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Medical Education

Medical Education. Memory competition?. Learning methods vs knowledge keeping. listening = 5% reading = 10% audio-visual = 20% demonstration = 30% discussion = 50% hands-on = 75% teaching/using = 90%. Learning Philosophy. I hear and I forget, I see and I remember,

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Medical Education

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  1. Medical Education Memory competition?

  2. Learning methods vs knowledge keeping listening = 5% reading = 10% audio-visual = 20% demonstration = 30% discussion = 50% hands-on = 75% teaching/using = 90%

  3. Learning Philosophy I hear and I forget, I see and I remember, I do and I understand.

  4. Dr. Charles Sidney Burwell(Dean of HMS from 1935 to 1949) • At an HMS graduation in the late 1940s, he said “…Half of what we have taught you is wrong. Unfortunately, we don’t know which half.” • Dr. Burwell was a cardiologist who specialized in circulation changes associated with heart disease. He is credited with bringing attention to obstructive sleep apnea syndrome. In 1944, while Dr. Burwell was Dean, women entered Harvard Medical School for the first time on an equal basis with men.

  5. "It has been estimated that, from the beginning of civilization — 5,000 years ago or more — until 2003, humanity created a total of five exabytes (billion gigabytes) of information. From 2003 to 2010, we created this amount every two days. By 2013, we will be doing so every ten minutes, exceeding within hours all the information currently contained in all the books ever written. So it isn't that we need more knowledge; it is that we need to distinguish between what we know and what we don't know, through what Firestein calls “controlled neglect”. Researchers must selectively ignore vast quantities of facts and data that block creative solutions, and focus on a narrow range of possibilities. "To make discoveries, researchers need to look beyond the facts.” Ignorance includes an important discussion about scientific errors and their propagation in textbooks. I admit that I passed one on in my last book, The Believing Brain (Times Books, 2011): I repeated as gospel the 'fact' that the human brain contains about 100 billion neurons. Firestein reports that it is actually around 80 billion, and that the number of glial cells is an order of magnitude smaller than most textbooks state. The 'neural spike' recorded by neuroscientists as a fundamental unit of brain activity, Firestein reminds us, is an artefact of our measuring devices and ignores other forms of neural activity. Even the famous and widely printed 'tongue map', which shows sweet flavours sensed on the tip of the tongue, bitter on the back and salt and sour on the sides, is wrong — the result of a mistranslation of a German physiology paper. These and other errors arise as a result of our lack of scepticism towards the knowledge we have.”

  6. Handheld device software • Archimedes: medical calculator • >150 equations • Unit exchange • Epocrates: drugs manual • >3300drugs • More than 45% medical doctors used • DynaMed: evidence based medicine database

  7. Introduction to Human Physiology XIA Qiang, MD & PhD Department of Physiology Room 518, Block C, Research Building School of Medicine, Zijingang Campus Email: xiaqiang@zju.edu.cn Tel: 88208252

  8. Course Structure • Lectures: 80 academic hours • 5 a.h./week • 2 a.h. on Tue., 3 a.h. on Thu. • Practicals: 64 a.h. • 4 a.h./week • Begin from second week (11/3)

  9. Evaluation Participation: 5% Practical reports: 15% Weekly assessments, mini-tests at lecture & midterm exam: 30% Final examination: 50%

  10. Recommended textbook Widmaier EP, Raff H, Strang KT (2006) Vander’s Human Physiology: The Mechanisms of Body Function, Tenth Edition. McGraw-Hill.

  11. Course website • Course website: • http://m-learning.zju.edu.cn • Demo

  12. Life Logic Study 生 理 学 Physiology: the study of the logic of life

  13. Viral Physiology Bacterial Physiology …… Physiology Human Physiology Plant Physiology Animal Physiology

  14. Human Physiology • Specificcharacteristics, functions and mechanisms of the human body that make it a living being What ? How ?

