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Respiration Course Objectives

ANATOMY:At the end of the course, students will be able to:


1. Describe the anatomy of the nasal cavity including the para-nasal air sinuses (Lecture,
Practical and PBL).
2. Describe the anatomy of the naso-pharynx (Lecture, Practical).
3. Describe the anatomy of the larynx (Lecture, Practical, and PBL).
4. Describe the anatomy of the trachea (Lecture, Practical).
5. List the muscles of respiration in quiet and forced breathing (Lecture, Practical).
6. Describe the anatomy of the thoracic wall and cavity with special reference to muscles
of respiration (Lecture, Practical, and PBL).
7. Describe the anatomy of the left and right lungs (Lecture, Practical, and PBL).
8. Describe the anatomy of the bronchial tree (Lecture).
9. Discuss the anatomy of the pleurae and pleural cavities (Lecture, Practical, and
PBL).
10. Describe the nerve supply, arterial supply and venous and lymphatic drainage of the
lungs, pleurae, and bronchial tree (Lecture, PBL).
11. Describe the histology of the respiratory system, emphasising the changes in the walls
and epithelial linings of the respiratory tract (Practical).
12. Identify the different structures of the respiratory system on prosected anatomical
specimens and histological sections (Practical).
13. Describe the development of the respiratory system (Lecture, PBL).
14. Discuss the important congenital abnormalities in the respiratory system (Lecture).
15. Explain the changes in the respiratory system occurring at birth (Lecture).
Course Objectives
BIOCHEMISTRY:
At the end of the course, students will be able to:
1. Discuss and compare the principles of the allosteric models (concerted and sequential)
of enzymes/proteins. (Lecture)

2. Discuss the role of allosteric effector molecules. (Lecture)


3. Discuss the importance of allosteric control in the regulation of biological activity (e.g.
regulation of metabolism and oxygen delivery to tissue). (Lecture, PBL)
4. Compare the structure, function and oxygen binding properties of haemoglobin and
myoglobin. (Lecture)
5. Discuss the factors which influence oxygen binding by haemoglobin. (e.g. the effect of
H+ and CO2 , etc.) (Lecture, PBL)
6. Explain how the exchange of gases, i.e. CO2 and O2 is regulated (Bohr-Haldane
effects). (Lecture, PBL)
7. Explain how oxygen delivery to the foetus is facilitated by:
o a. structural differences in haemoglobin and
o b. metabolic factors. (Lecture)
8. Describe the organisational structure of the electron transport chain. (PBL)
9. Discuss the relevance of oxidative phosphorylation to the life of cells. (PBL)
10. Discuss the significance of the disruption of oxidative phosphorylation by:
o a. Inhibitors
o b. Uncouplers
o c. Physical methods (choking, drowning etc).

(PBL)

11. Discuss the basic concepts of the chemiosmotic theory. (PBL)


12. Explain the biochemistry of cigarette smoking as it relates to the functioning of -1
antitrypsin. (Lecture, PBL)
Course Objectives
PHYSIOLOGY:
At the end of the course, students will be able to:
OVERVIEW OF RESPIRATORY PHYSIOLOGY
1. Describe the respiratory and metabolic functions and defense mechanisms of the lung
(Lecture).

2. Define the following: (Lecture)


o eupnoea
o tachypnoea
o hyperoxia
o apnoea
o hypoventilation
o oxygen debt
o dyspnoea
o hyperventilation
o hypocapnia
o hypopnoea
o hypoxia (and its types)
o hypercapnia
o hyperpnoea
o hypoxaemia (and its types)
o asphyxia
3. Explain the difference between, breathing, ventilation and respiration (Lecture).
MECHANICS OF BREATHING
4. Explain, with diagrams, the pressure-volume changes which occur during breathing
(PBL and Lecture).
5. Draw a spirogram indicating the lung volumes and capacities and discuss the factors
affecting them (Lecture, PBL and Lab).
6. Describe the physiological significance of the residual volume and RV/TLC ratio (PBL
and Lecture).

7. Explain flow-volume curves with special reference to the effort-dependent and effortindependent regions and their change with disease states (PBL, Lecture and
Practical).
8. Distinguish between obstructive and restrictive lung diseases (PBL and Lecture).
9. Define airway resistance (RAW) and lung compliance (CL) and discuss the components
of each and factors affecting them (PBL and Lecture).
10. Discuss the mechanics and measurement of surface tension (Lecture).
11. Discuss the role of pulmonary surfactant in the optimal functioning of the respiratory
system (Lecture).
12. Explain the concept of dynamic compression of airways (Lecture and self-directed
learning).
13. Explain the work of breathing and discuss the effects of resistance, compliance and
surface tension on it (PBL and Lecture).
PULMONARY VENTILATION AND GAS EXCHANGE
14. Explain the relevance of the Gas Laws in respiratory physiology (PBL and Lecture).
15. List the normal fractional concentrations and partial pressures (at sea level) for the
main constituents of air (PBL and Lecture).
16. Calculate the partial pressures of gases in atmospheric and alveolar air (PBL).
17. Define and quantitate alveolar ventilation (VA), physiologic dead space and anatomic
dead space (VD) (PBL and Lecture).
18. Explain the concept of the ventilation/perfusion ratio (Lecture).
19. Discuss the regional differences in normal alveolar ventilation and pulmonary blood
flow (Lecture).
20. Describe the various laboratory methods used to assess ventilatory function (PBL and
Lecture).
21. Explain the measurement and significance of closing volume (Lecture).
22. Define diffusion capacity (transfer factor) and discuss its measurement and factors
affecting it (PBL and Lecture).
23. Relate abnormal ventilation/perfusion ratios to PaO2 and PaCO2 values (Lecture).

