My Disease is celiac disease and the subtopic you're supposed to write about isDiagnosis: clinical and sub-clinical categorizationsiagnosis: clinical and sub-clinical categorizations
Microsoft Word - Disease Seminar Handbook W'22.docx Disease Seminar Handbook BIOL*1080: Biological Concepts of Health Winter, 2022 UNIVERSITY OF GUELPH 2 TableofContents INTRODUCTION:DISEASESEMINARS 3 INTRODUCTION 3 OVERVIEWOFASSIGNMENT 4 EVALUATIONANDIMPORTANTDATES 5 DISEASECATEGORIES-“THENORMAL/BACKGROUND” 6 WHATISHEALTH?WHATISDISEASE? 6 SKINCANCER 7 PARKINSON’SDISEASE 11 LYMEDISEASE 14 CELIACDISEASE 17 RHEUMATOIDARTHRITIS 20 GASTROESOPHAGEALREFLUXDISEASE 23 EVALUATION 25 RUBRIC:ORALPRESENTATION 26 RUBRIC:WRITTENASSIGNMENTS 26 RUBRIC:PEEREVALUATION 27 REFERENCESHEETSFORHOMEWORK 28 SUGGESTEDRESOURCES 28 HOWTOREFERENCETHEBIOL1080TEXTBOOK 29 UNACCEPTABLEREFERENCESOURCESFORBIOL1080 30 TEMPLATEFORSEMINARSLIDES 31 ORGANIZINGINFORMATION 34 TIPSFORPOWERPOINT 35 TIPSFORORALPRESENTATION 36 3 Introduction: ThisseminaractivityforBIOL*1080involvesindependentandgroupresearchintomultiple diseasesbyfollowingacommondiseasetemplateprovidedforyou.Eachweek’sactivityand assignmentbuildstowardsthenext.Asyouprogressthroughyourindividualresearch,youwill meetweeklywithyourdiseasegrouptodiscussyourfindingsandlearnfromyourgroup members’perspectives.Thistimewillallowyoutothinkofyourassigneddiseaseasawhole– notjustasyourindividualcomponent.Youwillalsohavetheopportunitytodiscussyourtopic withstudentsresearchingadifferentdiseaseallowingyoutocomparesimilaritiesand differencesbetweendiseases.Youmightbesurprisedtoseesimilartrendsacrossdisease categories! Theprimarylearningobjectivesofthediseaseseminarsare: 1. Learnaboutdiseasesusingastandardtemplate. 2. Practiceandimproveoralcommunicationskills. Morespecifically,bytheendofthediseaseseminars,successfulstudentswillbeableto: 1. Logicallyorganizeinformationtoeffectivelycommunicateideasorally. 2. Researchasubjectinthewrittenliterature,distill,convertandorganizetheinformation intoaclear,concisestoryfororalpresentation. 3. Describeandparticipateintheprocessofpreparingapresentation. 4. Identifyandperformtheskillsnecessaryforaneffectivepresentation. 5. Demonstratetheimportanceoflanguage,voice,gestures,andvisualaidsinaneffective presentation. 6. Illustrate,throughapublicpresentation,theabilitytoshareinformationandincrease audienceunderstandingaboutachosentopic. 7. Gainafunctionalappreciationandanincreasedawarenessfortheirownoral presentationstyle. 8. Usefeedbacktoenhancetheirpresentationskillsforfuturepresentations. Thishandbookwillserveasahelpfulguideasyoustartyourresearchonyourassigneddisease andtopic.Whenwestudyadisease,itisbesttostartbyunderstandingthe‘normal’.Thatis– howdoesthebodyorsystemoperateundernon-diseaseconditions?Onlyonceweunderstand thenormalfunctionofthebodycanwestarttouncoverthechangesthatoccurduringthe course/progressionofadisease.Then,whenweunderstandwhatchangesleadtodisease itself(i.e.:diseasepathology)wecanbegintoask–howcanwepreventthesechanges?How significantdothesechangesneedtobetocauseclinicalmanifestationofdisease?Whatcanwe dotomanage,treatorreversethechanges?Whatimpactdothesechangeshaveonanindividual, theirfamily,oursociety?Whatrecentadvancementshavebeenmadeinthefield?Thesewillbe themainquestionsexploredinthediseaseseminars. Theinformationprovidedinthishandbookwillserve2mainfunctions. 1. Itwillhelpyouunderstandthebasicunderlying‘normal’physiologyofthebodysystems relevanttoyourassigneddiseasesothatyoucanstarttobuildonitanduncoverdisease specificconcerns. 2. Itwillserveasareferenceguidewithhelpfultipsandsuggestionsforcompletingyour independentresearch,writtenassignmentandoralpresentation. 4 OverviewofAssignment AspartoftheBIOL*1080course,thelargelecturesarecomplementedwithweekly,smallgroup seminars.Theseseminarsareamandatorycomponentofthecourseandwillaccountfor25%of yourfinalmark.Intheweeklyseminars,youwillbeworkinginsmallgroupstoresearchan assigneddisease,andthenpresentitorallyinashortPowerPointpresentation. TheselecteddiseasesfortheW’22semesterare: 1. SkinCancer 2. Parkinson’sDisease 3. LymeDisease 4. CeliacDisease 5. RheumatoidArthritis 6. GastroesophagealRefluxDisease Withineachseminarsection,studentswillbeassignedtoaresearchgroupof5andtheneach groupwillbeassignedoneofthe6diseases.Usinga5-categoryresearchtemplate(seebelow), eachgroupmemberwillberesponsibleforcoveringadistinctaspectofhis/herassigneddisease. Theseareashavebeendividedasfollows: 1. Anatomy,physiologyandpathology–thenaturalcourseofthedisease 2. Riskfactors,causesandpreventiveinterventions 3. Diagnosis:clinicalandsub-clinicalcategorizations 4. Therapeutictreatmentsandpost-treatmentmanagement 5. Individualandfamilialwellbeing,societalimpact,andmostpromisingresearch advancement Basicbackgroundinformationoneachdiseasecategoryisfoundinthismanualasitappliesto normalphysiologicalfunctiontohelpyougetstarted.Alladditionalinformationthatyouneedto completeyourresearchwillbegatheredindependently. Duringthefirst4seminarsessions,youwillattendyourweeklyseminartomeetwithyourgroup andworkontheassignment.EachclasswillbeginwithadifferentlessonbyyourTAtohelpyou progressinyourresearchandworkthroughchallenges.Asignificantpartofeachseminarwill