BIO4155 PATHOPHYSIOLOGY
4 Credit Hours
Student Level:
This course is open to students on the college level in either freshman or sophomore year.
Catalog Description:
BIO4155 - Pathophysiology (4 hrs.)
This course is designed for students entering the health professions. It focuses on essential mechanisms of disordered physiological function which produce common diseases. Diseases are presented as examples to explain basic processes and functions, rather than an exhaustive list of diseases and disorders.
Course Classification
Lecture/ Lab
Prerequisite:
BIO 4150 Human Anatomy and Physiology or BIO4148 Human Anatomy and Physiology I and BIO4149 Human Anatomy and Physiology II (can be concurrently enrolled).
Controlling Purpose:
This course is applicable to current health professionals seeking a broader understanding in their field experiences and for students requiring a basic pathophysiology course before advancing to specific courses in a professional degree program.
Learner Outcomes:
Upon completion of this course, the student will be able to discuss internal and external factors that affect specific physiological states of health and illness. The student will also be able to describe the appropriate epidemiology, etiology, pathophysiology and clinical or laboratory presentations of specific disease processes. Finally, the student will be able to apply basic diagnostic reasoning in assessment and evaluation of others with specific pathophysiological presentations.
Unit Outcomes for Criterion Based Evaluation
The following outline defines the minimum core content, not including the final examination period. Instructors may add other material as time allows.
Unit 1: Cellular and Genetic Components of Pathophysiology
Outcome: The student will gain a basic understanding of basic cellular and molecular function as well as genetics and how their dysfunction can manifest disease
- Transcribe DNA to RNA given a strand of coding DNA
- Given an amino acid chart, translate RNA codons into amino acid structure
- Define epidemiology, etiology, pathophysiology, diagnosis, clinical course incidence and prevalence.
- Compare/contrast incidence and prevalence as they relate to disease frequency
- Identify patterns of inheritance including: sex-linked recessive, sex-linked dominant, autosomal-recessive, autosomal-dominant, codominance, polygenic inheritance, incomplete dominance
- Define genotype, phenotype, heterozygous, homozygous dominant, homozygous recessive.
- Given a particular cross, solve for the frequency of a particular genotype or phenotype occurrence
- Define polyploidy and monoploidy, and classify the following aneuploidies: Triple X, Klienfelter’s Syndrome, Turner’s Syndrome, X Polysomy, Jacob’s Syndrome (XYY)
- Identify chromosomal structural abnormalities that occur during cell division including: deletion, translocation, inversion, duplication, ring formation.
- Explain the etiology and pathogenesis of the following disorders as representations of genetic disorder/dysfunction: Marfan Syndrome, Neurofibromatosis, phenylketonuria, tay-sach’s disease, fragile X syndrome, cleft lip/cleft palate, down syndrome
Unit 2: Cancer
Outcome: The student will gain an understanding of the cell cycle and the consequences of its disruption as well as the progression of cancer as a result of disruption.
Unit 3: Respiratory System
Outcome: The student will gain an understanding of the functions of the respiratory system, physiology of respiration and the airways as well as the pathology of common respiratory diseases
Unit 4: Immune System and Infectious Disease
Outcome: The student will gain an understanding of the detailed functions of the immune system for protection from infectious diseases as well as clinical manifestations that result from immune responses and abnormal immune responses.
