Students will complete three modules addressing cellular energy production, cardiac conduction system, and oxygen uptake and release, and relevant diseases associated with each. Each module will be presented in a clinical context and will use four learning modalities: reading text, viewing animations and illustrations, watching videos, and answering questions.
Athena Title
Fdn of Clinical Medicine III
Non-Traditional Format
This course will be taught 95% or more online.
Prerequisite
BIOL 1104 or BIOL 2104H or BIOL 1108 or BIOL 2108H
Semester Course Offered
Offered fall, spring and summer
Grading System
A - F (Traditional)
Student Learning Outcomes
Students will understand how to describe the biochemical processes involved in the generation of ATP from metabolism of glucose molecules.
Students will understand how to explain where glycolysis, the citric acid cycle, and oxidative phosphorylation occur in the cell.
Students will understand how to describe the processes involved in substrate phosphorylation.
Students will understand how to recognize the relative roles of NADH and FADH2 in the generation of ATP during the metabolism of glucose molecules
Students will understand how to describe where ATP synthase is located and how the electron transfer chain and oxidative phosphorylation generate ATP.
Students will understand how to describe the processes responsible for the generation of lactate and why replenishment of NAD+ is critical.
Students will understand how to explain how lactate molecules are converted to pyruvate and eventually to glucose molecules.
Students will understand how to explain how the pH of the intermembrane space might play an important role in the activity of the citric acid cycle.
Students will understand how to describe the basic anatomy of the heart and its electrical conduction system.
Students will understand how to explain why electrical signals pass so quickly between myocardial cells.
Students will understand how to describe the changes in movement of ions into and out of the cells in the SA node during generation of an action potential.
Students will understand how to explain the effects of changes in membrane potential (i.e., voltage) on different ion channels.
Students will understand how to describe the processes responsible for repolarization of cells in the SA node.
Students will understand how to compare the rates of depolarization of cells in the SA node, AV node, and Purkinje fibers.
Students will understand how to compare the action potentials of cells in the SA node to those of myocardial cells.
Students will understand how to explain the processes responsible for the development of either tachycardia or bradycardia.
Students will understand how to describe the differences between first, second, and third-degree heart block, and how each of these conditions is treated.
Students will understand how to describe the basis for the current use of pacemakers in clinical practice.
Students will understand how to describe the interactions between oxygen and hemoglobin molecules, and how they account for the change in color of blood as it passes through the lungs.
Students will understand how to explain where red blood cells are produced, their primary function in the body, and why they are biconcave in shape.
Students will understand how to describe the processes responsible for movement of oxygen molecules in alveolar air into the bloodstream.
Students will understand how to recognize the organs responsible for removal of red blood cells from the circulation.
Students will understand how to describe the changes in saturation of hemoglobin with oxygen as blood flows from the heart, through the lungs, to the tissues, and back to the heart.
Students will understand how to predict the effects of moving from Athens, GA, to the Grand Teton mountains in Wyoming and then to Mount Everest on the saturation of hemoglobin in arterial blood with oxygen molecules.
Students will understand how to describe the process responsible for the development of sickle cell trait in a newborn child.
Students will understand how to explain a positive effect of having the sickle cell trait and where in the world this might be most apparent.
Students will understand how to explain the clinical relevance of sickle cell disease in a group of patients.
Students will understand how to explain why people with sickled red blood cells develop anemia.
Topical Outline
The production of ATP via glycolysis and the Kreb’s cycle
Generation of pyruvate and ATP molecules from glucose via substrate phosphorylation
Entry of acetyl-CoA into the citric acid cycle and the generation of NADH, FADH2, and CO2
Components of the electron transport chain in the inner mitochondrial membrane
Pumping of H+ ions from the matrix to the intermembrane space by complexes I, III, and IV
Generation of ATP by movement of H+ ions through ATP synthase
Interaction of NADH and FADH2 with specific components of the electron transport chain
Conversion of pyruvate to lactate by lactate dehydrogenase
The importance of replenishment of NAD+
Use of blood concentrations of lactic acid as a marker for circulatory shock in people
Conversion of lactate to glucose via the Cori cycle in the liver
The effects of cyanide on cytochrome c oxidase and its effects on ATP production
Effects of barbiturates on complex I in the electron transport chain
The role of coenzyme Q10 (ubiquinone) in the function of the electron transport chain
The effects of pH in the intermembrane space on the mitochondrial pyruvate carrier protein
The roles of the fibrous skeleton and gap junctions in the heart
The cardiac conduction system and its components
Propagation of electrical signals from the SA node to the internodal tracts, interatrial tract, and AV node
Distribution of electrical signals to ventricular myocytes via the Bundle of His, bundle branches, and Purkinje fibers
The roles of the Na+/K+ ATPase, K+ channels, and electrolytes in the resting membrane potential
The roles of Na+/K+ ATPase, K+ channels, Na+ channels, and Ca++ channels on action potentials in the SA node
The processes responsible for diastolic depolarization in the SA node
The roles of threshold, phase 0, phases 3 and 4 in an action potential in the SA node
The development of action potentials in myocardial cells
The potential for cells in the AV node to serve as pacemaker cells
Components of a normal ECG by the cardiac conduction system
Changes in membrane potential responsible for tachycardia
The roles of epinephrine and norepinephrine on the rate of change in membrane potential in SA nodal cells
The roles of acetylcholine and K+ channels on changes in membrane potential during bradycardia
First, second, and third degree heart block and their clinical effects
Cardiac pacemakers, how they work, and conditions in which they are used
Production and release of red blood cell
Structure of hemoglobin and how it binds and releases oxygen molecules
The importance of the biconcave shape of red blood cells
The effects of binding and release of oxygen molecules on the shape of hemoglobin molecules in the lungs and tissues
The role of partial pressure of oxygen on its uptake and release by hemoglobin
The basics of the oxygen-hemoglobin dissociation curve
Measurement of oxygen saturation by pulse oximeter and changes in SpO2 with pulmonary diseases
The life span of normal red blood cells vs those from a patient with sickle cell anemia
The effects of deoxygenation on the shape and rigidity of red blood cells in patients with sickle cell anemia
A comparison of sickle cell anemia and sickle cell trait
The incidence of sickle cell trait based on epidemiological data
Why clinical signs of sickle cell disease first occur in children around 4 months of age
Common clinical signs associated with sickle cell anemia
Factors that trigger clinical signs in people with sickle cell trait
The role of sickle cell trait in the resistance to malaria
Changes in the oxygen-hemoglobin dissociation curve due to changes in pH, temperature, and 2,3 BPG concentrations
The prevalence of malaria in different regions of the world and the populations at greatest risk for developing the disease
The role of malaria in the development of the CDC in the 1940’s
Gene therapy for patients with sickle cell disease