bereservedforgroupworkontheassigneddisease.Weeklyattendanceofallgroupmembers iscrucialinordertosucceedattheseminarassignment.Pleasenote:1%ofthefinalmarkis basedonpeer-evaluation!Inaddition,ahomeworkassignmentwillbegivenduringseminar three. Bytheendofseminarweek6,eachstudentwillhaveprepared3PowerPointslidestobeputinto agroupPowerPointpresentation.Inseminars#7-9,studentswillpresentagroupPowerPoint presentationontheirdisease(3minutesperstudent,witheachstudentdiscussingtheir assigneddiseasesubtopic).ThescheduleofpresentationsforW’22willbeasfollows: SeminarWeek7:SkinCancer&Parkinson’sDisease SeminarWeek8:LymeDisease&CeliacDisease SeminarWeek9:RheumatoidArthritis&GastroesophagealRefluxDisease 5 Inadditiontooralcommunicationoftheresearch,allstudentsaretosubmit3pagesof additionaltexttoaccompanytheirslidesonthedayoftheirpresentation.More informationwillbeprovidedaboutthis(i.e.levelofdetailetc.)fromyourTAduringseminar. Evaluation: Theseminaractivitiesareworth25%ofyourfinalmark,dividedasfollows: 4%HomeworkAssignment • Submittedinweekfourofthesemesteronthedayofyourscheduledseminar by11:59pmtotheonlinedropbox 10%OralPresentationonYourDiseaseSubtopic • MustalsosubmitahardcopyofyourPowerPointslidesby11:59pmontheday ofyourpresentationtotheonlinedropbox 10%SupplementaryTextonYourDiseaseSubtopic • Submittedonthedayofyourdiseasepresentationby11:59pmtotheonline dropbox • 3pagesummaryofyourresearchonyourdiseasesubtopic 1%PeerEvaluation • Submittedonthedayofyourpresentationby11:59pmtotheonlinedropbox • Youmustalsoevaluateyourself.Ifyoudonotsubmitapeerevaluation,you giveyourselfa“0” NOTE:ifastudentmissesthegrouppresentationforanunapprovedreason–agradeofZERO (0)willbeassignedforboththeoralcommunicationandadditionaltext(i.e.lossof20%ofthe finalgrade).Approvedabsenceswillbedealtwithonacase-by-casebasis. ImportantDates: NOTE:Pleaseseethecoursescheduleforthespecificdatesofgivenseminars,astheychange dependingonwhichdayoftheweekyourseminarfalls. Week HomeworkDue(%worth) HomeworkGiven 1 NoSeminars 2 None No‘formal’homework 3 None SeminarHomeworkAssignment(4%) 4 SeminarHomeworkAssignment(4%) No‘formal’homework 5 None No‘formal’homework 6 NoSeminars READINGWEEK 7,8,9 Grouppresentations(seescheduleattopofpage) PowerPointslides,finalwrittenpaper,andpeerevaluationstobe submittedby11:59pmonthedayofyourpresentation 10 IntegrativeThinkingProjectSeminar 11 IntegrativeThinkingProjectSeminar(Optional) 12 NoSeminars 6 Whatishealth?Whatisdisease? Fortheentiretyoftheseminarexercise,keepinmindthathealthcanbedefinedas‘physical, mentalorsocialwell-being’andillnessisdefinedas‘physical,mentalandsocialharmful dysfunction’.Thesearefairlybroaddefinitionsand,therefore,itisimportanttorecognizethe multiplecomponentsthatcontributetothecomplexityofhealthanddifferentdiseasestates, ultimatelyemphasizingthevalueofconsideringhealthanddiseasefromasystemsbiology approach.Itisalsoimportanttorememberthateachpersonrepresentsauniquebiological systemandcanrespondtothesehealthanddiseasecomponentsinvaryingways. Diseaseoccurswhenthenormalfunction/physiologyofthebodyisdisrupted.Thisdisruption couldbecausedbyseveralfactors,includinggeneticcomplications,viralorbacterialinvaders, long-termaccumulationofsmallerchallenges/insultstothebody,oroftenacombinationof factors(involvinggenetic,lifestyleandhealthcarebehaviouralandenvironmentalfactors).As such,itisimportanttorecognizethatthereisnouniversalcategorizationofdiseases.Regardless ofcause,themainsimilaritybetweenalldiseasesisthatthenormalstateisalteredsuch thattheControlandCommunicationNetwork(CCN)cannotcorrecttheproblem,the systemshiftsfromhomeostasisanddiseaseensues. Diseasemanagementcanbetargetedbyapreventativemedicineapproach(focusingonrisk assessmentandinterventionpriortodisease)oratherapeuticmedicineapproach(focusingon diagnosisandtreatmentofdisease).Throughtheseminarexercises,itisimportanttoremember thatagingisalsoassociatedwithdiminishedfunctionofthecontrolandcommunicationnetwork and,thus,theagingprocessitselfcanbeconsideredariskfactorforthedevelopmentofdisease. Thediseasesselectedforthewintersemesteraredividedintothefollowingcategories: 1. NeoplasticDisease–SkinCancer 2. MentalIllness–Parkinson’sDisease 3. InfectiousDisease–LymeDisease 4. MetabolicDisease–CeliacDisease 5. Auto-ImmuneDisease–RheumatoidArthritis 6. Trauma/AnatomicalDisease–GastroesophagealRefluxDisease Inordertolearnaboutthesediseases,togetherwithyourgroupyouwillfollowthetemplate belowtoaddressnumerousaspectsofyourassigneddisease. 1. Anatomy,physiologyandpathology–thenaturalcourseofthedisease 2. Riskfactors,causesandpreventiveinterventions 3. Diagnosis:clinicalandsub-clinicalcategorizations 4. Therapeutictreatmentsandpost-treatmentmanagement 5. Individualandfamilialwellbeing,societalimpact,andmostpromisingresearch advancement *Althoughyouwillbeindividuallyassignedaspecificdiseasetopicandaspectofthatassigned disease,itisimportanttogatheraglobalunderstandingofallaspectsofyourassigneddisease,as wellastheadditionaldiseasetopicsbeingcoveredbyyourclassmates.Assuch,attendanceatall presentationsinseminars7,8and9ismandatory. 