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Define host, infectious disease, colonization, microflora, virulence, pathogen
- Compare the structure of: prions, viruses, bacteria, fungi, protozoans and worms as agents of infectious disease
- Outline the stages of infectious disease after a pathogen enters the body
- Identify systemic manifestations of disease
- Define culture, serology, and antigen
- Identify the different steps that would be taken to diagnose an infectious disease such as in serology and PCR
- Outline the function of the immune system
- Compare/contrast the properties of innate and adaptive immunity
- Identify and characterize the chemical mediators that signal the immune response (Interleukins, TNF-a, Chemokines, interferons, CSFs)
- List the leukocytes involved in innate and adaptive immunity and their function
- Describe the function of the complement cascade and the three ways it can be activated
- Compare/contrast T and B cell lymphocytes
- Describe the significance and function of major histocompatibility complex
- Explain the transfer of passive immunity from mother to fetus in utero and during breast feeding
- Compare naturally acquired passive immunity to: artificially acquired passive immunity, artificially acquired active immunity, naturally acquired active immunity
- Outline development of active immunity from infant to child
- Explain how a vaccination triggers immunity for an individual
- List the four types of inflammatory mediators and their functions
- Describe vascular changes that occur during acute inflammatory responses
- Describe the role of adhesion molecules, chemokines and cytokines in: leukocyte adhesion, migration, phagocytosis
- Trace the steps of wound-healing process through the inflammatory, proliferative and remodeling phases
- Identify the negative impact of: malnutrition, ischemia, oxygen deprivation, immune and inflammatory impairment, infection, wound separation and foreign bodies on wound healing processes
- Describe etiology, pathogenesis and clinical manifestations of selected: primary and secondary B cell immunodeficiencies (X-linked hypogammaglobinemia, nephrotic syndrome); primary and secondary T cell immunodeficiencies (Digeorge syndrome, hyper IgM syndrome, Hodgkin disease, T cell suppression due to viral infection such as HIV- AIDS); combined: B and T cell primary and secondary immunodeficiencies (SCID, WiskottAldrich syndrome, irradiation immune suppression and cytotoxic drugs); Complement system disorders; disorders of phagocytosis (Chediak-Higashi syndrome, drug induced diabetes mellitus)
- Describe immune response involved in development of: type I hypersensitivity, type II hypersensitivity, type III hypersensitivity, type IV hypersensitivity
- Describe pathogenesis of common hypersensitivity reactions: allergic rhinitis, food allergy, serum sickness, arthus reactions, contact dermatitis, hypersensitivity pneumonitis
- Discuss the need for HLA/MHC matching in organ transplantation
- Describe mechanisms and manifestations of graft vs host disease
- Discuss failure of self-tolerance and how this many manifest as autoimmune diseases
- Identify possible mechanisms for autoimmune diseases
Unit 5: Cardiovascular System
Outcome: The student will gain an understanding of the normal physiological functions of the heart and circulations as well as the pathology of common cardiovascular diseases.
Unit 6: Vascular System and Blood Disorders
Outcome: The student will gain an understanding of the physiological functions of blood, the creation of blood, and the regulation of blood pressure by the vascular system as well as the pathology of common vascular and blood disorders.
Unit 7: Gastrointestinal System
Outcome: The student will gain an understanding of the physiological function of the gastrointestinal tract and accessory organs in digestion and elimination, including hormones involved and dietary guidelines as well as pathologies of selected diseases
- Describe the anatomic features of the upper, middle and lower gastrointestinal tract including the four walls and the peritoneum
- Explain the interaction of interstitial smooth muscle cells, enteric and autonomic nervous systems to cause tonic and peristaltic movements in the GI tract
- Describe the function of the gastric mucosal barrier, gut flora, and saliva
- Compare the digestion and absorption of carbohydrates, fats and proteins
- Identify the relationship between anorexia, nausea, retching and vomiting
- Describe neural structures involved with vomiting and their mediators
- Describe etiology, pathogenesis and clinical manifestations of selected gastrointestinal tract diseases: gastroesophageal reflux disease, esophageal cancer, Helicobacter pylori gastritis, peptic ulcers, stomach cancer, irritable bowel syndrome, inflammatory bowel diseases (crohn’s and ulcerative colitis), bacterial infections (E. coli O157:H7, C. dificle), acute/chronic diarrhea, celiac disease, colorectal cancer
- Compare the causes of: dysphagia, odynophagia, achalasia
- Identify function of liver in terms of carbohydrate, protein and fat metabolism
- Describe mechanism of bile formation and elimination
- Describe etiology, pathogenesis and clinical manifestations of selected liver, gallbladder and pancreatic diseases: jaundice, viral hepatitis, primary and secondary biliary cirrhosis, nonalcoholic fatty liver disease, cirrhosis, ascites, hepatocellular carcinoma, cholelithiasis, acute/chronic cholecystitis, choledocholithiasis, pancreatitis, pancreatic cancer
- Define calorie, metabolism, catabolism, anabolism, basal metabolic rate, thermogenesis
- Explain the dietary standards utilized to formulate dietary guidelines
- Identify hormone interactions in both short and long term mechanisms of food intake control
- Using the body mass index, identify clinical classifications of overweight and obese
- Identify causes and preventions for obesity
- Compare eating disorders (anorexia nervosa, bulimia nervosa, binge-eating disorder) and the complications related to each
- Identify the effects of malnutrition on the body
Unit 8: Renal System
Outcome: The student will gain an understanding of the physiological functions of the kidney in regulation of acid-base balance, urine production, absorption of ions, blood volume balance, and creation of blood as well as common diseases/disorders that affect the kidneys and bladder directly or impact other areas of the body as a result of their pathophysiology.
