Donetsk 2009 mechanisms and changes of respiration phases. Regulation of respiration icon

Donetsk 2009 mechanisms and changes of respiration phases. Regulation of respiration




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Ministry of Public Health of Ukraine

M. Gorky Donetsk National Medical University


MECHANISMS AND CHANGES OF RESPIRATION PHASES. REGULATION OF RESPIRATION.


Methodical instructions for students


Donetsk


2009


MECHANISMS AND CHANGES OF RESPIRATION PHASES. REGULATION OF RESPIRATION.


Actuality of subject: Importance of studying the topic “Mechanisms and changes of respiration phases. Regulation of respiration” consists in understanding of interaction and correlation of organs, structures and physiological systems, taking place in the processes of gas exchange on different stages and levels. Change of excitability of the respiratory center can manifest in external respiration disorder. The knowledge of mechanisms of respiration regulation is necessary for a therapeutist to understanding the genesis of some states and diseases.

Common purpose: To be able to interpret the mechanisms of respiration regulation for understanding their role in forming the integrity activity of organism and for further use of this knowledge in the clinic of internal diseases.

^ Specific purposes Purposes of initial level of knowledge

To be able to:





1. Interpret notion about functional and structural mechanisms of respiratory center for explaining of breathing rhythm.

2. Explain neurohumoral mechanisms, role of CO2,O 2 and H+ for respiratory regulation.

3. Explain mechanisms of reflexive regulation and self-regulation under various conditions and states of organism.

4.Explain different pattern of respiration disorders.


1. Different macro- and microstructure of the CNS formations which take part in breathing.(Anatomy and Histology Departments) 2. Interpret notion about nervous center (Medical Biology Department).

3. Interpret principles of self-regulation (Biophysics Department).



You must decide some tasks in order to reveal your initial level of knowledge-skill:

^

Tasks for control of initial level of knowledge



Task#1

Man died of fighting poisoning agent which selective damaged only brain structures which took part in respiration regulation. After dyeing by histological paint such brain damaged structures acquired brightly-blue colour. Which brain structures were stolen?

1) Fundus of IV ventricle.

2) Thalamus.

3) Vestibular nuclei.

4) Black substance.

5) Cerebellum


Task # 2. During autopsia of a cadaver who had died following a sudden stop of breathing. The hemorrhage in bottom of IV ventricle of medulla oblongata was revealed. Which formation on the bottom of IV ventricle was damaged?

  1. Respiratory center.

  2. Center of saturation.

  3. Center of hunger.

  4. Visual center.

  5. Center of punishment.


Task # 3. A sportsman had involuntary deep breathing before the start. What caused the change of breathing?

  1. Conditioned reflex under influence of the cortex.

  2. Activate influence of reticular formation.

  3. Thermoregulatory change.

  4. Change of tonus of inspiratory muscles.

  5. Influence of hypothalamus.


If you decide previous tasks then you must decide following tasks independently.


Task # 4. Electrical activity of neurons increased before inspiration and in beginning of breathing in. Where were these neurons located?

  1. Midbrain.

  2. Medulla oblongata.

  3. Diencephalon.

  4. Spinal cord.

  5. Cortex.

Task # 5. The respiratory center structure was damaged during an experiment on an animal. It led to changes of normal breathing in to the resting change. Which part of the brain was damaged?

  1. Ventral respiratory nucleus.

  2. Motoneurones of spinal cord.

  3. Dorsal respiratory nucleus.

  4. Pneumotaxic center.

  5. Ventral and dorsal nuclei.


Task # 6. A 27 year old mountaineer was on the great height (5000 m). During sleep his breathing rhythm changed: after several deep enhalation the breathing was stopped and then he started breathing deeply again. What caused the breathing change in mountaineer?

  1. Fall of partial pressure of O2 in air.

  2. Fall of partial pressure of CO2 in air.

  3. Increase in hemoglobin level.

  4. Increase in volume circulation rate.

  5. Fall of environment temperature.



Basic theoretical questions.

  1. Respiratory center. Localization and structure of bulbar respiratory center.

  2. Modern idea about the structure and functional interaction of respiratory center neurons.

  3. Mechanism of inspiration and expiration.

  4. Neurohumoral regulation of respiration.

  5. Functional system of stabilization of blood gas composition as mechanism of respiration self regulation.

  6. Defense respiratory reflex.

  7. Mechanism of first breath in.

  8. Types of respiratory dysfunction (hypopnea, apnea, hyperpnea).



Literature



Textbook of medical physiology/Arthur C. Guyton, John E. Hall – 2001, 474- 493 Lectures .

Methodical recommendation for students.


^

The educational tasks



Task # 1. An experimental animal spinal cord was cut higher IV cervical segment. What changes breathing occurred after spinal cord cutting on this level?

  1. Breathing stopped.

  2. Breathing became superficial.

  3. Became slow.

  4. Didn’t change.

  5. It became deeper and slower.


Task # 2. The influence of different factors on respiratory center was studied on the dog. Which factors of blood more stimulate the medulla oblongata receptors?

  1. H+.

  2. CO2.

  3. Na+.

  4. Glucose.

  5. K+.


Task # 3. The mountaineer during ascent on mountain on altitude of 3 km felt headache, weakness, vertigo, heart rate decrease. What caused this state?

  1. Hypoxemia.

  2. Alkalosis.

  3. Acidosis.

  4. Hypercapnia.

  5. Hypocapnia.


Task#4. At patient with diabetes mellitus during development of comatose condition very deep, rare and noisy respiration revealed. What type of disorder of pulmonary ventilation such breathing belong to?

