Preparation (self-studying – study following topics prior to the tutorial)

Definition of terms: eupnoea, tachypnoea, bradypnoea, hyperventilation, hypoventilation, dyspnoea, orthopnoea, apnoea, hyperpnoea, hypopnoea. Definition of the lung volumes and capacities: tidal volume, inspiratory and expiratory reserve volume, vital capacity, one-second forced expiratory volume (FEV1), inspiratory and expiratory capacity, total lung capacity, residual volume, functional residual capacity. Ventilation (resting, maximal), breathing reserve. Death space – anatomical vs. functional. Binding of oxygen to haemoglobin, dissociation curve. Saturation of haemoglobin by oxygen (SpO₂). Transport of CO₂ in blood. Definition of terms: partial pressure, hypoxia, hypercapnia. Possible causes of hypoxia – hypoxic, anaemic (transport), ischemic (circulatory), or histotoxic hypoxia. Chemoreceptor important for regulation of breathing – central vs. peripheral, location, sensitivity to changes of pCO₂/pH and pO₂.

Content

1.   Pulmonary ventilation

Mechanism of breathing – breathing muscles, intrathoracic and intrapulmonary pressure. Surface tension in alveoli, surfactant. Application of the law of Laplace in lungs. Respiratory work. Pneumothorax.

2.   Transport of gases through alveolar-capillary membrane

Composition of atmospheric and alveolar air. Diffusion through the alveolar-capillary membrane. Oxygen – haemoglobin dissociation curve, the Bohr effect. CO₂ dissociation curve.

3.   Regulation of breathing

Neuronal regulation – respiratory centre. Chemoreceptors – effect of hypoxia and hypercapnia. Mechanoreceptors in lungs – Hering–Breuer reflexes. Protective reflexes of respiratory system. Response of the ventilation to physical activity.

4.   Diagnostic and therapeutic methods in clinical practice

Spirometry – flow-volume loop. Pneumotachography. Pneumography. Measurement of the death space. Measurement of residual volume of the lungs. Artificial ventilation.

Schedule

* substitution (5. 4. 2021 – bank holiday)