- Explain why the kidneys require such a large percentage of cardiac output
- Describe the mechanisms for regulating renal blood flow
- Describe structure and function of the glomerulus and tubular components of the nephron
- Identify the requirements for producing concentrated or dilute urine
- Explain the endocrine functions of the kidney including the renin angiotensinogen-aldosterone mechanism, the regulation of RBC production via erythropoietin, and calcium metabolism via vitamin D activation
- Explain the glomerular filtration rate concept
- Explain the use of urine-specific gravity tests, serum creatinine, and blood urea nitrogen levels in evaluating renal function
- Compare intracellular and extracellular fluid compartments with respect to distribution/composition of water, electrolytes and osmotically active solute
- Describe control of cell volume and the effects of isotonic, hypotonic, and hypertonic solutions on diffusion, osmosis and cell size
- Explain the physiological mechanisms controlling water levels and sodium concentration (effective circulating volume, sympathetic NS, renin angiotensin-aldosterone, antidiuretic hormone)
- Describe the effects of increased antidiuretic hormone on the reabsorption of water
- Describe etiology, pathogenesis and clinical manifestations of: diabetes insipidus, inappropriate antidiuretic hormone syndrome, hyponatremia, hypernatremia, hypokalemia, hyperkalemia, hypoparathyroidism, hyperparathyroidism, hypocalcemia, hypercalcemia, hypophosphatemia, hyperphosphatemia, hypomagnesemia, hypermagnesemia
- Explain the regulation of potassium levels in the body
- Describe the regulation of calcium, phosphorous and magnesium levels with intestinal absorption, renal elimination, bone storage, vitamin D, parathyroid hormone
- Describe the three forms of carbon dioxide transport and their contribution of acid-base balance in the blood
- Describe the mechanisms for buffering changes in body pH
- Compare the roles of kidneys and respiratory system to regulation of the acid-base balance
- Describe etiology, pathogenesis and clinical manifestations of selected acid base balance disorders: metabolic acidosis, metabolic alkalosis, respiratory acidosis, respiratory alkalosis
- Describe etiology, pathogenesis and clinical manifestations of selected kidney diseases: polycystic kidney disease, kidney stones, urinary tract, infections, nephritic syndromes, rapidly progressive glomerulonephritis, nephroci syndrome, asymptomatic glomerular disorders, chronic glomerulonephritis, tubular acidosis, pyelonephritis, Wilms tumor, renal cell carcinoma
- List four common causes of a urinary tract obstruction
- Identify the causes of acute renal injury and compare to chronic kidney disease
- List the causes of chronic kidney diseases in children and the unique problems in this population vs older adults
- Trace the neuronal pathways that control the urinary sphincters and the micturition reflex
- Define incontinence and compare stress incontinence, overactive bladder/urge incontinence and overflow incontinence
- Describe etiology, pathogenesis and clinical manifestations of two types of bladder cancer
Unit 9: Endocrine System
Outcome: The student will gain an understanding of the physiological functions of hormones and endocrine glands as well as disease/disorder that results from the over or underproduction of selected hormones
- Identify the function of a hormone receptor and the difference between cell surface and intracellular receptors
- Describe the role of the hypothalamus in regulating the pituitary gland and endocrine function as a whole
- Describe positive and negative feedback control mechanisms in the body, giving an example of each.
