Respiratory physiology course

respiratory physiology
(BLOCK)
 
 
Learning Objectives.
 
Lecture 1:  Functions and Organization of the Respiratory System
          By the end of this lecture the Students should be able to:-
1- Understand the difference between internal and external respiration.
2- Describe the structures and functions of the conductive and respiratory zones.
3- Understand functions of the respiratory system, including non- respiratory functions, like clearance mechanism by mucus and cilia, production of surfactant and converting enzyme.
 
 
 Lecture 2: Mechanics of breathing
 By the end of this lecture the students should be able to:
1- List the muscles of respiration and describe their roles during inspiration and expiration.
2- Understand the importance of the following pressures in respiration:
 Atmospheric, alveolar, intrapleural, and transpulmonary
3- Explain why intrapleural pressure is always subatmospheric under normal conditions, and the
significance of the thin layer of the intrapleural fluid surrounding the lung.
4- Describe pneumothorax.
5- Describe the pressure and volume relationships in a single respiratory cycle.
6- Define lung compliance and list the determinants of compliance.
7- Describe the physiological significance of surfactant and provide an example of abnormal
lung function due to a deficiency of surfactant.
 
 
Lecture 3:      Respiratory ventilation-1
By the end of these lectures the students should be able to: -
1-Define the various Lung Volumes and capacities and provide typical values for each.
2-Define ventilation rate, their typical values, and their measurement.
3- Describe FEV1.o and its role in differentiating obstructive and restrictive lung diseases
 
Lecture 4:      Respiratory ventilation-2
By the end of these lectures the students should be able to: -
1- Understand air movement and airway resistance:
     Definition, determinants, role of autonomic nervous system and mechanical factors
2- Describe the types of dead space. State a volume for the anatomical dead space.
3- Define the term minute ventilation and state a typical value.
4- Distinguish minute ventilation from alveolar ventilation.
5-Understand the work of breathing
 
 
Lecture 5:   Gas Transfer
 By the end of this lecture the students should able to: -
1-Define partial pressure of a gas. Describe how partial pressure of a gas is influenced by
altitude.
 
 2- Understand that the pressure exerted by each gas in a mixture of gases is independent of         the pressure exerted by the other gases (Dalton's Law)
 
 3- Understand that gases in a liquid diffuse from higher partial pressure to lower partial pressure (Henry’s Law)
 
 4- Describe the factors that determine the concentration of a gas in a liquid.
 
 5- Describe the components of the alveolar-capillary membrane (i.e., what does a molecule of gas pass through).
 
 6- Knew the various factors determining gas transfer: -
Surface area, thickness, partial pressure difference, and diffusion coefficient of gas
 
7- State the partial pressures of oxygen and Carbon dioxide in the atmosphere, alveolar gas, at
the end of the pulmonary capillary, in systemic capillaries, and at the beginning of a pulmonary
capillary.
 
 
Lecture 6:  Oxygen and Carbon dioxide Transport
By the end of this lecture the students should be able to: -
1-      Understand the forms of oxygen transport in the blood, the importance of each form and,
 
2-      Describe: -
     a- The relationship between PO2 and % saturation of hemoglobin with oxygen (Oxygen-    hemoglobin dissociation curve), and the significance of the shape of this relationship
     b- How DPG, temperature, H+ ions and PCO2 affect affinity of O2 for Hemoglobin and the physiological importance of these effects.
 
3-   Differentiate between O2 capacity, O2 content and O2 saturation.
4-   Define the P50 and its significance.
5-   Know the significance of fetal Hb and adult myoglobin.
6-Describe the three forms of Carbon dioxide that are transported in the blood, and the        chloride shift.
7- Describe the role of the enzyme carbonic anhydrase, and the CO2 dissociation curve.
8- Describe how H+ is transported in the blood.
 9- Define respiratory acidosis and respiratory alkalosis, and explain how these are related to
       hypoventilation and hyperventilation respectively.
 
 10- Enumerate the differences between the dissociation curves for O2 andCO2.
 
Lecture 7:   Control of breathing
 By the end of this lecture the students should be able to: -
 

1. Understand the role of the medulla oblongata in determining the basic pattern of respiratory activity.
2.  Describe the pacemaker activity of the medullary inspiratory neurons.
3. List some factors that can modify the basic breathing pattern  like e.g.

 
 

• The Hering-Breuer reflexes,  b- The proprioreceptor reflexes, and  c- The protective reflexes, like the irritant, and the J-receptors.

1. Understand the respiratory consequences of changing PO2, PCO2, and pH.

5- Describe the locations and roles of the peripheral and central chemoreceptors.
      6- Compare and contrast metabolic and respiratory acidosis and metabolic and  respiratory
          alkalosis.
 
Lectures 8 :   Alveolar - Arterial equilibration-1
 
 By the end of this lecture the students should be able to:-
         1-Define hypoxia and list its various physiological and pathological causes.
         2-Define hypo and hyper-ventilation in terms of arterial PCO2 and PO2.
         3- Define cyanosis.
         4-Understand regional variations in alveolar ventilation and blood flow.
        
Lectures 9 :   Alveolar - Arterial equilibration-2
     
          By the end of this lecture the students should be able to:-
        1- List causes of abnormal ventilation/perfusion (V͎/Q) ratios.
        2- Understand the normal matching of ventilation and perfusion , the mechanisms causing ventilation- perfusion inequality and an appreciation of its clinical significance.
       3- Explain the clinical significance of changes in anatomical and physiological dead space.
       4- Explain the effects of ventilation- perfusion inequality on oxygen transfere and carbon dioxide elimination.
 
 Lecture 10:   Effects of low and high gas pressure on the body
  By the end of this lecture the students should be able to: -
1-Describe the effects of exposure to low and high barometric pressures on the body.
2- Describe the body acclimatization to low barometric pressure.
3-Define decompression sickness and explain how it can be avoided.
4-Understand the effects of high nitrogen pressure, and nitrogen narcosis.
 
 
Lecture 11:    Effects of exercise on the respiratory system.
 
 By the end of this lecture the students should be able to: -
 1-Understand the difference between dynamic and isometric exercise.
1- Describe the effects of moderate and severe exercise on oxygen consumption, and ventilation volumes.
2-Describe the effects of exercise on arterial PO2, PCO2 and H+ ions.
3- Define the diffusing capacity of the respiratory membrane, and its typical values at rest, and explain its changes in exercise.
4-Explain causes of hyperventilation in exercise.
.Lecture 12:    Parameters for measuring work capacity.
 
By the end of this lecture the students should be able to: -
1-Know aerobic and anaerobic energy sources.
2-Understand the relationship between exercise intensity and energy sources.
3-Know energy expenditure at rest and during exercise.
 4-Understand the factors determining aerobic fitness.
5-Understand the other major components of physical fitness
6-Know how to measure total body fat and lean body mass.
7-Define oxygen debt, and oxygen deficit, and explain how they differ between athletes and non-athletes.