7 SKINCANCER Youhavebeenassignedskincancerforyourindependentresearchproject.Althoughmanyof youmaybefamiliarwiththediseaseinageneralsense,itisimportanttostartwiththebasicsof ahealthybiologicalsystembeforewecanproperlyunderstandtheonset,development,diagnosis andtreatmentofskincancer.Itisalwaysimportanttounderstandhealthybiologybeforewecan understandadiseasedstate!Thefollowinginformationhasbeencompiledfromgeneralhealth websites(theNationalCancerInstitute(NCI),theNationalInstituteforHealth(NIH))andreflects abasiclevelofdetail.Aswell,referencetothecoursetexthasbeenincluded.Besuretoreadand understandthisinformationbeforebeginningyourresearch. TheNon-Diseased(Normal)State Inordertounderstandchangesthatoccurinskincancer,itisfirstimportanttounderstandthe anatomyofthehealthyskin.Thefollowingsectionwilldiscusskeystructuralfeaturesoftheskin andimmuneresponse. (a)Skin Forinformationonthebasicanatomyandfunctionsofskin,pleaserefertoChapter1DSkin:An OrganSystemlocatedonpages72-76ofyourtextbook.Bynomeansareyouexpectedto memorizeeverythinginthechapter,butyouwilllikelyfindittobeagreatresourcefor definitionsandfigurestohelporientyourselfwhenreadingmorecomplexdiscussionsofskin cancer/melanoma. AnatomyandFunctionsoftheSkin Theskinisthebody’slargestorgan.Structurally,it’scomprisedofanouterlayercalledthe epidermis,andathickinnerlayercalledthedermis(seefigure1). Figure1:AnatomyoftheSkin: ImagecourtesyofNCI 8 Theepidermisservesasaprotectivebarrieragainsttheenvironment(seefigure2). Keratinocytesaretheprimarilycelltypeoftheepidermis. Theepidermisisfurthersubdividedintofivesublayers: (1)stratumcorneum (2)stratumlucidum (3)stratumgranulosum (4)stratumspinosum (5)stratumgerminativum Figure2:TheSkinasaProtectiveBarrier: (Image:Proksch,E.2008) Thedermisservesasacushioninglayer.Thedermisconsistsprimarilyofconnectivetissueand alsocontainsbloodvessels,lymphvessels,hairfollicles,andsweatglands.Itisfurther subdividedintotwosublayers:(1)thepapillaryregion,and(2)thereticularregion. Abasementmembraneconnectstheepidermistothedermis. Underneaththedermisliesalayerofsubcutaneoustissue(sometimescalledthehypodermis) thatisinvolvedinthermoregulationandprovidesfurthercushioningsupport. Skincolourisdictatedbythepigmentmelaninthatisproducedbymelanocytesintheepidermis (seefigure3). 9 Figure3:MelanocytesintheSkin’sEpidermis: ImagecourtesyofNCI (b)TheNormalImmuneResponse Forinformationonthebasicsofthehealthyimmunesystem,pleaserefertopages182-187. Bynomeansareyouexpectedtomemorizeeverythinginthechapter,butyouwilllikelyfinditto beagreatresourcetounderstandtheroleofproperimmunefunctionasitpertainstocancer development. (c)CancerDevelopment Cancer:Uncontrolledcelldivision Allformsofcancershareonecharacteristic–uncontrolledcelldivision.Normally,cellsgrow anddividetoformnewcellsasthebodyneedsthem.Whencellsgrowold,theydie,andnewcells taketheirplace.Sometimes,thisorderlyprocessgoeswrong.Newcellsformwhenthebodydoes notneedthem,andoldcellsdonotdiewhentheyshould.Theseextracellscanformamassof tissuecalledagrowthortumor.Thus,whileismayseemlikecancerisaninvadertakingoverthe body,cancercellsareactuallytraitorouscellsfromwithinourownbodies. Althoughskincancerisadiseasespecifictotheskin,certainfeaturesunderlieallcancers.The followingsectionhighlightscharacteristicspertinenttoalltypesofcancertohelpyouwithsome terminology.ForamorethoroughoverviewofCancer,refertoCancerIncidenceandMortality, pages432--438inyourtextbook. 10 PARKINSON’SDISEASE YouhavebeenassignedParkinson’s Diseaseforyourindependentresearchproject.Beforeyou canbegintouncoverhowParkinson’sdiseasedevelops,youmustfirstunderstandthenormal functionofthebrain.Asimplifiedoverviewofgeneralbiologypertinenttothiscomplexdisease hasbeencompiledforyousothatyoumaybecomefamiliarizedwithsomeoftheterminology andkeyaspectsofthedisease.TheinformationwasgatheredprimarilyfromtheNational InstituteforHealthandreflectsabasiclevelofdetail.Besuretoreadandunderstandthis informationbeforebeginningyourresearch. TheNon-Diseased(Normal)State (a)TheHealthyBrain: Forinformationonthebasicsofthenormalhumanbrain,refertoTheCentralNervousSystem, pages144-151.Bynomeansareyouexpectedtomemorizeeverythinginthechapter,butyou willlikelyfindittobeagreatresourcefordefinitionsandfigurestohelporientyourselfwhen readingmorecomplexdiscussionsofParkinson’sDisease. Whatdoesahealthybrainlooklike?Whatisitsroleinthebody? TounderstandParkinson’sdisease,itisimportanttoknowabitaboutthehealthybrain.The brainisaremarkableorgan.Seeminglywithouteffort,itallowsustocarryouteveryelement ofourdailylives.Itmanagesmanybodyfunctions,suchasbreathing,bloodcirculation,and digestion,withoutourknowledgeordirection.Italsodirectsallthefunctionswecarryout consciously.Wecanspeak,hear,see,move,remember,feelemotions,andmakedecisions becauseofthecomplicatedmixofchemicalandelectricalprocessesthattakeplaceinour brains. Thebrainismadeofnervecellsandseveralothercelltypes.Nervecellsalsoarecalled neurons.Neuronssurviveandfunctionwiththehelpandsupportofglialcells,theothermain typeofcellinthebrain.Glialcellsholdneuronsinplace(thinkofglialcellslikeglue!), providethemwithnutrients,ridthebrainofdamagedcellsandothercellulardebris,and provideinsulationtoneuronsinthebrainandspinalcord.Infact,thebrainhasmanymore glialcellsthanneurons—somescientistsestimateeven10timesasmany. Anotheressentialfeatureofthebrainisitsenormousnetworkofbloodvessels.Eventhough thebrainisonlyabout2percentofthebody’sweight,itreceives20percentofthebody’s bloodsupply.Billionsoftinycapillariescarryoxygen,glucose(thebrain’sprincipalsourceof energy),nutrients,andhormonestobraincellssotheycandotheirwork.Capillariesalso carryawaywasteproducts. Thebrainhasmanyparts,eachofwhichisresponsibleforparticularfunctions.Thefollowing sectiondescribesafewkeystructuresandwhattheydo. Fora3-Dviewofthebrainanditsparts,checkout:http://www.g2conline.org/andclickon the3-Dbrainlinkinthetoprighthandcorner. 