MED 353 — الجهاز التنفسي
السنة 2 · 40 محاضرة · 6 ساعة معتمدة
العناوين والأهداف منقولة من خطة كلية الطب الرسمية.
1. Introductory lecture
Multidisciplinary
- Understand the general outline of the respiratory system module (MED 353).
- Be familiarized with the modalities of teaching throughout the course.
- Be familiarized with the grading system and passing requirements of the course.
- Be introduced to the clinical implications of respiratory anatomy and physiology.
- Be introduced to the basic pulmonary function testing and arterial blood gases in respiratory diseases.
2. Upper respiratory tract
Anatomy
- Describe the structure of nasal cavity including nasal septum.
- Describe the structure of lateral wall of nasal cavity including chonchae and meatuses.
- Locate the openings of the paranasal air sinuses and naso-lacrimal duct in the meatuses.
- Describe nasal innervations, blood supply and its relation to epistaxis.
- Study the structure of nasopharynx and associated openings with their clinical importance.
3. Pulmonary ventilation
Physiology
- Describe the mechanics of pulmonary ventilation.
- Define pleural pressure, alveolar pressure and transpulmonary pressure.
- Describe changes in lung volumes, alveolar pressure, pleural pressure, and trans-pulmonary pressure during normal breathing.
- Define compliance of the lungs.
- Draw compliance diagram of the lungs in a normal person.
- Describe the chemical composition and function of the surfactant.
- Describe the significance of the major volume and capacities that are recorded during normal function test.
4. Lower respiratory tract
Anatomy
- Describe the structure of various cartilages and membranes of the larynx.
- Describe muscles of the larynx including their action, nerve and blood supply.
- Describe the trachea including its relations and subdivision.
5. Pleura, lung and mediastinum
Anatomy
- Define pleura and pleural cavity, and name its parts and recesses.
- Discuss the pleural nerve supply.
- Compare between right and left lungs by describing their lobes, fissures and surfaces.
- Be familiarized with the bronchopulmonary segments of each lung.
- Describe innervation, blood supply and lymphatic drainage of the lungs.
- Identify different parts and contents of the mediastinum.
- Study the origin, location, course and branches of the internal thoracic artery.
- Define the surface markings of the trachea, lungs and pleura.
6. Alveolar ventilation
Physiology
- Define alveolar ventilation.
- List the factors that determine alveolar ventilation.
- Understand differences between anatomic and physiologic dead spaces.
- Describe the effect of dead space on alveolar ventilation.
- Define rate of alveolar ventilation.
- Describe the effects of alveolar ventilation on PCO2 and PO2.
7. Pulmonary circulation
Physiology
- Compare the pulmonary and systemic circulations listing the main differences between them.
- Describe bronchial circulation and the concept of physiological shunt.
- Characterize pressures in the pulmonary system.
- Describe blood flow through the lungs and its distribution.
8. Thoracic cage and muscles of thoracic wall
Anatomy
- Describe the shape and outline of the thoracic cage, including its inlet and outlet.
- Describe the anatomical landmarks of the anterior chest wall.
- List the various structures that constitute the thoracic wall.
- Describe muscles of the thoracic wall including their nerve and blood supply as well as their actions.
- Describe the characteristic features of the various parts of the thoracic vertebrae.
- Describe the sternum and its joints.
- Be familiarized with the classification of ribs, and their various parts as compared with each other.
- Define intercostal spaces and discuss their various components including intercostal muscles.
- Describe the diaphragm, its origin, insertion, and function, as well as its nerve and blood supply.
- Study the openings in the diaphragm and the structures that pass through them.
9. Pulmonary infections I (acute, chronic and TB)
Pathology
- Define pneumonia and pneumonitis.
- Clarify pneumonias according to etiology and morphological patterns.
- Compare and contrast bacterial and nonbacterial pneumonias.
- Outline the events in the resolution of the pneumonic process.
- List the possible complications of pneumonia.
- Discuss the causes, morphology and outcome of lung abscess.
10. Pulmonary infections II (acute, chronic and TB)
Pathology
- Define atypical pneumonia and discuss its etiology and pathology.
- List the types of fungal and parasitic infections of the lung.
- Be familiar with lung infections in the immunocompromised host.
- Describe the pathology of pulmonary primary TB.
- Describe the pathology of secondary TB.
- Describe the pathology of progressive TB.
- Describe the pathology of chronic pulmonary infections.
11. Histology of respiratory tract
Anatomy
- Describe the microscopic structure of the upper respiratory passageway including the respiratory mucosa.
- Correlate the structure and expected function of the different components of the nose and trachea.
- Study the microscopic structure of the main bronchi and their subdivisions.
- Study the microscopic structure of the lung parenchyma, and correlate this structure with gas exchange function.
