Microsoft Word - Disease Seminar Handbook W'22.docx
Disease Seminar Handbook
BIOL*1080: Biological Concepts of Health
Winter, 2022
UNIVERSITY OF GUELPH
2
Table of Contents
INTRODUCTION: DISEASE SEMINARS 3
INTRODUCTION 3
OVERVIEW OF ASSIGNMENT 4
EVALUATION AND IMPORTANT DATES 5
DISEASE CATEGORIES - “THE NORMAL /BACKGROUND” 6
WHAT IS HEALTH? WHAT IS DISEASE? 6
SKIN CANCER 7
PARKINSON’S DISEASE 11
LYME DISEASE 14
CELIAC DISEASE 17
RHEUMATOID ARTHRITIS 20
GASTROESOPHAGEAL REFLUX DISEASE 23
EVALUATION 25
RUBRIC: ORAL PRESENTATION 26
RUBRIC: WRITTEN ASSIGNMENTS 26
RUBRIC: PEER EVALUATION 27
REFERENCE SHEETS FOR HOMEWORK 28
SUGGESTED RESOURCES 28
HOW TO REFERENCE THE BIOL 1080 TEXTBOOK 29
UNACCEPTABLE REFERENCE SOURCES FOR BIOL 1080 30
TEMPLATE FOR SEMINAR SLIDES 31
ORGANIZING INFORMATION 34
TIPS FOR POWER POINT 35
TIPS FOR ORAL PRESENTATION 36
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Introduction:
This seminar activity for BIOL*1080 involves independent and group research into multiple
diseases by following a common disease template provided for you. Each week’s activity and
assignment builds towards the next. As you progress through your individual research, you will
meet weekly with your disease group to discuss your findings and learn from your group
members’ perspectives. This time will allow you to think of your assigned disease as a whole –
not just as your individual component. You will also have the opportunity to discuss your topic
with students researching a different disease allowing you to compare similarities and
differences between diseases. You might be surprised to see similar trends across disease
categories!
The primary learning objectives of the disease seminars are:
1. Learn about diseases using a standard template.
2. Practice and improve oral communication skills.
More specifically, by the end of the disease seminars, successful students will be able to:
1. Logically organize information to effectively communicate ideas orally.
2. Research a subject in the written literature, distill, convert and organize the information
into a clear, concise story for oral presentation.
3. Describe and participate in the process of preparing a presentation.
4. Identify and perform the skills necessary for an effective presentation.
5. Demonstrate the importance of language, voice, gestures, and visual aids in an effective
presentation.
6. Illustrate, through a public presentation, the ability to share information and increase
audience understanding about a chosen topic.
7. Gain a functional appreciation and an increased awareness for their own oral
presentation style.
8. Use feedback to enhance their presentation skills for future presentations.
This handbook will serve as a helpful guide as you start your research on your assigned disease
and topic. When we study a disease, it is best to start by understanding the ‘normal’. That is –
how does the body or system operate under non-disease conditions? Only once we understand
the normal function of the body can we start to uncover the changes that occur during the
course/progression of a disease. Then, when we understand what changes lead to disease
itself (i.e.: disease pathology) we can begin to ask – how can we prevent these changes? How
significant do these changes need to be to cause clinical manifestation of disease? What can we
do to manage, treat or reverse the changes? What impact do these changes have on an individual,
their family, our society? What recent advancements have been made in the field? These will be
the main questions explored in the disease seminars.
The information provided in this handbook will serve 2 main functions.
1. It will help you understand the basic underlying ‘normal’ physiology of the body systems
elevant to your assigned disease so that you can start to build on it and uncover disease
specific concerns.
2. It will serve as a reference guide with helpful tips and suggestions for completing your
independent research, written assignment and oral presentation.
4
Overview of Assignment
As part of the BIOL*1080 course, the large lectures are complemented with weekly, small group
seminars. These seminars are a mandatory component of the course and will account for 25% of
your final mark. In the weekly seminars, you will be working in small groups to research an
assigned disease, and then present it orally in a short PowerPoint presentation.
The selected diseases for the W’22 semester are:
1. Skin Cancer
2. Parkinson’s Disease
3. Lyme Disease
4. Celiac Disease
5. Rheumatoid Arthritis
6. Gastroesophageal Reflux Disease
Within each seminar section, students will be assigned to a research group of 5 and then each
group will be assigned one of the 6 diseases. Using a 5-category research template (see below),
each group member will be responsible for covering a distinct aspect of his/her assigned disease.
These areas have been divided as follows:
1. Anatomy, physiology and pathology – the natural course of the disease
2. Risk factors, causes and preventive interventions
3. Diagnosis: clinical and sub-clinical categorizations
4. Therapeutic treatments and post-treatment management
5. Individual and familial well being, societal impact, and most promising research
advancement
Basic background information on each disease category is found in this manual as it applies to
normal physiological function to help you get started. All additional information that you need to
complete your research will be gathered independently.
During the first 4 seminar sessions, you will attend your weekly seminar to meet with your group
and work on the assignment. Each class will begin with a different lesson by your TA to help you
progress in your research and work through challenges. A significant part of each seminar will
e reserved for group work on the assigned disease. Weekly attendance of all group members
is crucial in order to succeed at the seminar assignment. Please note: 1% of the final mark is
ased on peer-evaluation! In addition, a homework assignment will be given during seminar
three.