24. Discuss the various types of hypoxia (PBL and Lecture).


25. Explain the significance of an elevated alveolar to arterial PO2 difference (PBL
and Lecture) .
26. Explain the physiological bases for hypoxaemia (PBL and Lecture).
TRANSPORT OF BLOOD GASES
27. Describe the transport of oxygen and the role played by haemoglobin (PBL and
Lecture).
28. Describe the transport of carbon dioxide and discuss the importance of the chloride
shift (PBL and Lecture).
29. Explain the oxyhaemoglobin and carbon dioxide dissociation curves and discuss the
factors which affect them (PBL and Lecture).
30. Define respiratory acidosis and alkalosis and describe the mechanism and function of
respiratory acid base compensations (Self-directed learning).
CONTROL OF RESPIRATION
31. Explain, in outline, the chemical control of breathing (including the role of the
chemoreceptors (PBL and Lecture).
32. Utilise appropriate diagrams to describe the pathways of the various respiratory
centres, feedback loops and peripheral nerve inputs used in the neural control of
breathing (PBL and Lecture).
33. Describe abnormal breathing patterns (e.g. Cheyne-Stokes, Kussmauls, Biots,
apneustic, sleep apnoea) (PBL and self-directed learning).
SOME CLINICAL APPLICATIONS AND RELEVANCE OF RESPIRATORY PHYSIOLOGY
34. Discuss the factors involved in the control of bronchomotor tone including the
mechanisms for clearance of vasoactive substances from the blood (Lecture).
35. Discuss the effect of domestic allergens (smoke, dust etc.) on the airways and the
mechanisms by which they are cleared (PBL).
36. Explain the physiological changes which occur during exercise and at high altitude
(PBL and self-directed learning).

37. Explain the physiological bases for coughing, sneezing, sighing, yawning, wheezing,
clubbing of the fingers, cyanosis, decompression sickness and shallow water blackout
(Self-directed learning).
Course Objectives
PHARMACOLOGY:
(All objectives are to be covered by self-directed learning)
At the end of the course, students will be able to:
1. Discuss the pharmacology of the following drugs that are used in the management of
bronchial asthma:
o i. sympathomimetics (adrenaline and epinephrine) b2 agonists (salbutamol).
o ii. phosphodiesterase inhibitors (aminophylline).
o iii. corticosteroids (beclomethasone).
o iv. cromolyn sodium
o v. anticholinergics (ipratropium bromide)
2. List the receptor subtypes of histamine, and name the agonists and antagonists acting at
these receptor subtypes.
3. List the drugs, which release histamine.
4. List the receptor subtypes of 5-HT, and name the agonists and antagonists acting at
these receptor subtypes.
5. Briefly discuss the role of acetazolamide with respect to acid-base balance.
Course Objectives
ANATOMICAL PATHOLOGY:(All objectives are to be covered by self-directed learning)
At the end of the course, students will be able to:
1. Define chronic obstructive pulmonary disease (COPD) and list the disorders that
comprise chronic obstructive pulmonary diseases (COPD).
2. Discuss the aetio-pathogenesis, pathology and clinical features of asthma.
3. List the causes of pulmonary oedema.

4. Define adult respiratory distress syndrome (ARDS) and list the causes.
5. Define pneumoconioses and their significance in relation to environmental pollution.
Course Objectives
CHEMICAL PATHOLOGY:At the end of the course, students will be able to:
1. Write the Henderson-Hasselbalch equation, and use it to explain acid-base disturbances
such as, non-compensated respiratory acidosis; non-compensated respiratory alkalosis;
compensated respiratory acidosis; compensated respiratory alkalosis (Lecture).
2. Define the term Anion gap and explain its application in patients with mixed acid base
disturbance. (Lecture)
3. Explain the control of blood pH. (Lecture)
Course Objectives
HAEMATOLOGY:(All objectives are to be covered by self-directed learning)
At the end of the course, students will be able to:
1. Discuss haemopoiesis and its regulation (growth factors with special reference to
erythropoeitin).
2. Review the structure and function of haemoglobin with special reference to the
disorders of oxygen carrying capacity.
3. Discuss the role of hypoxaemia and erythropoeitin in respiratory disorders.
4. Explain the role of white blood cells in respiratory disorders: e.g. asthma
o a. monocyte - phagocytic system (macrophages)
o b. eosinophils (hypereosinophilic syndrome)
o c. mast cells (basophils)
o d. hereditary haemolytic anaemias
5. Describe anaemia of chronic disease (ACD), with reference to respiratory diseases.
Course Objectives
IMMUNOLOGY:(All objectives are to be covered by self-directed learning)
At the end of the course, students will be able to:
1. Outline the major immune defenses in the upper and lower respiratory tract.

2. Discuss the immunopathogenesis, clinical features, diagnosis and treatment of hayfever


(seasonal allergic rhino-conjunctivitis) and perennial rhinitis.
3. Discuss the immunopathogenesis, clinical features, diagnostic investigation and
principles of management of asthma.
4. List the common respiratory infections seen in patients with inherited and acquired
forms of humoral and/or cell-mediated immunodeficiency.
5. Outline the respiratory complications of HIV infection.
Course Objectives
MICROBIOLOGY:(All objectives are to be covered by self-directed learning)
At the end of the course, the student will be able to:
1. Discuss the aetiology of upper respiratory tract infections under the following
headings:
Bacteria: Group A Streptococcus, Haemophilius influenzae, Corynebacterium diptheriae,
Mycoplasma pneumoniae, Neisseria gonorrhea
Viruses: Rhino, Corona, Epstein Barr, Herpes simplex, Coxsackie A and B,
Paramyxoviruses and Orthomyxoviruses
Opportunistic fungi: Candida albicans and Aspergillus species.