- Identify mechanism of action for the following hormones: ACTH, TSH, LH, FSH, GH, T3 and T4, mineralocorticoids, glucocorticoids, insulin, glucagon
- Differentiate between hypo-function and hyper-function; primary, secondary and tertiary endocrine disorders
- Describe etiology, pathogenesis and clinical manifestations of selected endocrine disorders: dwarfism, gigantism, acromegaly, hypothyroidism, hyperthyroidism, Graves’ disease, Addison disease, Cushing syndrome, diabetes mellitus (type 1, type 2, gestational diabetes,), diabetic ketoacidosis, hypoglycemia, diabetic neuropathy
Unit 10: Musculoskeletal System
Outcome: The student will gain an understanding of the formation and maintenance of bone, the healing of fractures and soft tissue injuries, and the pathology of selected diseases that impact muscles and bones.
- Describe the characteristics of elastic cartilage, hyaline cartilage and fibrocartilage including locations of each
- List the four types of bone cells and their function
- Describe the function of parathyroid hormone, calcitonin, and vitamin D in the creation of bone and its metabolism
- Explain the referral of pain in all joints in an extremity when the disease process only impacts one joint
- Describe the process of healing for soft tissue and fracture injuries
- Identify the 7 different types of fractures
- Describe etiology, pathogenesis and clinical manifestations of selected musculoskeletal disease/disorders: complex regional pain syndrome, thromboemboli, fat embolism syndrome, osteomyelitis, tuberculosis of the bone, osteonecrosis, neoplasms (benign, osteosarcoma, Ewing sarcoma, chondrosarcoma), mestatic bone disease, scoliosis, torsional deformities of the legs, blount disease, flatfoot, osteogenesis imperfecta, Legg-CalvePerthes disease, Osgood-Schlatter disease, osteoporosis, osteomalacia, rickets Paget disease
- Describe the function of the epiphyseal growth plate during skeletal development and growth
- Describe etiology, pathogenesis and clinical manifestations of selected rheumatic diseases: rheumatoid arthritis, systemic lupus erythematosus, scleroderma, ankylosing spondylitis, psoriatic arthritis, osteoarthritis syndrome, gout, juvenile idiopathic arthritis
Unit 11: Integumentary System
Outcome: The student will gain an understanding of the types of skin cells and accessory organs along with their functions and the pathology of selected skin disorders and cancers.
- Trace the changes a keratinocyte goes through from creation in the basal lamina to arrival at the outer surface of the skin
- Describe the function of the following skin accessory glands: sebaceous gland, eccrine gland, apocrine gland, nails, hair
- Identify the sensory and immunity functions provided by the skin
- Identify the function of the following cells: keratinocytes, melanocytes, merkel cells, Langerhans cells, papillary dermis, reticular dermis
- Describe the common skin rashes and lesions: macule, patch, papule, plaque, nodule, tumor, wheal, vesicle, bulla, pustule
- Describe the causes of pruritus (itching) and dry skin
- Describe etiology, pathogenesis and clinical manifestations of selected primary skin disorders: vitiligo, albinism, superficial fungal infections (ex. Candida albicans, ringworm/tinea), impetigo, cellulitis, warts, herpes simplex and zoster, acne vulgaris, rosacea, allergic/contact dermatitis, atopic/nummular eczema, uticaria, psoriasis, scabies, pediculosis
- Compare first, second, and third degree burns in terms of tissue involvement and clinical manifestations
- Identify potential systemic complications of burns
- Cite two causes of pressure ulcers
- Describe the origin of moles and draw a relationship to skin cancers
- Describe etiology, pathogenesis and clinical manifestations of selected skin cancers: basal cell carcinoma, squamous cell carcinoma, malignant melanoma
Unit 12: Reproductive System
Outcome: The student will gain an understanding of the development of male and female reproductive organs, the function of those organs, hormones that impact the development/function of the organs, and pathogenesis of diseases affecting the reproductive system as well as common STIs.