By the end of seminar week 6, each student will have prepared 3 PowerPoint slides to be put into
a group PowerPoint presentation. In seminars # 7-9, students will present a group PowerPoint
presentation on their disease (3 minutes per student, with each student discussing their
assigned disease subtopic). The schedule of presentations for W’22 will be as follows:
Seminar Week 7: Skin Cancer & Parkinson’s Disease
Seminar Week 8: Lyme Disease & Celiac Disease
Seminar Week 9: Rheumatoid Arthritis & Gastroesophageal Reflux Disease
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In addition to oral communication of the research, all students are to submit 3 pages of
additional text to accompany their slides on the day of their presentation. More
information will be provided about this (i.e. level of detail etc.) from your TA during seminar.
Evaluation:
The seminar activities are worth 25% of your final mark, divided as follows:
4% Homework Assignment
• Submitted in week four of the semester on the day of your scheduled seminar
y 11:59pm to the online dropbox
10% Oral Presentation on Your Disease Subtopic
• Must also submit a hardcopy of your PowerPoint slides by 11:59pm on the day
of your presentation to the online dropbox
10% Supplementary Text on Your Disease Subtopic
• Submitted on the day of your disease presentation by 11:59pm to the online
dropbox
• 3 page summary of your research on your disease subtopic
1% Peer Evaluation
• Submitted on the day of your presentation by 11:59pm to the online dropbox
• You must also evaluate yourself. If you do not submit a peer evaluation, you
give yourself a “0”
NOTE: if a student misses the group presentation for an unapproved reason –a grade of ZERO
(0) will be assigned for both the oral communication and additional text (i.e. loss of 20% of the
final grade). Approved absences will be dealt with on a case-by-case basis.
Important Dates:
NOTE: Please see the course schedule for the specific dates of given seminars, as they change
depending on which day of the week your seminar falls.
Week Homework Due (% worth) Homework Given
1 No Seminars
2 None No ‘formal’ homework
3 None Seminar Homework Assignment (4%)
4 Seminar Homework Assignment (4%) No ‘formal’ homework
5 None No ‘formal’ homework
6 No Seminars
READING WEEK
7, 8, 9
Group presentations (see schedule at top of page)
PowerPoint slides, final written paper, and peer evaluations to be
submitted by 11:59pm on the day of your presentation
10 Integrative Thinking Project Seminar
11 Integrative Thinking Project Seminar (Optional)
12 No Seminars
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What is health? What is disease?
For the entirety of the seminar exercise, keep in mind that health can be defined as ‘physical,
mental or social well-being’ and illness is defined as ‘physical, mental and social harmful
dysfunction’. These are fairly
oad definitions and, therefore, it is important to recognize the
multiple components that contribute to the complexity of health and different disease states,
ultimately emphasizing the value of considering health and disease from a systems biology
approach. It is also important to remember that each person represents a unique biological
system and can respond to these health and disease components in varying ways.
Disease occurs when the normal function/physiology of the body is disrupted. This disruption
could be caused by several factors, including genetic complications, viral or bacterial invaders,
long-term accumulation of smaller challenges/insults to the body, or often a combination of
factors (involving genetic, lifestyle and healthcare behavioural and environmental factors). As
such, it is important to recognize that there is no universal categorization of diseases. Regardless
of cause, the main similarity between all diseases is that the normal state is altered such
that the Control and Communication Network (CCN) cannot co
ect the problem, the
system shifts from homeostasis and disease ensues.
Disease management can be targeted by a preventative medicine approach (focusing on risk
assessment and intervention prior to disease) or a therapeutic medicine approach (focusing on
diagnosis and treatment of disease). Through the seminar exercises, it is important to remember
that aging is also associated with diminished function of the control and communication network
and, thus, the aging process itself can be considered a risk factor for the development of disease.
The diseases selected for the winter semester are divided into the following categories:
1. Neoplastic Disease – Skin Cancer
2. Mental Illness – Parkinson’s Disease
3. Infectious Disease – Lyme Disease
4. Metabolic Disease – Celiac Disease
5. Auto-Immune Disease – Rheumatoid Arthritis
6. Trauma/Anatomical Disease – Gastroesophageal Reflux Disease
In order to learn about these diseases, together with your group you will follow the template
elow to address numerous aspects of your assigned disease.
1. Anatomy, physiology and pathology – the natural course of the disease
2. Risk factors, causes and preventive interventions
3. Diagnosis: clinical and sub-clinical categorizations
4. Therapeutic treatments and post-treatment management
5. Individual and familial well being, societal impact, and most promising research
advancement
*Although you will be individually assigned a specific disease topic and aspect of that assigned
disease, it is important to gather a global understanding of all aspects of your assigned disease, as
well as the additional disease topics being covered by your classmates. As such, attendance at all
presentations in seminars 7, 8 and 9 is mandatory.
