plaque formation in
atherosclerotic vessels (Nature (2000) 407:233)
Regulation of Arterial Pressure (G. Ch 18)
CV 35. List the anatomical components of the baroreceptor reflex.
CV 36. Explain the sequence of events in the baroreflex that occur after an acute increase or
decrease in arterial blood pressure. Include receptor response, afferent nerve activity, CNS
integration, efferent nerve activity to the SA node, ventricles, arterioles, venules, and
hypothalamus.
CV 37. Explain the sequence of events mediated by cardiopulmonary (volume) receptors that
occur after an acute increase or decrease in arterial blood pressure. Include receptor
response, afferent nerve activity, CNS integration, efferent nerve activity to the heart, kidney,
hypothalamus, and vasculature.
CV 38. Contrast the sympathetic and parasympathetic nervous system control of heart rate,
contractility, total peripheral resistance, and venous capacitance. Predict the cardiovascular
consequence of altering sympathetic nerve activity and parasympathetic nerve activity.
CV 39. Contrast the relative contribution of short- and long-term mechanisms in blood
pressure and blood volume regulation.
CV 40. Outline the cardiovascular reflexes initiated by decreases in blood O2 and increases in
blood CO2.
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CV 41. Describe the release, cardiovascular target organs, and mechanisms of cardiovascular
effects for angiotensin, atrial natriuretic factor, bradykinin, and EDRF (endothelial-derived
relaxing factor).
Local Control of Blood Flow
CV 42. Define autoregulation of blood flow in the brain. Compare and contrast the myogenic
and metabolic theories of autoregulation. Identify which mechanism would predominate at
high and low mean arterial pressures. (G. Ch 61, p. 710)
CV 43. Describe how the theory of metabolic regulation of blood flow accounts for active
hyperemia and reactive hyperemia. (G. Ch 17)
CV 44. Identify the role of Po2, Pco2, pH, adenosine, and K+ in the metabolic control of blood
flow to specific tissues. (G. Ch 21, p 224, C. 17)
CV 45. Diagram the synthetic pathway for nitric oxide (EDRF, endothelial derived relaxing
factor), including substrate and the interplay between endothelium and vascular smooth
muscle. (G. Ch 17)
CV 46. Discuss the circumstances and the mechanisms whereby humoral substances
contribute to regulation of the microcirculation. (G. Ch 17)
CV 47. Discuss the interaction of a) intrinsic (local), b) neural, and c) humoral control
mechanisms, and identify one situation in which each dominates the regulation of blood flow
to a tissue. (G. Ch 17)
CV 48. Describe the role of angiogenesis in providing a long-term match of tissue blood flow
and metabolic need. (G. Ch 17)
Metabolism
CV 49. Describe the synthesis and metabolic pathways of chylomicrons, LDL and HDL,
including their apoproteins. (G. Ch 68)
CV 50. Describe the roles of LDL receptor, lipoprotein lipase, cholesterol ester transfer protein
and ABC-proteins. (G. Ch 68)
CV 51. Describe the basic physiology of glucose metabolism, and the defects in type 1 and
type 2 diabetes mellitus. (G. Ch 78)
CV 52. Contrast absence of insulin and insulin resistance. (Büller, p 81)
CV 53. Describe the components of the metabolic syndrome. (Büller, p 81)
GENOMICS (A.)
CV 54. Describe the formation of mRNA by DNA. Describe the difference between introns and
exons, between immature and mature RNA, between rRNA, tRNA and mRNA
CV 55. Describe how the entire genome can be studied. What techniques need to be used for
validating differentially changed genes.
CV 56. What is the difference between Northern, Western and Southern blots.
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CV 57. What is the principle of immunohistochemistry. Describe all necessary steps in relation
to an example of your own work.
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