- Describe the embryonic development of the male reproductive organs and genitalia
- Identify the structure/function of the testes, scrotum, genital ducts, accessory organs, and penis
- List the steps of spermatogenesis
- Diagram the secretion, action site and feedback control of GNRH, LH, FSH, and inhibin in the male reproductive system
- Describe the effects of testosterone secretion on the male body
- Describe etiology, pathogenesis and clinical manifestations of selected male reproductive disorders: hypogonadism, hypospadias, epispadias, peyronie disease, erectile dysfunction, epididymitis, cryptorchidism, testicular cancer, benign prostatic hyperplasia, prostate cancer
- Identify the autonomic and nonautonomic nerve system control of: erection, emission, ejaculation
- Explain the physiology of penile erection and relate it to erectile dysfunction and priapism
- List the signs of penile cancer and describe the cell types involved in seminoma, embryonal carcinoma, teratoma and choriocarcinoma tumors of the testes
- Compare the pathology and symptoms of acute bacterial prostatitis, chronic bacterial prostatitis, chronic prostatitis/pelvic pain syndrome
- Name the three layers of the uterus and describe their function
- State the location of the ovaries in relation to uterus and uterine tubes
- Describe feedback control of estrogen and progesterone levels by means of GNRH, LH, FSH and ovarian follicle function
- Relate FSH and LH levels to stages of follicular development and estrogen/progesterone production
- Discuss the risks/benefits of hormonal replacement therapy in postmenopausal women
- Discuss abnormalities associated with: Bartholin cysts, non-neoplastic epithelial disorders, vulvodynia and cancers of the vulva
- Describe etiology, pathogenesis and clinical manifestations of selected female reproductive disorders: vaginitis, cervical cancer, endometriosis, endometrial cancer, pelvic inflammatory disease, ectopic pregnancy, polycystic ovarian syndrome, ovarian cancer, dysfunctional menstrual cycles (including amenorrhea, dysmenorrhea), PMS, mastitis, breast cancer
- Identify the function of the supporting ligaments and pelvic floor muscles in maintaining position of pelvic organs including uterus, bladder and rectum and relate to failure such as: cystocele, rectocele, enterocele, uterine prolapse
- Provide a definition of infertility and list male/female factors that contribute to infertility
- Describe etiology, pathogenesis and clinical manifestations of selected STIs: genital warts, herpes, candidiasis, trichomoniasis, bacterial vaginosis, chlamydia, gonorrhea, syphilis
Unit 13: Nervous System
Outcome: The student will gain an understanding of the CNS, PNS, special senses, transmission of impulses throughout the body and disease/disorders that affect the nervous system, brain, and special senses
- Distinguish between functions of neurons and neuroglial cells of the nervous system
- Describe the structure and function of the three parts of a neuron
- Identify the metabolic requirements of nervous tissue
- Diagram the three phases of an action potential and relate the functional importance of ion channels to each phase
- Characterize the role of EPSPs and IPSPs as they relate to spatial and temporal summation of membrane potentials
- Diagram and explain how neurotransmitters are stored, released, inactivated and synthesized
- Describe the organization of the nervous system using terms afferent, efferent, ganglia, association neuron, cell column, tract, dorsal and ventral root
- Describe structures innervated by segmental nerves containing afferent and efferent processes
- Describe the function of spinal cord reflexes and diagram a general reflex
- Identify the structures of the brainstem, cerebral cortex, cerebellum and their functions
- Describe location and function of the twelve cranial nerves
- Compare the sensory and motor components of the ANS to those of the CNS
- Compare location of sympathetic and parasympathetic nervous systems
- Identify neurotransmitter synthesis, release, degradation and receptor function in sympathetic and parasympathetic nervous systems
- Describe the organization of the somatosensory system in terms of first, second and third order neurons
- Summarize the structure and function of the dorsal root ganglion neurons in terms of conduction velocity, spinal cord projections, and sensory receptors
- Compare tactile, thermal and position in terms of receptors, stimuli necessary, pathways used, and central integrative mechanisms
- Discuss difference among specificity, pattern, gate control, and neuromatrix theories of pain
- Discuss difference between the different types of pain and pain perception
- Explain transmission of pain signals with reference to the neospinothalamaic, paleospinothalamic, and reticulospinal pathways including chemical mediators and factors that modulate pain
- Describe the characteristics and cause of neuropathic pain, trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome
- Discuss a possible mechanism for phantom limb pain
- Describe etiology, pathogenesis and clinical manifestations of selected headaches: migraine, cluster, tension headaches, headache caused by TMJ syndrome, chronic daily headache,
- Identify the most common cause of TMJ pain
- Define “motor unit” and characterize its mechanism of controlling skeletal muscle movement
- Compare the effect of upper and lower motor neuron lesions on the spinal cord stretch reflex functions and muscle tone
- Compare peripheral mononeuropathies with polyneuropathies with respect to cause and manifestation
- Describe etiology, pathogenesis and clinical manifestations of selected muscular disorders/diseases: Muscular dystrophy, Clostridium botulinum toxin (botulism), Myasthenia gravis, carpal tunnel syndrome, Guillain-Barre Syndrome, herniated disk
- Describe etiology, pathogenesis and clinical manifestations of selected disorders of the cerebellum: Parkinson’s disease, basal ganglia movement disorders (such as tremor, atheotosis, chorea, dyskinesia, etc.)