7
SKIN CANCER
You have been assigned skin cancer for your independent research project. Although many of
you may be familiar with the disease in a general sense, it is important to start with the basics of
a healthy biological system before we can properly understand the onset, development, diagnosis
and treatment of skin cancer. It is always important to understand healthy biology before we can
understand a diseased state! The following information has been compiled from general health
websites (the National Cancer Institute (NCI), the National Institute for Health (NIH)) and reflects
a basic level of detail. As well, reference to the course text has been included. Be sure to read and
understand this information before beginning your research.
The Non-Diseased (Normal) State
In order to understand changes that occur in skin cancer, it is first important to understand the
anatomy of the healthy skin. The following section will discuss key structural features of the skin
and immune response.
(a) Skin
For information on the basic anatomy and functions of skin, please refer to Chapter 1D Skin: An
Organ System located on pages 72-76 of your textbook. By no means are you expected to
memorize everything in the chapter, but you will likely find it to be a great resource for
definitions and figures to help orient yourself when reading more complex discussions of skin
cance
melanoma.
Anatomy and Functions of the Skin
The skin is the body’s largest organ. Structurally, it’s comprised of an outer layer called the
epidermis, and a thick inner layer called the dermis (see figure 1).
Figure 1: Anatomy of the Skin:
Image courtesy of NCI
8
The epidermis serves as a protective ba
ier against the environment (see figure 2).
Keratinocytes are the primarily cell type of the epidermis.
The epidermis is further subdivided into five sublayers:
(1) stratum corneum
(2) stratum lucidum
(3) stratum granulosum
(4) stratum spinosum
(5) stratum germinativum
Figure 2: The Skin as a Protective Ba
ier:
(Image: Proksch, E. 2008)
The dermis serves as a cushioning layer. The dermis consists primarily of connective tissue and
also contains blood vessels, lymph vessels, hair follicles, and sweat glands. It is further
subdivided into two sublayers: (1) the papillary region, and (2) the reticular region.
A basement mem
ane connects the epidermis to the dermis.
Underneath the dermis lies a layer of subcutaneous tissue (sometimes called the hypodermis)
that is involved in thermoregulation and provides further cushioning support.
Skin colour is dictated by the pigment melanin that is produced by melanocytes in the epidermis
(see figure 3).
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Figure 3: Melanocytes in the Skin’s Epidermis:
Image courtesy of NCI
(b) The Normal Immune Response
For information on the basics of the healthy immune system, please refer to pages 182-187.
By no means are you expected to memorize everything in the chapter, but you will likely find it to
e a great resource to understand the role of proper immune function as it pertains to cancer
development.
(c) Cancer Development
Cancer: Uncontrolled cell division
All forms of cancer share one characteristic – uncontrolled cell division. Normally, cells grow
and divide to form new cells as the body needs them. When cells grow old, they die, and new cells
take their place. Sometimes, this orderly process goes wrong. New cells form when the body does
not need them, and old cells do not die when they should. These extra cells can form a mass of
tissue called a growth or tumor. Thus, while is may seem like cancer is an invader taking over the
ody, cancer cells are actually traitorous cells from within our own bodies.
Although skin cancer is a disease specific to the skin, certain features underlie all cancers. The
following section highlights characteristics pertinent to all types of cancer to help you with some
terminology. For a more thorough overview of Cancer, refer to Cancer Incidence and Mortality,
pages XXXXXXXXXX in your textbook.
10
PARKINSON’S DISEASE
You have been assigned Parkinson’s Disease for your independent research project. Before you
can begin to uncover how Parkinson’s disease develops, you must first understand the normal
function of the
ain. A simplified overview of general biology pertinent to this complex disease
has been compiled for you so that you may become familiarized with some of the terminology
and key aspects of the disease. The information was gathered primarily from the National
Institute for Health and reflects a basic level of detail. Be sure to read and understand this
information before beginning your research.
The Non-Diseased (Normal) State
(a) The Healthy Brain:
For information on the basics of the normal human
ain, refer to The Central Nervous System,
pages 144- 151. By no means are you expected to memorize everything in the chapter, but you
will likely find it to be a great resource for definitions and figures to help orient yourself when
eading more complex discussions of Parkinson’s Disease.
What does a healthy
ain look like? What is its role in the body?
To understand Parkinson’s disease, it is important to know a bit about the healthy
ain. The
ain is a remarkable organ. Seemingly without effort, it allows us to ca
y out every element
of our daily lives. It manages many body functions, such as
eathing, blood circulation, and
digestion, without our knowledge or direction. It also directs all the functions we ca
y out
consciously. We can speak, hear, see, move, remember, feel emotions, and make decisions
ecause of the complicated mix of chemical and electrical processes that take place in our
ains.
The
ain is made of nerve cells and several other cell types. Nerve cells also are called
neurons. Neurons survive and function with the help and support of glial cells, the other main
type of cell in the
ain. Glial cells hold neurons in place (think of glial cells like glue!),
provide them with nutrients, rid the
ain of damaged cells and other cellular de
is, and
provide insulation to neurons in the
ain and spinal cord. In fact, the
ain has many more
glial cells than neurons—some scientists estimate even 10 times as many.