11 Themainplayers: 1)Twocerebralhemispheresaccountfor85%ofthebrain’sweight.Thebillionsof neuronsinthetwohemispheresareconnectedbythickbundlesofnervecellfiberscalledthe corpuscallosum.Scientistsnowthinkthatthetwohemispheresdiffernotsomuchinwhat theydo(the“logicalversusartistic”notion),butinhowtheyprocessinformation.Theleft hemisphereappearstofocusondetails(suchasrecognizingaparticularfaceinacrowd).The righthemispherefocusesonbroadbackground(suchasunderstandingtherelativeposition ofobjectsinaspace).Thecerebralhemisphereshaveanouterlayercalledthecerebralcortex. Thisiswherethebrainprocessessensoryinformationreceivedfromtheoutsideworld, controlsvoluntarymovement,andregulatescognitivefunctions,suchasthinking,learning, speaking,remembering,andmakingdecisions.Thehemisphereshavefourlobes,eachof whichhasdifferentroles: • Thefrontallobe,whichisinthefrontofthebrain,controlsexecutivefunctionactivities likethinking,organizing,planning,andproblemsolving,aswellasmemory,attention andmovement. • Theparietallobe,whichsitsbehindthefrontallobe,dealswiththeperceptionand integrationofstimulifromthesenses. • Theoccipitallobe,whichisatthebackofthebrain,isconcernedwithvision. • Thetemporallobe,whichrunsalongthesideofthebrainunderthefrontaland parietallobes,dealswiththesensesofsmell,taste,andsound,andtheformationand storageofmemories. 2)Thecerebellumsitsabovethebrainstemandbeneaththeoccipitallobe.Ittakesupa littlemorethan10percentofthebrain.Thispartofthebrainplaysrolesinbalanceand coordination.Thecerebellumhastwohemispheres,whichreceiveinformationfromtheeyes, ears,andmusclesandjointsaboutthebody’smovementsandposition.Oncethecerebellum processesthatinformation,itsendsinstructionstothebodythroughtherestofthebrainand spinalcord.Thecerebellum’sworkallowsustomovesmoothly,maintainourbalance,and turnaroundwithouteventhinkingaboutit.Italsoisinvolvedwithmotorlearningand rememberinghowtodothingslikedriveacarorwriteyourname. 3)Thebrainstemsitsatthebaseofthebrain.Itconnectsthespinalcordwiththerestofthe brain.Eventhoughitisthesmallestofthethreemainplayers,itsfunctionsarecrucialto survival.Thebrainstemcontrolsthefunctionsthathappenautomaticallytokeepusalive— ourheartrate,bloodpressure,andbreathing.Italsorelaysinformationbetweenthebrain andthespinalcord,whichthensendsoutmessagestothemuscles,skin,andotherorgans. Sleepanddreamingarealsocontrolledbythebrainstem. Othercrucialpartsofthebrain Severalotheressentialpartsofthebrainliedeepinsidethecerebralhemispheresina networkofstructurescalledthelimbicsystem.Thelimbicsystemlinksthebrainstemwith thehigherreasoningelementsofthecerebralcortex.Itplaysakeyroleindevelopingand carryingoutinstinctivebehaviorsandemotionsandalsoisimportantinperceivingsmells andlinkingthemwithmemory,emotion,andinstinctivebehaviors. 12 Thelimbicsystemincludes: • Theamygdala,analmond-shapedstructureinvolvedinprocessingandremembering strongemotionssuchasfear.Itislocatedinthetemporallobejustinfrontofthe hippocampus. • Thehippocampus,whichisburiedinthetemporallobe,isimportantforlearningand short-termmemory.Thispartofthebrainisthoughttobethesitewhereshort-term memoriesareconvertedintolong-termmemoriesforstorageinotherbrainareas. • Thethalamus,locatedatthetopofthebrainstem,receivessensoryandlimbic information,processesit,andthensendsittothecerebralcortex. • Thehypothalamus,astructureunderthethalamus,monitorsactivitiessuchasbody temperatureandfoodintake.Itissuesinstructionstocorrectanyimbalances.The hypothalamusalsocontrolsthebody’sinternalclock. (b)TheNormalFunctioningofNeurons Forinformationonthenormalfunctioningofthecentralnervoussystem,pleaserefertoThe Brain/CentralNervousSystem3a(ii)(pg.131-140)ofyourtext.Bynomeansareyou expectedtomemorizeeverythinginthechapter,butyouwilllikelyfindittobeagreatresource fordefinitionsandfigurestohelporientyourselfwhenreadingmorecomplexdiscussionsof Parkinson’sDisease. (c)Parkinson’sDisease ForspecificinformationonParkinson’sDisease,pleaserefertoParkinson’sDiseaseand Dopamine(pg.144)ofyourtextbook. 