INTRODUCTION TO THE MODULE (MED 213 CIRCULATION AND BREATHING) DR NAZIA KHAN

Objectives of the module 1. Explain organization, development, structure and function of the cardiopulmonary system. (A) 2. Apply knowledge of basic sciences in understanding cardiopulmonary disorders. (A) 3. Integrate basic pathophysiology of cardiopulmonary system in cardiopulmonary disorders. (A, B) 4. Identify clinical manifestations and apply basic principles of management of cardiac and pulmonary disorders in Saudi Arabia, emphasizing on the interdisciplinary approach to the management of such disorders wherever necessary. (B,C, D) 5. Explore the incidence and prevalence of cardiopulmonary disorders in all age groups in Saudi Arabia using current literature. (D, E)

CONTENTS OF THE MODULE A:LECTURES(TOTAL 77)  THEME 1- RESPIRATION: 36 LECTURES  THEME 2-CIRCULATION : 41 LECTURES B. PRACTICAL SESSIONS(TOTAL 16)  ANATOMY: 4  HISTOLOGY: 2  PHYSIOLOGY: 5  PATHOLOGY:4  MICROBIOLOGY:1

C: CLINICAL SKILLS LAB (TOTAL 4)  Examination of Respiratory System  Examination of the Heart  General Physical Examination  Cardiopulmonary Resuscitation (CPR) D: PROBLEM BASED LEARNING (TOTAL 6)  3 RESPIRATORY AND 3 CIRCULATION E: SEMINARS (TOTAL 5)  Effect of High Gases Pressures on the Body  Congenital Anomalies of the Heart  Circulation Before and After Birth  Effect of Cigarette Smoking on cardiovascular and Respiratory Systems  Preventive Strategies in Cardiopulmonary Diseases

F: CASE DISCUSSION (TOTAL 5)  Pneumonia  Cor Pulmonale  Pericardial Effusion  Supraventricular Tachycardia  Systemic Hypertension G: FIELD VISIT (TOTAL 2)  Field Visit to Pulmonary Diseases Hospital  Field Visit to Heart Diseases Hospital

Module References   Basic & Clinical Pharmacology - 12 th ed.   Clinical Anatomy by Regions: R.S. Snell - 9 th ed.   Current Medical Diagnosis & Treatment -50 th ed.   Guyton & Hall Textbook of Physiology - 12 th ed.   Jawetz Medical Microbiology 25 th ed.   Junqueira's Basic Histology Text & Atlas: Mescher AL - 12 th ed.   Langman's Medical Embryology: T.W. Sadler - 12 th ed.   Lippincott’s Illustrated reviews – Biochemistry 5 th ed.   Lippincottts Illustrated Review in Pharmacology, 5 th ed.   Macleod's Clinical Examination 10 th ed.   Robbins Basic Pathology - 8 th ed

Teaching and learning methods  A. Interactive lectures  B. Small group learning sessions (PBL)  C. Large group learning sessions (seminars)  D. Practical sessions  E. Skills lab sessions  F. Clinical teaching and learning sessions  G. Tutorials

Assessment in the module A. Continuous assessment (60%) :  1. Activities (PBL, CD and Seminars) ----> 15 marks  2. Quizzes for (PBL, CD and Seminars) > 15 marks  3. Mid module -----> 20 marks  4. Mid module practical assessment----> 5 marks  5. Skills > 5 marks B. Final assessment (40%) :  The eligibility criterion for sitting the final exam will be the completion of 75% of attendance.  1. Theory exam -----> 30 marks  2. Final practical exam > 5 marks  3. Clinical skills exam > 5 marks

AN OUTLINE OF RESPIRATORY SYSTEM It is formed of:  1 – Nose: 2 nasal cavities separated by nasal septum, it has two function filtration and humidification of air.  2 – Nasopharynx: It connects the nose to the larynx.  3 – Larynx: it is formed of cartilages which is connected with each other by ligaments and muscles. It connects the nasopharynx to the trachea.

Right bronchus Left bronchus Trachea 4 – Trachea: It is about 10 cm, it is incomplete ring and its wall contains C shaped cartilage. It is divided into right and left bronchi. 5 – Pleura: It is closed serous sac invaginated by the lung and it is formed of visceral and parietal layer. 6 – Two lungs: Right lung formed of 3 lobes (superior, middle and inferior lobes) while the left is formed of 2 lobes (superior and inferior lobes).

 It is formed of heart and blood vessels. 1 – The heart  It is the pump which pushes blood into the circulation. It is formed of 2 sides, A – Right side: Right atrium and right ventricle. B – Left side: Left atrium and left ventricle.  The tricuspid valve connects between the right atrium and right ventricle.  The mitral valve connects between the left atrium and left ventricle.  The arterial supply of the heart is by coronary arteries.  The venous drainage of the heart is mainly by coronary sinus. CARDIOVASCULAR SYSTEM

2 – The blood vessels  A – Arteries: It carries oxygenated blood from the heart to the body except pulmonary trunk carries non oxygenated blood. It divides into smaller branches.  B – The veins: It carries non oxygenated blood from all parts of the body to the heart except the pulmonary veins carry oxygenated blood. It is formed of small veins called tributaries.  C – Capillaries: It is minute channels which connect arterioles and venules.

BLOOD CIRCULATION 1 – Pulmonary circulation  The venous blood from the right ventricles passes through pulmonary trunk to the lung to be oxygenated. Oxygenated blood from the lung passes through 4 pulmonary veins to the left atrium. 2 – Systemic circulation  Oxygenated blood from the left ventricles passes through aorta and its branches to all parts of the body. Venous blood return from all parts of the body passes through small veins then through superior and inferior vena cava to right atrium. 3 – Portal circulation  The venous blood from the stomach, intestine, pancreas and spleen are collected to the liver.

 ALL THE VERY BEST