Another essential feature of the
ain is its enormous network of blood vessels. Even though
the
ain is only about 2 percent of the body’s weight, it receives 20 percent of the body’s
lood supply. Billions of tiny capillaries ca
y oxygen, glucose (the
ain’s principal source of
energy), nutrients, and hormones to
ain cells so they can do their work. Capillaries also
ca
y away waste products.
The
ain has many parts, each of which is responsible for particular functions. The following
section describes a few key structures and what they do.
For a 3-D view of the
ain and its parts, check out: http:
www.g2conline.org/ and click on
the 3-D
ain link in the top right hand corner.
11
The main players:
1) Two cere
al hemispheres account for 85% of the
ain’s weight. The billions of
neurons in the two hemispheres are connected by thick bundles of nerve cell fibers called the
corpus callosum. Scientists now think that the two hemispheres differ not so much in what
they do (the “logical versus artistic” notion), but in how they process information. The left
hemisphere appears to focus on details (such as recognizing a particular face in a crowd). The
ight hemisphere focuses on
oad background (such as understanding the relative position
of objects in a space). The cere
al hemispheres have an outer layer called the cere
al cortex.
This is where the
ain processes sensory information received from the outside world,
controls voluntary movement, and regulates cognitive functions, such as thinking, learning,
speaking, remembering, and making decisions. The hemispheres have four lobes, each of
which has different roles:
• The frontal lobe, which is in the front of the
ain, controls executive function activities
like thinking, organizing, planning, and problem solving, as well as memory, attention
and movement.
• The parietal lobe, which sits behind the frontal lobe, deals with the perception and
integration of stimuli from the senses.
• The occipital lobe, which is at the back of the
ain, is concerned with vision.
• The temporal lobe, which runs along the side of the
ain under the frontal and
parietal lobes, deals with the senses of smell, taste, and sound, and the formation and
storage of memories.
2) The cerebellum sits above the
ain stem and beneath the occipital lobe. It takes up a
little more than 10 percent of the
ain. This part of the
ain plays roles in balance and
coordination. The cerebellum has two hemispheres, which receive information from the eyes,
ears, and muscles and joints about the body’s movements and position. Once the cerebellum
processes that information, it sends instructions to the body through the rest of the
ain and
spinal cord. The cerebellum’s work allows us to move smoothly, maintain our balance, and
turn around without even thinking about it. It also is involved with motor learning and
emembering how to do things like drive a car or write your name.
3) The
ain stem sits at the base of the
ain. It connects the spinal cord with the rest of the
ain. Even though it is the smallest of the three main players, its functions are crucial to
survival. The
ain stem controls the functions that happen automatically to keep us alive—
our heart rate, blood pressure, and
eathing. It also relays information between the
ain
and the spinal cord, which then sends out messages to the muscles, skin, and other organs.
Sleep and dreaming are also controlled by the
ain stem.
Other crucial parts of the
ain
Several other essential parts of the
ain lie deep inside the cere
al hemispheres in a
network of structures called the limbic system. The limbic system links the
ain stem with
the higher reasoning elements of the cere
al cortex. It plays a key role in developing and
ca
ying out instinctive behaviors and emotions and also is important in perceiving smells
and linking them with memory, emotion, and instinctive behaviors.
12
The limbic system includes:
• The amygdala, an almond-shaped structure involved in processing and remembering
strong emotions such as fear. It is located in the temporal lobe just in front of the
hippocampus.
• The hippocampus, which is buried in the temporal lobe, is important for learning and
short-term memory. This part of the
ain is thought to be the site where short-term
memories are converted into long-term memories for storage in other
ain areas.
• The thalamus, located at the top of the
ain stem, receives sensory and limbic
information, processes it, and then sends it to the cere
al cortex.
• The hypothalamus, a structure under the thalamus, monitors activities such as body
temperature and food intake. It issues instructions to co
ect any imbalances. The
hypothalamus also controls the body’s internal clock.
(b) The Normal Functioning of Neurons
For information on the normal functioning of the central nervous system, please refer to The
Brain/ Central Nervous System 3a(ii) (pg XXXXXXXXXX) of your text. By no means are you
expected to memorize everything in the chapter, but you will likely find it to be a great resource
for definitions and figures to help orient yourself when reading more complex discussions of
Parkinson’s Disease.
(c) Parkinson’s Disease
For specific information on Parkinson’s Disease, please refer to Parkinson’s Disease and
Dopamine (pg.144) of your textbook.
13
LYME DISEASE
You have been assigned lyme disease for your independent research project. Before you can
egin to uncover how lyme disease develops or how it can be treated, you must first understand
the normal function of the skin as a defensive ba
ier. A simplified overview of general biology
pertinent to this complex disease has been compiled for you so that you may become familiarized
with some of the terminology and key aspects of the disease. The information was gathered
primarily from the MedPrep, Biology On-line, the National Institute for Health and reflects a basic
level of detail. Be sure to read and understand this information before beginning your research.
The Non-Diseased (Normal) State
In order to understand lyme disease, it is first important to understand the anatomy of the
healthy skin. The following section will discuss key structural features of the skin.