13 LYMEDISEASE Youhavebeenassignedlymediseaseforyourindependentresearchproject.Beforeyoucan begintouncoverhowlymediseasedevelopsorhowitcanbetreated,youmustfirstunderstand thenormalfunctionoftheskinasadefensivebarrier.Asimplifiedoverviewofgeneralbiology pertinenttothiscomplexdiseasehasbeencompiledforyousothatyoumaybecomefamiliarized withsomeoftheterminologyandkeyaspectsofthedisease.Theinformationwasgathered primarilyfromtheMedPrep,BiologyOn-line,theNationalInstituteforHealthandreflectsabasic levelofdetail.Besuretoreadandunderstandthisinformationbeforebeginningyourresearch. TheNon-Diseased(Normal)State Inordertounderstandlymedisease,itisfirstimportanttounderstandtheanatomyofthe healthyskin.Thefollowingsectionwilldiscusskeystructuralfeaturesoftheskin. (a)Skin Forinformationonthebasicanatomyandfunctionsofskin,pleaserefertoChapter1DSkin:An OrganSystemlocatedonpages63-68ofyourtextbook.Bynomeansareyouexpectedto memorizeeverythinginthechapter,butyouwilllikelyfindittobeagreatresourcefor definitionsandfigurestohelporientyourselfwhenreadingmorecomplexdiscussionsoflyme disease. AnatomyandFunctionsoftheSkin Theskinisthebody’slargestorgan.Structurally,it’scomprisedonanouterlayercalledthe epidermis,andathickinnerlayercalledthedermis.Theepidermisservesasaprotectivebarrier againsttheenvironment(seefigure1). Figure1:TheSkinasaProtectiveBarrier: (Image:Proksch,E.2008) 14 Keratinocytesaretheprimarilycelltypeoftheepidermis.Theepidermisisfurthersubdivided intofivesublayers:(1)stratumcorneum(2)stratumlucidum(3)stratumgranulosum(4) stratumspinosum(5)stratumgerminativum Thedermisservesasacushioninglayer.Thedermisconsistsprimarilyofconnectivetissueand alsocontainsbloodvessels,lymphvessels,hairfollicles,andsweatglands.Itisfurther subdividedintotwosublayers:(1)thepapillaryregion,and(2)thereticularregion. (b)TheHealthyImmuneSystem Forinformationonbiologicalcelldefense/immuneresponse,pleasereferto3a(v)TheLocal Support&DefenseSystem(p.182-197)inyourtext.Payparticularattentiontopages182- 186.Bynomeansareyouexpectedtomemorizeeverythinginthechapter,butyouwilllikely findittobeagreatresourcefordefinitionsandfigurestohelporientyourselfwhenreading morecomplexdiscussionsoflymedisease. (c)TheBasicsofaBacterium Bacteriaareunicellular(microscopic)prokaryoteswhichlackmembraneboundorganelleslike mitochondria,golgiapparatusandendoplasmicreticulum.Bacteriarangeinsizefrom0.15to4 micrometers.Bacteriaarefoundinsoil,inwater,andintheair.Theyarealsofoundonplants,on thesurfacesofdecayedordecayingmatter,andinthedigestiveandreproductivetractsof humansandotheranimals.Abacterialcellconsistsofatinymassofcytoplasmsurroundedby threedistinctlayers:thecytoplasmicmembrane,thecellwall,andthecapsule(seefigure2). WithinthecytoplasmisDNA,materialcontaininggeneticinformation.Unlikethatofhigher organisms,theDNAofbacteriaisnotenclosedinamembrane-boundstructure,ornucleus.Some strainsofbacteriahaveflagellathatenablethemtomovewithaswimmingmotion,orpilithat helpthemadheretocertainsurfaces.Somebacteriacontainaspecialsubstancethatallowsthem toemitlightbyaprocesscalledbioluminescence. Figure2:GeneralBacterium: Imagecourtesyofhttp://www.singleton-associates.org/bacteri2.htm 15 Bacteriaoccurinawiderangeofenvironments,butaremostabundantinmoistandmoderate temperatureclimates.Mostbacteriaareheterotrophic;thatis,theyobtainfoodfromother organisms,whileothersareautotrophic,ormanufacturetheirownfood.Heterotrophicbacteria usuallyfeedondeadorganicmatter,althoughsomespeciesareparasitic.Mostautotrophic bacteriauseenergyfromsunlighttomanufacturefoodbyphotosynthesis.Heterotrophicand autotrophicbacteriacanbeeitheraerobicoranaerobic.Aerobicbacterialiveinenvironmentsin whichfree(molecular)oxygenispresent;anaerobicbacterialiveinenvironmentsinwhichfree oxygenisabsent. Basedoncellwallcomposition,bacteriacanbeseparatedintotwogroups;Gram-positiveand Gram-negative.ThesebacteriareacttothestaincalledastheGramstain.Thecellwallofthe Gram-positivebacteriaismadeupofmanylayersofpeptidoglycanandteichoicacids.Thegram- negativebacteriahaveaslightlythinnercellwallmadeupofafewlayersofpeptidoglycan.They aresurroundedbyanotherlayeroflipidmembranecontaininglipopolysaccharidesand lipoproteins.MostbacteriahavetheGram-negativecellwall. ClassificationofBacteria Bacteriaaregenerallyclassifiedbytwomethods.Thesimplestandoldestmethodisbyshape. Thethreeprincipalcategoriesarebacilli,cocci,andspirilla.Bacilliarerod-shapedandthemost numerousofalltypes.Theyincludecoccobacilliandstreptobacilli.Cociareasphericalbacteria, andaredividedintobacteriathatoccurinpairs(ex.Diplococci),inclusters(ex.Staphylococci), andchains(i.e.streptococci).Spirillaarespiralshapedbacteria,andaretheleastnumeroustype. Thesecondmethodofclassificationisbasedonothercharacteristics,suchassize,color,and chemicalcomposition,andthusaregroupedintoPhylum. Ticks Ticksaresmallparasitesthatcanactasvectors(agentsthattransmitpathogens)fordisease. Theytendtoresideingrass,woodedareasandshrubsandcanlatchontohumansoranimalsif theycomeincontact.Whenatickattaches,itcanburrowintotheskin,biteanddrawblood,as wellastransferbacteriathatcancausedisease(seefigure3). Figure3:TickBites ImagecourtesyofNIH 16 CELIACDISEASE Youhavebeenassignedceliacdiseaseforyourindependentresearchproject.Althoughmanyof youmaybefamiliarwiththediseaseinageneralsense,itisimportanttostartwiththebasicsof ahealthybiologicalsystembeforewecanproperlyunderstandtheonset,development,diagnosis andtreatmentofceliacdisease.Itisalwaysimportanttounderstandhealthybiologybeforewe canunderstandadiseasedstate!Thefollowinginformationhasbeencompiledfromgeneral healthwebsitesandreflectsabasiclevelofdetail.Aswell,referencetothecoursetexthasbeen included.Besuretoreadandunderstandthisinformationbeforebeginningyourresearch. TheNon-Diseased(Normal)State (a)TheHealthyGastrointestinal(GI)Tract ForinformationonthebasicsofthehealthydigestivesystempleaserefertoChapter3b(ii),The DigestiveSystem,pages239-255.Bynomeansareyouexpectedtomemorizeeverythinginthe chapter,butyouwilllikelyfindittobeagreatresourcefordefinitionsandfigurestohelporient yourselfwhenreadingmorecomplexdiscussionsofceliacdisease.Payparticularattentionto thesectionontheSmallIntestine,pages249-252. AnatomyoftheSmallIntestine Thesmallintestinefollowsthestomachandprecedesthelargeintestine.Itispartofthe gastrointestinaltract,andisapproximately20feetlong!Itissubdividedintotheduodenum, jejunum,andtheileum(seefigure1).Thepyloricsphincterregulatespassageofsemi-digested foodfromthestomachtotheduodenum,whereitthenpassesintothejejunumandintothe ileum.Theileocecalvalvepassesdigestedfoodfromtheileumtothelargeintestine. Figure1:TheSmallIntestine ImagecourtesyofNIH 17 FunctionsoftheSmallIntestine Therearetwoprimaryfunctionsofthesmallintestine:(1)chemicaldigestionoffoodand(2) absorptionofnutrients. (1)Pancreaticenzymesenteringthesmallintestineviathepancreaticductandareresponsible forthemajorityofthedigestionthatoccursinthesmallintestine.Chymefromthestomachand bilefromtheliveralsoplayanimportantroleinthechemicaldigestionoffoodinthesmall intestine.Inparticular,bileassistswiththebreakdownoffatsbyemulsifyingtriglycerides, enablingpancreaticlipasetoaccessthemforbreakdown. (2)Theinnerwallofthesmallintestineispleatedintofoldsthatarelinedwithfinger-like projectionstermedvillithatacttoincreasethesurfaceareaofthesmallintestineandenhance absorption(seefigure2).Furthermore,thevillithemselvesarelinedwithevensmaller projectionstermedmicrovillithatfurtherincreasetheintestinalsurfaceareaandcollectively formthebrushbordermembrane(seefigure3). Figure2:VillioftheSmallIntestine ImagecourtesyofNIH Figure3:MicrovillioftheSmallIntestine Image:PearsonEducation,Inc. 18 (b)TheNormalImmuneResponse Forinformationonthenormalimmunesystem/response,refertoChapter3a(v)(pg.188-200): TheLocalSupport&DefenseSystem.Payparticularattentiontopages188-189.Bynomeans areyouexpectedtomemorizeeverythinginthechapter,butyouwilllikelyfindittobeagreat resourcefordefinitionsandfigurestohelporientyourselfwhenreadingmorecomplex discussionoftheimmuneresponseinceliacdisease. Whatisanormalimmuneresponse?Whatisitsroleinthebody? Inordertounderstandwhatishappeningwhenapersonhasceliacdiseaseitisnecessaryto knowalittleabouthowthehealthyimmunesystemworks.Theimmunesystem-acomplex networkofspecializedcellsandorgans-defendsthebodyagainstattacksbyforeigninvaders suchasbacteria,viruses,fungi,andparasites.Itdoesthisbyseekingoutanddestroyingthe invadersastheyenterthebody.Substancescapableoftriggeringanimmuneresponsearecalled antigens. Nowyoumightbewondering–howdoestheimmunesystemknowwhatisforeignandhow doesitknowwhatisnative?Whyareweabletorecognizebacteriasuchase-coliasforeignwhile atthesametimeallowingmillionsofbacteriatohappilyflourishinourgut?Whyareweableto tolerateourownlungs,butoftentransplantpatientsrejectasetoflungsfromadonor? Amazingly,theimmunesystemdisplaysbothenormousdiversityandextraordinaryspecificity.It canrecognizemillionsofdistinctiveforeignmoleculesandproduceitsownmoleculesandcells tomatchupwithandcounteracteachofthem.Inordertohaveroomforenoughcellstomatch themillionsofpossibleforeigninvaders,theimmunesystemstoresjustafewcellsforeach specificantigen.Whenanantigenappears,thosefewspecificallymatchedcellsarestimulatedto multiplyintoafull-scalearmy.Later,topreventthisarmyfromover-expanding,powerful mechanismstosuppresstheimmuneresponsecomeintoplay. However,theimmunesystemisn’tperfect.Itcanalsomistakenormalsubstancesandtissuesin thebodyaspathogensorforeigninvaders.Inthiscase,anautoimmuneresponsecanoccur– characterizedbythebody’simmunesystemattackingitself.Formoreinformationon autoimmunedisorders,pleasereferto3aProblemsoftheImmuneSystem:Autoimmune Disorderspages197-199inyourtextbook. (c)Inflammation Forgeneralinformationoninflammation,pleasereferto3a(v)TheLocalSupport&Defense System(p.182-197)inyourtext.Payparticularattentiontopages186-187.Bynomeansare youexpectedtomemorizeeverythinginthechapter,butyouwilllikelyfindittobeagreat resourcefordefinitionsandfigurestohelporientyourselfwhenreadingmorecomplex discussionsofceliacdisease. 19 RHEUMATOIDARTHRITIS Youhavebeenassignedrheumatoidarthritisforyourindependentresearchproject.Although manyofyoumaybefamiliarwiththediseaseinageneralsense,itisimportanttostartwiththe basicsofahealthybiologicalsystembeforewecanproperlyunderstandtheonset,development, diagnosisandtreatmentofrheumatoidarthritis.Itisalwaysimportanttounderstandhealthy biologybeforewecanunderstandadiseasedstate!Thefollowinginformationhasbeencompiled fromgeneralhealthwebsitesandreflectsabasiclevelofdetail.Besuretoreadandunderstand thisinformationbeforebeginningyourresearch. TheNon-Diseased(Normal)State (a)HealthyConnectiveandMuscleTissue Foranoverviewofthedifferenttissuesinthebody,pleaserefertoChapter1DFromCellsto Organslocatedonpages63-83.Bynomeansareyouexpectedtomemorizeeverythinginthe chapter,butyouwilllikelyfindittobeagreatresourcefordefinitionsandfigurestohelporient yourselfwhenreadingmorecomplexdiscussionsofrheumatoidarthritis. AnatomyofaJoint