- Identify the three general efferent pathways leading out of the cerebellum and their function
- Describe etiology, pathogenesis and clinical manifestations of selected upper motor neuron disorders: Lou Gehrig disease, multiple sclerosis, acute spinal cord injury
- Identify the characteristics of the levels of consciousness
- Determine the mechanisms that control intracranial pressure
- Compare cytotoxic, vasogenic, and interstitial cerebral edema
- Describe the effects of primary and secondary brain injury
- Summarize the different types of hematomas that can occur in the brain
- Differentiate between focal and diffuse brain injuries
- Identify the major vessels in cerebral circulation
- Describe etiology, pathogenesis and clinical manifestations of selected brain injuries or diseases: hydrocephaly, ischemic stroke, hemorrhagic stroke, arteriovenous malformation, meningitis, encephalitis, brain tumors, primary CNS lymphoma, seizures (focal and generalized)
- Discuss the stress-diathesis theory and the role of trauma in the development of psychiatric disorders
- Identify the effect of the following brain neurochemicals: Ach, dopamine, norepinephrine and epinephrine, serotonin, GABA, corticotropin-releasing hormone, cortisol, DHEA
- Describe etiology, pathogenesis and clinical manifestations of selected psychiatric disorders: schizophrenia, major depression/dysthymia, bipolar disorder, panic disorder, generalized anxiety disorder, OCD, social phobia
- Describe etiology, pathogenesis and clinical manifestations of selected memory/cognition disorders: Alzheimer’s, dementia, Creutzfeldt-Jakob disease, Wernicke-korsakoff syndrome, Huntington disease
- Describe etiology, pathogenesis and clinical manifestations of selected diseases/disorders of the special senses: ptosis, blepharitis, dry eye, dacryocystitis, conjunctivitis, keratitis, glaucoma, cataracts, colorblindness, retinitis pigmentosa, retinopathy, retinal detachment, macular degeneration, retinoblastoma, strabismus, amblyopia, otitis externa, otitis media (acute and with effusion), hearing loss (conductive and sensorineural), tinnitus, nystagmus, vertigo, Meniere disease
- Trace the pathway of light as it enters the eye
- Explain how a sound wave enters the ear and is transmitted to the brain as sound
Project Required:
Instructor determined
Textbook:
Contact Bookstore for current textbook.
Materials/Equipment Required:
None
Attendance Policy:
Students should adhere to the attendance policy outlined by the instructor in the course syllabus.
Grading Policy:
The grading policy will be outlined by the instructor in the course syllabus.
Maximum class size:
Based on classroom occupancy
Course Time Frame:
The U.S. Department of Education, Higher Learning Commission and the Kansas Board of Regents define credit hour and have specific regulations that the college must follow when developing, teaching and assessing the educational aspects of the college. A credit hour is an amount of work represented in intended learning outcomes and verified by evidence of student achievement that is an institutionally established equivalency that reasonably approximates not less than one hour of classroom or direct faculty instruction and a minimum of two hours of out-of-class student work for approximately fifteen weeks for one semester hour of credit or an equivalent amount of work over a different amount of time. The number of semester hours of credit allowed for each distance education or blended hybrid courses shall be assigned by the college based on the amount of time needed to achieve the same course outcomes in a purely face-to-face format.
Refer to the following policies:
402.00 Academic Code of Conduct
263.00 Student Appeal of Course Grades
403.00 Student Code of Conduct
Disability Services Program:
Cowley College, in recognition of state and federal laws, will accommodate a student with a documented disability. If a student has a disability which may impact work in this class and which requires accommodations, contact the Disability Services Coordinator.
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