(a) Skin
For information on the basic anatomy and functions of skin, please refer to Chapter 1D Skin: An
Organ System located on pages 63-68 of your textbook. By no means are you expected to
memorize everything in the chapter, but you will likely find it to be a great resource for
definitions and figures to help orient yourself when reading more complex discussions of lyme
disease.
Anatomy and Functions of the Skin
The skin is the body’s largest organ. Structurally, it’s comprised on an outer layer called the
epidermis, and a thick inner layer called the dermis. The epidermis serves as a protective ba
ier
against the environment (see figure 1).
Figure 1: The Skin as a Protective Ba
ier:
(Image: Proksch, E. 2008)
14
Keratinocytes are the primarily cell type of the epidermis. The epidermis is further subdivided
into five sublayers: (1) stratum corneum (2) stratum lucidum (3) stratum granulosum (4)
stratum spinosum (5) stratum germinativum
The dermis serves as a cushioning layer. The dermis consists primarily of connective tissue and
also contains blood vessels, lymph vessels, hair follicles, and sweat glands. It is further
subdivided into two sublayers: (1) the papillary region, and (2) the reticular region.
(b) The Healthy Immune System
For information on biological cell defense/immune response, please refer to 3a(v) The Local
Support & Defense System (p XXXXXXXXXX) in your text. Pay particular attention to pages 182-
186. By no means are you expected to memorize everything in the chapter, but you will likely
find it to be a great resource for definitions and figures to help orient yourself when reading
more complex discussions of lyme disease.
(c) The Basics of a Bacterium
Bacteria are unicellular (microscopic) prokaryotes which lack mem
ane bound organelles like
mitochondria, golgi apparatus and endoplasmic reticulum. Bacteria range in size from 0.15 to 4
micrometers. Bacteria are found in soil, in water, and in the air. They are also found on plants, on
the surfaces of decayed or decaying matter, and in the digestive and reproductive tracts of
humans and other animals. A bacterial cell consists of a tiny mass of cytoplasm su
ounded by
three distinct layers: the cytoplasmic mem
ane, the cell wall, and the capsule (see figure 2).
Within the cytoplasm is DNA, material containing genetic information. Unlike that of higher
organisms, the DNA of bacteria is not enclosed in a mem
ane-bound structure, or nucleus. Some
strains of bacteria have flagella that enable them to move with a swimming motion, or pili that
help them adhere to certain surfaces. Some bacteria contain a special substance that allows them
to emit light by a process called bioluminescence.
Figure 2: General Bacterium:
Image courtesy of http:
www.singleton-associates.org
acteri2.htm
15
Bacteria occur in a wide range of environments, but are most abundant in moist and moderate
temperature climates. Most bacteria are heterotrophic; that is, they obtain food from other
organisms, while others are autotrophic, or manufacture their own food. Heterotrophic bacteria
usually feed on dead organic matter, although some species are parasitic. Most autotrophic
acteria use energy from sunlight to manufacture food by photosynthesis. Heterotrophic and
autotrophic bacteria can be either aerobic or anaerobic. Aerobic bacteria live in environments in
which free (molecular) oxygen is present; anaerobic bacteria live in environments in which free
oxygen is absent.
Based on cell wall composition, bacteria can be separated into two groups; Gram-positive and
Gram-negative. These bacteria react to the stain called as the Gram stain. The cell wall of the
Gram-positive bacteria is made up of many layers of peptidoglycan and teichoic acids. The gram-
negative bacteria have a slightly thinner cell wall made up of a few layers of peptidoglycan. They
are su
ounded by another layer of lipid mem
ane containing lipopolysaccharides and
lipoproteins. Most bacteria have the Gram-negative cell wall.
Classification of Bacteria
Bacteria are generally classified by two methods. The simplest and oldest method is by shape.
The three principal categories are bacilli, cocci, and spirilla. Bacilli are rod-shaped and the most
numerous of all types. They include coccobacilli and streptobacilli. Coci are a spherical bacteria,
and are divided into bacteria that occur in pairs (ex. Diplococci), in clusters (ex. Staphylococci),
and chains (i.e. streptococci). Spirilla are spiral shaped bacteria, and are the least numerous type.
The second method of classification is based on other characteristics, such as size, color, and
chemical composition, and thus are grouped into Phylum.
Ticks
Ticks are small parasites that can act as vectors (agents that transmit pathogens) for disease.
They tend to reside in grass, wooded areas and shrubs and can latch onto humans or animals if
they come in contact. When a tick attaches, it can bu
ow into the skin, bite and draw blood, as
well as transfer bacteria that can cause disease (see figure 3).
Figure 3: Tick Bites
Image courtesy of NIH
16
CELIAC DISEASE
You have been assigned celiac disease for your independent research project. Although many of
you may be familiar with the disease in a general sense, it is important to start with the basics of
a healthy biological system before we can properly understand the onset, development, diagnosis
and treatment of celiac disease. It is always important to understand healthy biology before we
can understand a diseased state! The following information has been compiled from general
health websites and reflects a basic level of detail. As well, reference to the course text has been
included. Be sure to read and understand this information before beginning your research.