Ajointisthelocationwheretwoormorebonescometogether.Thebonesofajointarecovered byasmoothandspongymaterialcalledcartilage.Cartilageallowsthejointtomovesmoothly, withoutpain.Inaddition,thejointislinedbysynovium;athinlayeroftissuewhichproducesa slipperyfluidcalledsynovialfluidthatnourishesthejointandactsasashockabsorber,helping toreducefriction.Ligamentsarestrongbandsoftissuethatconnectthebonesandstabilizethe jointinadditiontomusclesandtendonstoenablemovement(seefigure1) Figure1:Thestructureofasynovialjoint ImageCourtesyofNIH Cartilageiscomposedofchondrocytesandanextracellularmatrixofwater,collagen, 20 proteoglycans,inadditiontoothercomponentssuchasadhesivesandlipids.Cartilageissub--- dividedintoseveraldifferenttypes:hyaline,elastic,andfibrocartilage.Pleaserefertoyour textbookintheassignedreadingpages(above)foradescriptionofeachofthesetypesofcartilage! Unlikeotherconnectivetissues,cartilagedoesnotcontainbloodvessels.Becauseofthis,itheals veryslowly. (b)Inflammation Forgeneralinformationoninflammation,pleasereferto3a(v)TheLocalSupport&Defense System(p.182-197)inyourtextbook.Payparticularattentiontopages186-187.Bynomeans areyouexpectedtomemorizeeverythinginthechapter,butyouwilllikelyfindittobeagreat resourcefordefinitionsandfigurestohelporientyourselfwhenreadingmorecomplex discussionsofrheumatoidarthritis. Inflammationisaprotectiveresponsetotissueinjuryorinvasionofaforeignparticle.Ithas severalcausesrangingfrominfectiontotoxinstophysicalstressorinjury. Inflammationcanbeacuteorchronic.Acuteinflammationistransientandlastsashortduration oftime(typicallyjustafewdays). Acuteinflammationischaracterizedbyfivecardinalsigns(seefigure2): (1)Heat–duetoincreasedbloodflow (2)Pain–duetoincreasednervoussensation (3)Redness–duetoincreasedbloodflow (4)Swelling–duetofluidaccumulation (5)Immobility–duetolossoffunction Figure2:Thecardinalsignsofinflammation (Image:Lawrence,T.2002) 21 Acuteinflammationisprimarilymediatedbyleukocytesandendsinresolutionofinflammation. Ifthebodyisunsuccessfulinresolvingacuteinflammation,chronicinflammationcanensue. Chronicinflammationlastsamuchlongerdurationoftime(monthsoryearsorevenalifetime) andoftenleadstotissuenecrosis.Itismediatedprimarilybymacrophagesandlymphocytes. (c)TheNormalImmuneResponse Forinformationonthenormalimmunesystem/response,refertoChapter3a(v)TheLocal SupportandDefenseSystemlocatedonpages182-197.Bynomeansareyouexpectedto memorizeeverythinginthechapter,butyouwilllikelyfindittobeagreatresourcefor definitionsandfigurestohelporientyourselfwhenreadingmorecomplexdiscussionofthe immuneresponseinrheumatoidarthritis. Whatisanormalimmuneresponse?Whatisitsroleinthebody? Inordertounderstandwhatishappeningwhenapersonhasrheumatoidarthritisitisnecessary toknowalittleabouthowthehealthyimmunesystemworks.Theimmunesystem-acomplex networkofspecializedcellsandorgans-defendsthebodyagainstattacksbyforeigninvaders suchasbacteria,viruses,fungi,andparasites.Itdoesthisbyseekingoutanddestroyingthe invadersastheyenterthebody.Substancescapableoftriggeringanimmuneresponsearecalled antigens. Nowyoumightbewondering–howdoestheimmunesystemknowwhatisforeignandhow doesitknowwhatisnative?Whyareweabletorecognizebacteriasuchase-coliasforeignwhile atthesametimeallowingmillionsofbacteriatohappilyflourishinourgut?Whyareweableto tolerateourownlungs,butoftentransplantpatientsrejectasetoflungsfromadonor? Amazingly,theimmunesystemdisplaysbothenormousdiversityandextraordinaryspecificity.It canrecognizemillionsofdistinctiveforeignmoleculesandproduceitsownmoleculesandcells tomatchupwithandcounteracteachofthem.Inordertohaveroomforenoughcellstomatch themillionsofpossibleforeigninvaders,theimmunesystemstoresjustafewcellsforeach specificantigen.Whenanantigenappears,thosefewspecificallymatchedcellsarestimulatedto multiplyintoafull-scalearmy.Later,topreventthisarmyfromover-expanding,powerful mechanismstosuppresstheimmuneresponsecomeintoplay. However,theimmunesystemisn’tperfect.Itcanalsomistakenormalsubstancesandtissuesin thebodyaspathogensorforeigninvaders.Inthiscase,anautoimmuneresponsecanoccur– characterizedbythebody’simmunesystemattackingitself.Formoreinformationon autoimmunedisorders,pleasereferto3aProblemsoftheImmuneSystem:Autoimmune Disorderspages198-201inyourtextbook. 22 GASTROESOPHAGEALREFLUXDISEASE Youhavebeenassignedgastroesophagealrefluxdiseaseforyourindependentresearch project.Althoughmanyofyoumaybefamiliarwiththediseaseinageneralsense,itisimportant tostartwiththebasicsofahealthybiologicalsystembeforewecanproperlyunderstandthe onsetandtreatmentofgastroesophagealrefluxdisease.Itisalwaysimportanttounderstand healthybiologybeforewecanunderstandadiseasedstate!Thefollowinginformationhasbeen compiledfromgeneralhealthwebsitesandreflectsabasiclevelofdetail.Aswell,referencetothe coursetexthasbeenincluded.Besuretoreadandunderstandthisinformationbeforebeginning yourresearch. TheNon-Diseased(Normal)State (a)TheHealthyGastrointestinalTract ForinformationonthebasicsofthehealthydigestivesystempleaserefertoChapter3b(ii),The DigestiveSystem,pages239--255.Bynomeansareyouexpectedtomemorizeeverythingin thechapter,butyouwilllikelyfindittobeagreatresourcefordefinitionsandfigurestohelp