1) Eupnea.

2) Biotis.

3) Hyperpnea.*

4) Apnea.

5) Tachypnea.


If you decide previous tests then you must decide following tests independently.


Task # 5. A 15 years old boy jumped into river and he hit hard head the against bottom of river. The damage of cervical part of the vertebral column and phrenic nerves on both sides was arisen in that boy. How did it affect breathing?

  1. Breathing became slow and deep.

  2. Breathing didn’t change.

  3. Breathing became more frequent and superficial.

  4. Respiratory standstill occurred.

  5. Breathing became more slow and superficial.


Task # 6. The level of O2, CO2 and pH of blood was changed in a 25 year old young man after physical loading. Which factor was a stronger stimulus for the carotid sinus chemoreceptors?

  1. Low level of O2 in blood.

  2. High level of O2 in blood.

  3. Increase in O2 strain in blood.

  4. Change of blood pH.

  5. Accumulation of blood lactate.

Task # 7. Workers, who made cement, had an intensive cough reflex. What receptors were stimulated during this situation?

  1. Stretch receptors.

  2. Irritant.

  3. Chemoreceptors.

  4. Thermoreceptors.

  5. Nociceptors.


Task #8. At 80 year old after craniocerebral injury the convulsations appeared, short stop of respiration alternated with solitary inspiration. What type of respiration arose at patient?

1) Cheyne--Stokes.

2) Gasping.

3) Biotis.

4) Kussmaul.

5) Apnea.


Approximate basic of work.

Laboratory work # 1.

The study of defense respiratory reflex arising from the irritation nose of mucous membrane lay, of the upper respiratory tracts by ammonia. Normal pneumogram is writing down. A patient closes his eyes and you brings 5% solution of ammonia to his nose. Changes in pneumogram, reflex reaction and time of stop breathing are notes.

Laboratory work # 2.

^ Test with maximum breath delay.

Stange’s test with maximum breath delay after inspiration. After quite inspiration patient must close the nose and keep this state more longer as possible. Fix time of delay and notes result of experiment. Next test must repeat after 5 minutes only.

Genche’s test with maximum breath delay after expiration. After quite expiration patient must close the nose and keep this state more longer as possible. Fix time of delay and notes result of experiment. Next test must repeat after 5 minutes only.

Test with maximum breath delay after a deep inspiration after hyperventilation. For several seconds patient make hyperventilation: he must breath deeply and frequently. After deep inspiration patient must close the nose and keep this state more longer as possible. Fix time of delay and notes result of experiment.

Laboratory work # 3.

Spirographia in a state of rest and after physical loading. Make record of spirogram in rest and after short physical loading (20 squatting). After 20 squatting you must start recording of spirogram and determine the amount of O2 consumed, respiratory rate, minute ventilation volume of the lungs in the rest state and immediately after loading.

^

The task for the control of final level of knowledge



Task. During experiment the patient was long time in environment with low atmospheric pressure O2. What factors take part in adaptation of human organism to this condition?

А. Increasing in erythropoiesis.

В. Increasing in hemoglobin maintenance.

С. Increasing in pulmonary ventilation.

D. Deviation of dissociation cure of oxyhemoglobin to the right.

E. Firmness of nervous cells to hypoxia.


^ SHORT METHODICAL INSTRUCTIONS

After organization part , in the beginning of study, after actualisation of topic pay attention to necessity to be able to interpret the mechanisms of nervous and humoral regulation of respiration in normal and pathological state.

After this the teacher ascertains initial level of knowledge-skill which received before.

After decision of teaching tasks students independent interpret the scheme of respiration regulation. After this you must explain physiologic importance of respiration regulation. During this students use table-train, graph - logical structure of topic (addition 1).

After this students decide teaching tasks which they receive from teacher.

Students with teacher modulate situation tasks on these topics. Teacher corrects mistake students’ actions.

Students carry out laboratory works independent. For consolidate the topic students see education film

After this students decide control tasks. Sum up of study and announcement marks.

^ TECHNOLOGICAL MAP OF THE STUDY MECHANISMS AND CHANGES OF RESPIRATION PHASES. REGULATION OF RESPIRATION.



Stage

Time

Teaching aids

Place

Note







Min

Means of training

Equipment

of study




1.

Organization part Actuality of subject. Purpose of study

5







Classroom




2.

Control initial level of knowledge-skill with the help of tasks/ Independent work of students with recommend models and scheme. Independent work of students with recommend teaching tasks. Model situation tasks and correct mistake action of students.

60

Tasks Graf logical structure of topic. Table-train




-//-




3.

Independent carry out laboratory works. Seeing of educational videofilm.

40

Instruction for laboratory works

Spirograph, ammonium solution , watch with second hand, bell, lamp . Tv set


Classroom Videoroom




4.

The task for the control of final level of knowledge. Sum up of study. Announcement of marks

15

Tests

Computer

Computer room Classroom






Addition 1. Graf logical structure of topic "^ MECHANISMS AND CHANGES OF RESPIRATION PHASES. REGULATION OF RESPIRATION.”.


Regulation of the breathing

Respiratory center

Neuronal structure and organization

Medulla oblongata

Pons Varolii

Inspiratory center

Expiratory center

Pneumotoxic center

Regulation of rate and depth respiration

Mechanoreceptors

Chemoreceptors

Central

Juxtaglomerular

Peripheral

Lungs receptors

Irritation


Hyperpnea

Apnea

Dyspnea

Rhinopnea

Methods of examination

Clinical tests


Interpret of organism physiological state for further use this knowledge in clinic



Pathological types of breathing


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