The Non-Diseased (Normal) State
(a) The Healthy Gastrointestinal (GI) Tract
For information on the basics of the healthy digestive system please refer to Chapter 3b (ii), The
Digestive System, pages 239-255. By no means are you expected to memorize everything in the
chapter, but you will likely find it to be a great resource for definitions and figures to help orient
yourself when reading more complex discussions of celiac disease. Pay particular attention to
the section on the Small Intestine, pages 249-252.
Anatomy of the Small Intestine
The small intestine follows the stomach and precedes the large intestine. It is part of the
gastrointestinal tract, and is approximately 20 feet long! It is subdivided into the duodenum,
jejunum, and the ileum (see figure 1). The pyloric sphincter regulates passage of semi-digested
food from the stomach to the duodenum, where it then passes into the jejunum and into the
ileum. The ileocecal valve passes digested food from the ileum to the large intestine.
Figure 1: The Small Intestine
Image courtesy of NIH
17
Functions of the Small Intestine
There are two primary functions of the small intestine: (1) chemical digestion of food and (2)
absorption of nutrients.
(1) Pancreatic enzymes entering the small intestine via the pancreatic duct and are responsible
for the majority of the digestion that occurs in the small intestine. Chyme from the stomach and
ile from the liver also play an important role in the chemical digestion of food in the small
intestine. In particular, bile assists with the
eakdown of fats by emulsifying triglycerides,
enabling pancreatic lipase to access them for
eakdown.
(2) The inner wall of the small intestine is pleated into folds that are lined with finger-like
projections termed villi that act to increase the surface area of the small intestine and enhance
absorption (see figure 2). Furthermore, the villi themselves are lined with even smaller
projections termed microvilli that further increase the intestinal surface area and collectively
form the
ush border mem
ane (see figure 3).
Figure 2: Villi of the Small Intestine
Image courtesy of NIH
Figure 3: Microvilli of the Small Intestine
Image: Pearson Education, Inc.
18
(b) The Normal Immune Response
For information on the normal immune system
esponse, refer to Chapter 3a(v) (pg XXXXXXXXXX):
The Local Support & Defense System. Pay particular attention to pages 188-189. By no means
are you expected to memorize everything in the chapter, but you will likely find it to be a great
esource for definitions and figures to help orient yourself when reading more complex
discussion of the immune response in celiac disease.
What is a normal immune response? What is its role in the body?
In order to understand what is happening when a person has celiac disease it is necessary to
know a little about how the healthy immune system works. The immune system - a complex
network of specialized cells and organs - defends the body against attacks by foreign invaders
such as bacteria, viruses, fungi, and parasites. It does this by seeking out and destroying the
invaders as they enter the body. Substances capable of triggering an immune response are called
antigens.
Now you might be wondering – how does the immune system know what is foreign and how
does it know what is native? Why are we able to recognize bacteria such as e-coli as foreign while
at the same time allowing millions of bacteria to happily flourish in our gut? Why are we able to
tolerate our own lungs, but often transplant patients reject a set of lungs from a donor?
Amazingly, the immune system displays both enormous diversity and extraordinary specificity. It
can recognize millions of distinctive foreign molecules and produce its own molecules and cells
to match up with and counteract each of them. In order to have room for enough cells to match
the millions of possible foreign invaders, the immune system stores just a few cells for each
specific antigen. When an antigen appears, those few specifically matched cells are stimulated to
multiply into a full-scale army. Later, to prevent this army from over-expanding, powerful
mechanisms to suppress the immune response come into play.
However, the immune system isn’t perfect. It can also mistake normal substances and tissues in
the body as pathogens or foreign invaders. In this case, an autoimmune response can occur –
characterized by the body’s immune system attacking itself. For more information on
autoimmune disorders, please refer to 3a Problems of the Immune System: Autoimmune
Disorders pages 197-199 in your textbook.
(c) Inflammation
For general information on inflammation, please refer to 3a(v) The Local Support & Defense
System (p XXXXXXXXXX) in your text. Pay particular attention to pages 186-187. By no means are
you expected to memorize everything in the chapter, but you will likely find it to be a great
esource for definitions and figures to help orient yourself when reading more complex
discussions of celiac disease.
19
RHEUMATOID ARTHRITIS
You have been assigned rheumatoid arthritis for your independent research project. Although
many of you may be familiar with the disease in a general sense, it is important to start with the
asics of a healthy biological system before we can properly understand the onset, development,
diagnosis and treatment of rheumatoid arthritis. It is always important to understand healthy
iology before we can understand a diseased state! The following information has been compiled
from general health websites and reflects a basic level of detail. Be sure to read and understand
this information before beginning your research.
The Non-Diseased (Normal) State
(a) Healthy Connective and Muscle Tissue
For an overview of the different tissues in the body, please refer to Chapter 1D From Cells to
Organs located on pages 63-83. By no means are you expected to memorize everything in the
chapter, but you will likely find it to be a great resource for definitions and figures to help orient
yourself when reading more complex discussions of rheumatoid arthritis.