orientyourselfwhenreadingmorecomplexdiscussionsofgastroesophagealrefluxdisease. AnatomyoftheGastrointestinalTract Thegastrointestinaltractextendsfromthemouthtotheanusandisessentiallyaseriesofhollow tubesthroughwhichfoodpasses,isbrokendown,absorbedandexcreted.Theupper gastrointestinaltractconsistsoftheesophagus,stomachandduodenum,andthelower gastrointestinaltractconsistsofthesmallintestine,thelargeintestine,andtherectumandanus. Figure1:Anatomyofthegastrointestinaltract ImagecourtesyofNIH 23 Histologically,thewallsofthegastrointestinaltractaredividedintofourlayers(seefigure2): (1) Themucosa–amostlayerthatsecreteslubricatingmucus(theinnermostlayer) (2) Thesubmucosa–connectivetissuerichinbloodvessels,lymphatics,andnerves (3) Themuscularis–adoublelayerofsmoothmuscle (4) Theserosa–layersofconnectivetissue(theoutermostlayer) Figure2:Layersofthegastrointestinaltract ImageCourtesyofNIH Foodmovesthroughthegastrointestinaltractbyperistalsis–whichisdefinedasawaveof normalcoordinated,rhythmicmusclecontractionsthatpushesfoodthroughthedigestivetract withunidirectionalflow(seefigure3). Figure3:Peristalsis ImageCourtesyofNIH 24 AnatomyoftheEsophagusandStomach Theesophagusisamusculartubethroughwhichfoodspassestothestomach.Thestomachisa muscularsacthatfunctionsasareservoirforfoodstorage;whenexpanded,itcanholdseveral litersoffood!! Thestomachalsosecreteshydrochloricacidandtheenzyme,pepsin.Whencombined,this mixtureistermedgastricjuice,whichplaysakeyroleindigestion.Importantly,theliningofthe stomachisprotectedfromtheactionsofgastricjuice;however,theesophagusissusceptibleto damagefromgastricjuices.Consequently,thereisaone-wayvalvecalledtheloweresophageal sphincterthatactsasajunctionbetweentheesophagusandthestomach,therebypreventingthe refluxofstomachacidbackintotheesophagus(seefigure4). Figure4:Anatomyoftheesophagusandstomach ImageCourtesyofNIH Iftheloweresophagealsphincterfailstocloseproperly,stomachacidcanmovebackoutofthe stomachandintotheesophaguswhereitcausesheartburnanddiscomfort. Figure5:Theloweresophagealsphincter ImageCourtesyofNIH 25 Evaluation: Assignments: Forallwrittenassignments,pleasefollowtheseimportantformatting/styleguidelines,unless otherwisestatedbyyourTA: 1. Doublespaced(referencelistcanbesinglespaced) 2. 12pt,blackfont,1inchmargins,TimesNewRomanfont 3. Yourname,studentIDnumberandseminardayandtime(i.e.Monday2:30pm) indicatedatthetopofthepage(nocoverpageneeded). 4. Properlyreferenced(seeInformationManagementOnlineWorkshop) • Includeintextcitationsandfullcitationsattheend FinalAssignmentRubrics Belowyouwillseearubricthathasbeendevelopedtoevaluateyourhomeworkassignment,oral communication,presentationstyleandthetext/researchthataccompaniesyourspecificdisease topic.Byreferringtothisrubricwhenconductingyourresearchorpracticingyourportionofthe oralpresentation,youwillbeabletoseewhatkeyfeaturesarebeingevaluated.Forexample,as partofyouroralcommunication,theTAwillbelookingforprofessionalbodylanguage,eye contact,goodvolumeinyourvoice,andarelaxedpace.AsforthelayoutofyourPowerPoint slides,youwillbeevaluatedforyouruseoffiguresandtext,aswellastheorganizationof informationonyourslides.Also,theyshouldbevisuallyappealingwithlargefontand appropriateuseofcolourwithlittledistractions.Finally,youwillbeaskedtosubmitacopyof your3PowerPointslidesaswellas3pagesoftext,expandingontheinformationontheslides themselves.Thisinformationwillbemarkedfortheaccuracyanddemonstrationof comprehension.Theinformationcanbegatheredfrommultiplereputablesourcesbutshouldbe focusedtothetopicofthediseaseofwhichyouwereassignedandmustbewritteninyourown words. 26 OralPresentationRubric: WrittenAssignmentsRubric: 27 PeerEvaluationRubric CRITERIA Level3 (1) Level2 (0.75) Level1 (0.5) Level0 (0) Gather Information Collectsagreat dealofinformation onthetopic Collectssome basicinformation onthetopic Collectsverylittle informationon thetopic Doesnotcollect anyinformationon thetopic Participatein Discussion Enthusiastically participatein discussionto accomplishtask Willingto participatein discussionto accomplishtask Occasionally participatein discussionto accomplishtask Doesnottakepart indiscussionto accomplishtask Besensitive toothers’ feelings Verywillingto listenandis sensitivetoothers’ feelingsand learningneeds Showssensitivity toothers’feelings andwillingto listentoothers’ opinions Sometimesneeds occasional remindertobe sensitiveto others’feelings Shownorespectto others’feelings Cooperate withteam members Takesupanytask assigned enthusiastically Willingtotakeup mosttasks assigned Takesupsome tasksassigned whenurged Alwaysargueswith teammembersand refusestodoany work Availability forgroup work Attendedall seminarsand respondedrapidly toemails. Occasionally missedseminar, butwasaccessible viaemail. Frequently missedseminar anddidnot respondwellto email. Nevermetwith groupforwork. YOURNAME: Student #1 Student #2 Student #3 Student #4 Student #5 Student #6 NAMES: Gather Information /1 /1 /1 /1 /1 /1 Participatein Discussion /1 /1 /1 /1 /1 /1 Besensitive toothers’ feelings /1 /1 /1 /1 /1 /1 Cooperate withteam members /1 /1 /1 /1 /1 /1 Availability forgroup work /1 /1 /1 /1 /1 /1 TOTAL: /5 /5 /5 /5 /5 /5 28 SuggestedInternetResourcesforSeminars