12. Physical principles of gas exchange
Physiology
- Appreciate the measurement of partial pressure of gases.
- Define the factors which affect the rate of gas diffusion.
- Identify the respiratory membrane through which gases diffuse.
13. Ventilation-perfusion ratio
Physiology
- Define the concept of ventilation–perfusion ratio.
- Describe the effect of ventilation–perfusion ratio on alveolar gas concentration.
- Define the concepts of physiologic shunt and physiologic dead space.
- Characterize the pathophysiology of abnormal ventilation perfusion ratio.
- Define the applications of oxygen hemoglobin dissociation curve.
14. The role of the respiratory system in maintaining acid-base homeostasis
Biochemistry
- Describe the bicarbonate buffer system.
- Describe the biochemical changes associated with respiratory acidosis and alkalosis.
- Describe the role of hemoglobin in the buffer system.
15. Regulation of respiration: neural and chemical control
Physiology
- Locate and comment on the function of the dorsal and ventral groups of respiratory neurons, the pneumotaxic center, and the apneustic center in the brain stem.
- List the effects on respiration that are mediated by the vagus nerves.
- List the neural factors that affect the activity of respiratory center.
- Describe abnormal patterns of breathing.
- Describe cough and sneezing reflexes.
- List the specific functions of the respiratory receptors in the carotid body, the aortic body, and in the ventral surface of the medulla oblongata.
- Describe the effects of arterial PO2, PCO2 and pH on alveolar ventilation.
16. Bacterial infections I
Microbiology
- Be familiarized with bacterial classification and characteristic properties.
- Describe virulence factors, and pathogenesis.
- Describe clinical presentation and differential diagnosis.
- Describe laboratory diagnosis including specimen collection, culture techniques, and sensitivity to antibiotics.
- Describe management including specific therapeutic agents.
- Describe the epidemiology including modes of transmission, prevention and control measures.
17. Bacterial infections II
Microbiology
- Describe bacterial classification and characteristic properties.
- Describe virulence factors, and pathogenesis.
- Describe clinical presentation and differential diagnosis.
- Describe laboratory diagnosis including specimen collection, culture techniques, and sensitivity to antibiotics.
- Describe management including specific therapeutic agents.
- Describe the epidemiology including modes of transmission, prevention and control measures.
18. Application of hemoglobin oxygen dissociation curve
Physiology
- Calculate the affinities of hemoglobin by using P50 value.
- Understand the shape of this curve in anemia, and carbon monoxide poisoning.
- Describe the methods of calculations oxygen consumption in normal, anemic and carbon monoxide poisoning people.
19. Bacterial infections III
Microbiology
- Describe bacterial classification and characteristic properties.
- Describe virulence factors, and pathogenesis.
- Describe clinical presentation and differential diagnosis.
- Describe laboratory diagnosis including specimen collection, culture techniques, and sensitivity to antibiotics.
- Describe management including specific therapeutic agents.
- Describe the epidemiology including modes of transmission, prevention and control measures.
20. Treatment of respiratory tract infections
Pharmacology
- Understand the pharmacokinetics, mechanisms of action, and adverse effects of the antibiotic classes commonly used in the treatment of upper and lower respiratory tract infections, including: penicillins, cephalosporins, fluoroquinolones, and macrolides.
21. Treatment of asthma and COPD
Pharmacology
- Understand the general aims of therapy in bronchial asthma and COPD.
- Be familiarized with the concepts of bronchodilators versus long-term controllers in the management of asthma and COPD.
- Outline the specific mechanisms of action and the pharmacokinetic and pharmaco-dynamic properties of the following classes of drugs: beta-2 agonists, methylxanthines, anticholinergic agents, corticosteroids, mast cell stabilizers, leukotriene modifiers, and oxygen.
22. Clinical case
Medicine
- Covers clinical topics of SGD.
23. Fungal infections
Microbiology
- Describe fungal classification and characteristic properties.
- Describe pathogenesis.
- Describe the clinical presentation and differential diagnosis.
- Describe laboratory diagnosis including specimen collection, and microscopic findings.
- Describe management including specific therapeutic agents.
- Describe epidemiology including modes of transmission, prevention and control measures.
24. Anti-histamines and anti-cough medications
Pharmacology
- Review the concept of autacoids and their biological significance, with emphasis on histamine synthesis, storage, release, actions, and the clinical manifestations of histamine shock.
- Understand the mechanisms of action of anti-histamine drugs.
- Be able to classify, and understand the pharmacokinetics, uses, and adverse effects of anti-histamine drugs.
- Understand the pathophysiology of cough that is relevant to the pharmacological aspects of the treatment.
- Understand the sites of actions of anti-cough medications.