Anatomy of a Joint
A joint is the location where two or more bones come together. The bones of a joint are covered
y a smooth and spongy material called cartilage. Cartilage allows the joint to move smoothly,
without pain. In addition, the joint is lined by synovium; a thin layer of tissue which produces a
slippery fluid called synovial fluid that nourishes the joint and acts as a shock abso
er, helping
to reduce friction. Ligaments are strong bands of tissue that connect the bones and stabilize the
joint in addition to muscles and tendons to enable movement (see figure 1)
Figure 1: The structure of a synovial joint
Image Courtesy of NIH
Cartilage is composed of chondrocytes and an extracellular matrix of water, collagen,
20
proteoglycans, in addition to other components such as adhesives and lipids. Cartilage is sub---
divided into several different types: hyaline, elastic, and fi
ocartilage. Please refer to your
textbook in the assigned reading pages (above) for a description of each of these types of cartilage!
Unlike other connective tissues, cartilage does not contain blood vessels. Because of this, it heals
very slowly.
(b) Inflammation
For general information on inflammation, please refer to 3a(v) The Local Support & Defense
System (p XXXXXXXXXX) in your textbook. Pay particular attention to pages 186-187. By no means
are you expected to memorize everything in the chapter, but you will likely find it to be a great
esource for definitions and figures to help orient yourself when reading more complex
discussions of rheumatoid arthritis.
Inflammation is a protective response to tissue injury or invasion of a foreign particle. It has
several causes ranging from infection to toxins to physical stress or injury.
Inflammation can be acute or chronic. Acute inflammation is transient and lasts a short duration
of time (typically just a few days).
Acute inflammation is characterized by five cardinal signs (see figure 2):
(1) Heat – due to increased blood flow
(2) Pain – due to increased nervous sensation
(3) Redness – due to increased blood flow
(4) Swelling – due to fluid accumulation
(5) Immobility – due to loss of function
Figure 2: The cardinal signs of inflammation
(Image: Lawrence, T. 2002)
21
Acute inflammation is primarily mediated by leukocytes and ends in resolution of inflammation.
If the body is unsuccessful in resolving acute inflammation, chronic inflammation can ensue.
Chronic inflammation lasts a much longer duration of time (months or years or even a lifetime)
and often leads to tissue necrosis. It is mediated primarily by macrophages and lymphocytes.
(c) The Normal Immune Response
For information on the normal immune system
esponse, refer to Chapter 3a(v) The Local
Support and Defense System located on pages 182-197. By no means are you expected to
memorize everything in the chapter, but you will likely find it to be a great resource for
definitions and figures to help orient yourself when reading more complex discussion of the
immune response in rheumatoid arthritis.
What is a normal immune response? What is its role in the body?
In order to understand what is happening when a person has rheumatoid arthritis it is necessary
to know a little about how the healthy immune system works. The immune system - a complex
network of specialized cells and organs - defends the body against attacks by foreign invaders
such as bacteria, viruses, fungi, and parasites. It does this by seeking out and destroying the
invaders as they enter the body. Substances capable of triggering an immune response are called
antigens.
Now you might be wondering – how does the immune system know what is foreign and how
does it know what is native? Why are we able to recognize bacteria such as e-coli as foreign while
at the same time allowing millions of bacteria to happily flourish in our gut? Why are we able to
tolerate our own lungs, but often transplant patients reject a set of lungs from a donor?
Amazingly, the immune system displays both enormous diversity and extraordinary specificity. It
can recognize millions of distinctive foreign molecules and produce its own molecules and cells
to match up with and counteract each of them. In order to have room for enough cells to match
the millions of possible foreign invaders, the immune system stores just a few cells for each
specific antigen. When an antigen appears, those few specifically matched cells are stimulated to
multiply into a full-scale army. Later, to prevent this army from over-expanding, powerful
mechanisms to suppress the immune response come into play.
However, the immune system isn’t perfect. It can also mistake normal substances and tissues in
the body as pathogens or foreign invaders. In this case, an autoimmune response can occur –
characterized by the body’s immune system attacking itself. For more information on
autoimmune disorders, please refer to 3a Problems of the Immune System: Autoimmune
Disorders pages 198-201 in your textbook.
22
GASTROESOPHAGEAL REFLUX DISEASE
You have been assigned gastroesophageal reflux disease for your independent research
project. Although many of you may be familiar with the disease in a general sense, it is important
to start with the basics of a healthy biological system before we can properly understand the
onset and treatment of gastroesophageal reflux disease. It is always important to understand
healthy biology before we can understand a diseased state! The following information has been
compiled from general health websites and reflects a basic level of detail. As well, reference to the
course text has been included. Be sure to read and understand this information before beginning
your research.
The Non-Diseased (Normal) State
(a) The Healthy Gastrointestinal Tract
For information on the basics of the healthy digestive system please refer to Chapter 3b (ii), The
Digestive System, pages 239-- 255. By no means are you expected to memorize everything in
the chapter, but you will likely find it to be a great resource for definitions and figures to help
orient yourself when reading more complex discussions of gastroesophageal reflux disease.
Anatomy of the Gastrointestinal Tract
The gastrointestinal tract extends from the mouth to the anus and is essentially a series of hollow
tubes through which food passes, is
oken down, abso
ed and excreted. The upper
gastrointestinal tract consists of the esophagus, stomach and duodenum, and the lower
gastrointestinal tract consists of the small intestine, the large intestine, and the rectum and anus.
