Learning outcomes

Human physiology courses are designed to provide an understanding of the pathophysiology of diseases, their causes, progression and treatment. A mastery of the physiology of the various systems (respiratory, cardiovascular, renal, digestive, etc.) is an essential prerequisite for medical practice. MMEDB207 is devoted to the physiology (and introduction to pathophysiology) of the digestive and renal systems. 
 
The part dedicated to renal physiology deals with the different functions of the kidneys and their contribution to the regulation of hydric, ionic and acid-base balance, blood pressure, phosphocalcic metabolism, as well as the excretion of metabolic waste or exogenous substances. Certain fundamental principles covered in the general physiology course will be reviewed in order to facilitate understanding of the cellular and molecular mechanisms involved in the functioning of the nephron (tubular reabsorption/secretion, glomerular filtration, etc.).
 
The section on digestive physiology deals with the functions of the digestive tract: digestion, secretions, absorption and elimination. The physiology of glands attached to the digestive tract, such as the pancreas, liver and bile ducts, is developed, as well as the regulation of appetite and the functions of the intestinal microbiota. This teaching is intended to be integrative and may draw on knowledge acquired in other courses. In this case they will be reintroduced and it will be explained how distant systems can interact.

Goals

At the end of this course, the student will be able to master the normal physiology of the digestive and renal systems. To this end, the student must master the concepts involved in the functioning of the digestive and renal systems and develop a transversal vision of physiology, i.e. integrated with the other parts of the physiology courses (respiratory physiology, cardiovascular physiology, etc.). Elements of physiopathology are developed during the course and form an integral part of the subject. At the end of the course, students will be able to use the material taught to analyse and solve simple pathological cases. The specific objectives for each chapter of the subject are detailed and available in a document published on the Webcampus platform.
 
In addition, at the end of the course, students will be able to demonstrate their understanding of the interconnection of the functions described in the course, for example with the help of diagrams.

Content

The course is given for 5 hours per week (2 hours of renal physiology and 3 hours of digestive tract physiology) during the second four-month period. The slides projected during the course are available on the Webcampus platform. Clinical examples will be used regularly during the course to illustrate physiological and pathophysiological concepts and to facilitate understanding. The content of these examples may vary according to the interest of the audience or the questions raised during the discussions. In addition, course notes summarising the main points of the subject and providing additional information are available on the Webcampus platform. The material covered in the lecture notes and the material covered in the audience form part of the examination material. Self-evaluation may be offered in the auditorium (discussion in the auditorium, interactive devices, etc.). Lectures or other non-conventional material may be provided by teachers to illustrate their lectures; examination questions may be related to these. 

Table of contents

The subjects taught in the renal physiology section are as follows:
  1. Anatomy and functional histology of the kidneys
  2. Glomerular filtration
  3. Principles of tubular transport
  4. Tubular transport of NaCl, water, metabolic waste and exogenous substances
  5. Regulation of water and sodium, circulating volume and osmolality
  6. Regulation of potassium balance
  7. Regulation of acid-base balance
  8. Regulation of calcium, phosphate and magnesium
 
 
The topics taught in the digestive physiology section include the following (order of presentation may change):
 
  1. Anatomy and functional histology
  2. Digestive and intestinal vascularisation
  3. Regulation of the digestive system
  4. Secretion from the digestive tract
  5. Motility of the digestive tract
  6. Digestive absorption
  7. Liver physiology
  8. Colon and microbiota
  9. Regulation of appetite
 

Exercices

Twenty hours of exercises are planned in the form of practical laboratory work and tutorials. Their main aim is to illustrate various characteristic and important elements of physiopathology. In this context, clinical cases in which the student is required to seek information and propose a diagnostic approach will be proposed. Some of the elements seen during the tutorial sessions form part of the subject. These points will be clarified.

Teaching methods

The students will present the results of this practical work to the audience in groups.
 
1. Ex cathedra course, based on a slide show, available on Webcampus. Schematics developed on the blackboard will not systematically be made available online.
2. Regular self-assessment in class via an interactive platform.
3. Course notes (not exhaustive and summarising or supplementing the material taught) available on Webcampus.
4. TP-TDs (attendance compulsory except for bisseurs students) in groups covering different themes (see ‘Exercises’ section):
  • Renal failure
  • Acid-base balance
  • Dilution and concentration of urine and blood sugar regulation
  • Effects of diuretics
  • Glycaemic balance
  • Digestion and assimilation of nutrients
 

Assessment method

The assessment will take the form of a written exam: multiple-choice questions and/or open-ended questions covering topics covered in lectures and practicals. Some open-ended questions and/or graded exercises may be offered online and counted towards the final grade.


In the event of an unjustified absence from a practical or tutorial, a negative assessment will be communicated to the professor in charge. 


The exam is divided into two parts, one part assessing understanding of the material covered in renal physiology, which accounts for 50% of the marks, and another part assessing understanding of digestive tract physiology, which accounts for 50% of the marks. A score of 50% or higher on the exam will result in the awarding of credits for the course unit, provided that a minimum of 50% has been obtained in each of the two parts.


The final grade is negatively affected by 


one or more deficiencies deemed serious in relation to the defined course objectives, as revealed by the answers to the open-ended questions in the exam.

unjustified absence from practical and supervised work sessions (TP-TDs). The mark out of 20 is reduced by 1/20 (of the overall mark for the teaching unit) for each absence from a TP-TD session. In the event of an absence that is justified and verifiable, an alternative solution to this penalty will be discussed with the teachers.

A score of less than 50% in one of the two parts. In this case, the total is capped at 9/20. Only the failed exam must be retaken in the second session. 


The exact assessment methods are subject to change when the exam schedule is drawn up, depending on the practical constraints that the faculty administration may face, or in the event of illness, force majeure, or an internship-related emergency preventing the student from taking the exam on the originally scheduled date.


Credit award criteria


Credits for the course are awarded when a grade of 50% or higher is obtained, provided that a minimum of 50% has been obtained in each of the two parts. The average takes into account any decimal places; a grade of 9.4/20 is therefore well below 10/20 and is rounded down to 9/20.


In the event of failure in the second session (average of the two parts <50% and/or one of the two parts <50% with a cap of 9/20), the entire teaching unit must be retaken the following year. There is therefore no partial exemption from one academic year to the next.


A session to consult exam papers will be offered at the end of the session, after deliberation. It is intended to enlighten students on the nature of the errors made. At the end of the session, the exam grade is never changed.


Sources, references and any support material

Slideshows and lecture notes available on Webcampus.
 
Additional references are strictly optional:
 
  • Boron WF, Boelpaep EL. Medical physiology. 2nd edition. Elsevier Saunders. ISBN 978-0-8089-2449-4
  • Hall JE. Guyton and Hall Textbook of Medical Physiology. 13th ed. Saunders. ISBN 978-1455770052
  • Ganong, Barett, Barman, Boitano, Brooks. Medical Physiology. 3rd edition. Editions de Boeck. ISBN 978-2804169022

Language of instruction

French
Training Study programme Block Credits Mandatory
Bachelor in Medicine Standard 0 4
Bachelor in Medicine Standard 2 4