- Understand the mechanisms of action, clinical uses, and adverse effects of codeine and dextromethorphan.
25. Biochemistry of oxygen radicals
Biochemistry
- Describe the production of free oxygen radicals and their intermediates.
- Discuss the cell-based antioxidant defense mechanisms.
26. Obstructive lung disease I
Pathology
- Define obstructive lung diseases.
- Differentiate between OLD and RLD.
- Subtype OLD.
27. Mycobacterium tuberculosis
Microbiology
- Describe bacterial classification and characteristic properties.
- Describe virulence factors, and pathogenesis.
- Describe clinical presentation and differential diagnosis.
- Describe laboratory diagnosis including specimen collection, culture techniques, and sensitivity to antibiotics.
- Describe management including specific therapeutic agents.
- Describe the epidemiology including modes of transmission, prevention and control measures.
28. Obstructive lung disease II
Pathology
- Discuss the pathogenesis, pathological features, and possible complications of: asthma, chronic bronchitis, bronchiectasis, and emphysema.
- Classify emphysema according to morphologic and etiologic patterns.
29. Restrictive lung disease I
Pathology
- Define restrictive lung disease.
- Be familiar with the principles, cause and mechanisms in acute restrictive lung disease identifying acute respiratory distress syndrome in adults and newborn.
- Discuss the pathology of idiopathic pulmonary fibrosis.
- List the commoner cause of pulmonary fibrosis with emphasis on the pathology of sarcoidosis.
30. Treatment of tuberculosis
Pharmacology
- Understand the concepts of TB treatment with special emphasis on the two phases of therapy; intensive versus continuation phases.
- Understand the concept of combination therapy in the treatment of TB, particularly the advantages and disadvantages.
- Describe the mechanisms of action, pharmacokinetics, uses, and side effects of first-line anti-TB drugs: isoniazid, rifampin, ethambutol, and pyrazinamide.
- Understand the therapeutic use of second-line anti-TB drugs.
31. Restrictive lung disease II
Pathology
- Be familiar with causes and pathology of pneumoconiosis.
- Identify causes and pathology of asbestosis and mesothelioma.
- List the pulmonary hemorrhage syndromes which may lead to pulmonary fibrosis.
32. Emerging respiratory tract infections
Medicine
- Recognize cases of emerging upper respiratory tract infections.
- Understand the genetic background of emerging upper respiratory tract infections.
- Be familiarized with the historical aspects of emerging respiratory tract infections.
33. Surgical procedures for respiratory tract
Medicine
- Describe the clinical anatomy of respiratory tract.
- Describe the surgical procedures used commonly.
34. Viral infections
Microbiology
- Describe viral classification and characteristics properties.
- Describe growth, multiplication, and pathogenesis.
- Describe clinical presentation and differential diagnosis.
- Describe laboratory diagnosis including specimen collection.
- Describe management including specific therapeutic agents.
- Describe epidemiology including modes of transmission, prevention and control measures.
35. Pre- and post-natal development of the respiratory system
Anatomy
- Describe the development of nasal cavity.
- Describe development of the larynx.
- Describe the development of lungs and bronchi.
- Describe the development of the diaphragm.
36. Lung tumors I
Pathology
- Describe the etiology of lung cancer.
- Distinguish between small cell carcinoma and non-small cell carcinoma, and know the clinical and pathologic findings of the various types, together with their prognosis.
- Be familiar with bronchial carcinoid.
- Describe paraneoplastic syndromes associated with lung cancer.
- List other tumors in the lung and know the commonest metastatic tumor.
37. Lung tumors II
Pathology
- List the diagnostic techniques used for respiratory disease.
- Be familiar with pleural effusions, pneumothorax and pleural tumors.
- Identify nasal polyp, nasal papilloma and carcinoma.
- Understand the etiology and pathology of nasopharyngeal carcinoma.
- Describe laryngeal polyp, papilloma and carcinoma.
38. Epidemiology of acute upper respiratory tract infections and antibiotic use
Community Medicine
- Be oriented about the epidemiology of the common acute upper respiratory tract infections including distribution, risk factors, incidence, and prognosis.
- Be introduced to the false beliefs related to acute upper respiratory infections.
- Discuss the common use of antibiotics in acute upper respiratory infections.
- Present the main findings of a clinical trial conducted at JUST about the effectiveness of antibiotics in acute upper respiratory tract infections.
39. Radiology
Medicine
- Be introduced to the anatomical radiology of the respiratory system: ENT and pulmonary.
- Understand the radio-pathological correlation in respiratory diseases.
- Describe the radiological patterns of common respiratory illnesses.
- Describe the various radiological modalities in respiratory diseases, when and where.
40. Diagnostics
Microbiology
- Diagnostic tests for RS.