Figure 1: Anatomy of the gastrointestinal tract
Image courtesy of NIH
23
Histologically, the walls of the gastrointestinal tract are divided into four layers (see figure 2):
(1) The mucosa – a most layer that secretes lu
icating mucus (the innermost layer)
(2) The submucosa – connective tissue rich in blood vessels, lymphatics, and nerves
(3) The muscularis – a double layer of smooth muscle
(4) The serosa – layers of connective tissue (the outermost layer)
Figure 2: Layers of the gastrointestinal tract
Image Courtesy of NIH
Food moves through the gastrointestinal tract by peristalsis – which is defined as a wave of
normal coordinated, rhythmic muscle contractions that pushes food through the digestive tract
with unidirectional flow (see figure 3).
Figure 3: Peristalsis
Image Courtesy of NIH
24
Anatomy of the Esophagus and Stomach
The esophagus is a muscular tube through which foods passes to the stomach. The stomach is a
muscular sac that functions as a reservoir for food storage; when expanded, it can hold several
liters of food!!
The stomach also secretes hydrochloric acid and the enzyme, pepsin. When combined, this
mixture is termed gastric juice, which plays a key role in digestion. Importantly, the lining of the
stomach is protected from the actions of gastric juice; however, the esophagus is susceptible to
damage from gastric juices. Consequently, there is a one-way valve called the lower esophageal
sphincter that acts as a junction between the esophagus and the stomach, thereby preventing the
eflux of stomach acid back into the esophagus (see figure 4).
Figure 4: Anatomy of the esophagus and stomach
Image Courtesy of NIH
If the lower esophageal sphincter fails to close properly, stomach acid can move back out of the
stomach and into the esophagus where it causes heartburn and discomfort.
Figure 5: The lower esophageal sphincter
Image Courtesy of NIH
25
Evaluation:
Assignments:
For all written assignments, please follow these important formatting/style guidelines, unless
otherwise stated by your TA:
1. Double spaced (reference list can be single spaced)
2. 12 pt, black font, 1 inch margins, Times New Roman font
3. Your name, student ID number and seminar day and time (i.e. Monday 2:30pm)
indicated at the top of the page (no cover page needed).
4. Properly referenced (see Information Management Online Workshop)
• Include in text citations and full citations at the end
Final Assignment Ru
ics
Below you will see a ru
ic that has been developed to evaluate your homework assignment, oral
communication, presentation style and the text
esearch that accompanies your specific disease
topic. By refe
ing to this ru
ic when conducting your research or practicing your portion of the
oral presentation, you will be able to see what key features are being evaluated. For example, as
part of your oral communication, the TA will be looking for professional body language, eye
contact, good volume in your voice, and a relaxed pace. As for the layout of your PowerPoint
slides, you will be evaluated for your use of figures and text, as well as the organization of
information on your slides. Also, they should be visually appealing with large font and
appropriate use of colour with little distractions. Finally, you will be asked to submit a copy of
your 3 PowerPoint slides as well as 3 pages of text, expanding on the information on the slides
themselves. This information will be marked for the accuracy and demonstration of
comprehension. The information can be gathered from multiple reputable sources but should be
focused to the topic of the disease of which you were assigned and must be written in your own
words.
26
Oral Presentation Ru
ic:
Written Assignments Ru
ic:
27
Peer Evaluation Ru
ic
CRITERIA Level 3
(1)
Level 2
(0.75)
Level 1
(0.5)
Level 0
(0)
Gather
Information
Collects a great
deal of information
on the topic
Collects some
asic information
on the topic
Collects very little
information on
the topic
Does not collect
any information on
the topic
Participate in
Discussion
Enthusiastically
participate in
discussion to
accomplish task
Willing to
participate in
discussion to
accomplish task
Occasionally
participate in
discussion to
accomplish task
Does not take part
in discussion to
accomplish task
Be sensitive
to others’
feelings
Very willing to
listen and is
sensitive to others’
feelings and
learning needs
Shows sensitivity
to others’ feelings
and willing to
listen to others’
opinions
Sometimes needs
occasional
eminder to be
sensitive to
others’ feelings
Show no respect to
others’ feelings
Cooperate
with team
members
Takes up any task
assigned
enthusiastically
Willing to take up
most tasks
assigned
Takes up some
tasks assigned
when urged
Always argues with
team members and
efuses to do any
work
Availability
for group
work
Attended all
seminars and
esponded rapidly
to emails.
Occasionally
missed seminar,
ut was accessible
via email.
Frequently
missed seminar
and did not
espond well to
email.
Never met with
group for work.
YOUR NAME:
Student
#1
Student
#2
Student
#3
Student
#4
Student
#5
Student
#6
NAMES:
Gather
Information
/1
/1
/1
/1
/1
/1
Participate in
Discussion
/1
/1
/1
/1
/1
/1
Be sensitive
to others’
feelings
/1
/1
/1
/1
/1
/1
Cooperate
with team
members
/1
/1
/1
/1
/1
/1
Availability
for group
work
/1
/1
/1
/1
/1
/1
TOTAL:
5
5
5
5
5
5
28
Suggested Internet Resources for Seminars