  15. Exercise Physiology

  16. Aviation, high-altitude, and space physiology

  17. Diving and Hyperbaric physiology

  18. History of Physiology C. Galen (129-200) (Ancient Greco-Roman)

  19. Leonardo da Vinci (1452-1519) (Italian)

  20. Rise of modern physiology De Motu Cordis “On The Motion Of The Heart And Blood In Animals” (1628) (http://www.fordham.edu/halsall/mod/1628harvey-blood.html) W. Harvey (1578-1657) (English)

  21. An Italian physiologist who used a microscope to discover the capillaries, crowning Harvey’s investigation M. Malpighi (1628-1694)

  22. L. Galvani (1737-1798) (Italian)

  23. A French physiologist known for his idea of theinternal environment (1813-1878)

  24. A Russian physiologist known chiefly for his development of the concept of the conditioned reflex Awarded the Nobel Prize for Physiology or Medicine in 1904 Павлов (Ivan Pavlov) (1849-1936)

  25. 中国生理学会 Chinese Association for Physiological Sciences (founded in 1926) 林可胜(Robert Kho Seng Lim)(1897-1969) “Father of Chinese Modern Physiology”

  26. Levels of Physiological research

  27. 1.3 340/380 0.6 5s 5s Measurement of [Ca2+]i 120 Cell length (m) 90 Measurement of cell shortening 1. Cellular and molecular Physiology

  28. 2. Organ and System Physiology

  29. 3. Integrative Physiology Acute experiment

  30. Chronic experiment

  31. Body Fluid = 60% of Body Weight (BW) Plasma 5% of BW Extracellular Fluid 1/3, 20% of BW Interstitial Fluid 15% of BW 70 kg Male, 42 L Intracellular Fluid 2/3, 40% of BW Internal environment

  32. Plasma 5% of BW Extracellular Fluid 1/3, 20% of BW Interstitial Fluid 15% of BW Internal Environment External Environment

  33. Extracellular Fluid= Internal Environment

  34. Homeostasis Homeostasis(from the Greek words for “same” and “steady”): maintenance of static or constant conditions in the internal environment W. Cannon

  35. Components of Homeostasis: • Concentration of O2 and CO2 • pH of the internal environment • Concentration of nutrients and waste products • Concentration of salt and other electrolytes • Volume and pressure of extracellular fluid

  36. How is homeostasis achieved? ----Regulation Body's systems operate together to maintain homeostasis: Skin system Skeletal and muscular system Circulatory system Respiratory system Digestive system Urinary system Nervous system Endocrine system Lymphatic system Reproductive system

  37. Regulation of body functions • Nervous Regulation • Humoral Regulation • Autoregulation

  38. Nervous regulation Reflex Knee jerk reflex

  39. Reflex Arc • Receptor • Afferent (sensory) nerve • Reflex center (brain or spinal cord) • Efferent (motor) nerve • Effector

  40. Hormone Endocrine cells Receptor Hormone Humoral regulation Traditional description of humoral regulation by hormone

  41. Endocrine action:the hormone is distributed in blood and binds to distant target cells • Paracrine action:the hormone acts locally by diffusing from its source to target cells in the neighborhood • Autocrine action:the hormone acts on the same cell that produced it

  42. Neuroendocrine (Neurosecretion) Vasopressin Oxytocin

  43. Pheromone Ant Alarm Pheromone Pheromone for Men Original price: $99.95

  44. Autoregulation Definition:Intrinsic (independent of any neural or humoral influences) ability of an organ to maintain a constant blood flow despite changes in perfusion pressure Mechanism: Stretch-activated constriction of vessels Significance: Maintenance of near-constant cerebral, renal and coronary blood flow

  45. 80~180 mmHg

  46. Control systems of the body CYBERNETICS or Control and Communicationin the Animal and the Machine (MIT Press 1948) Norbert Wiener (1894-1964) Originator of Cybernetics

  47. Stimulus Response Control Center Effectors 1. Non-automatic Control System Open-loop system Seldom seen under physiological conditions Stress

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