RSC436 Clinical Respiratory Physiology (16)
CSU Discipline Area: Biomedical Science (BIMSC)
Duration: One session
Abstract:
This subject describes the practical performance and physiologic basis of specialised clinical respiratory measurement. These measurements include determination of static lung volumes, distribution of ventilation and perfusion, pulmonary gas transfer, respiratory mechanics including compliance, resistance and maximal intrapulmonary pressures, blood gas analysis, need for domiciliary oxygen and assisted ventilation, bronchial challenge testing, exercise testing and sleep disordered breathing. Quality control procedures relevant to the pulmonary function laboratory are also detailed.
+ Subject Availability Modes and Locations
| Session 2 | |
|---|---|
| Distance | Wagga Wagga |
Continuing students should consult the SAL for current offering details: RSC436
Where differences exist between the Handbook and the SAL, the SAL should be taken as containing the correct subject offering details.
Prerequisite(s):
Enrolment restrictions:
Available only to students enrolled in undergraduate BMedSci(Clinical Physiology), postgraduate Respiratory Science or at the discretion of the Subject Co-ordinator.
Objectives:
Upon successful completion of this subject, students should:
* describe the equipment and the testing methods used in determination of functional residual capacity, thoracic gas volume, homogeneity of pulmonary ventilation and perfusion, pulmonary gas transfer, compliance, resistance and maximal intrapulmonary pressure measurements, blood gas concentrations, bronchial hyperresponsiveness, exercise performance and obstructive sleep apnoea;
* describe the calibration procedures and minimum equipment specifications for instruments used in the specialised clinical respiratory tests described above;
* demonstrate an appreciation of the influence of equipment characteristics on the accuracy of physiological measurements attained by these methods;
* identify the rationale governing minimum patient performance criteria for each of the specialised clinical respiratory tests described above;
* define the parameters measured and their physiologic significance for each of the tests described above;
* describe the process of quality control specific to each of the specialised clinical respiratory tests described above;
* perform the specialised clinical respiratory tests described above, including the use of statistics in monitoring laboratory quality assurance;
* indicate the appropriate use of these clinical testing methods as aids in the assessment of respiratory disease;
* describe appropriate therapeutic methods such as domiciliary oxygen or assisted ventilation for improving patient care when respiratory pathology is determined.
Syllabus:
The subject will cover the following topics:
Module 1: Respiratory mechanics and lung volumes * physiological basis of compliance, resistance and maximal intrapulmonary pressure measurement * physiological basis of static lung volume measurement, including gas dilution, gas washout methods and plethysmographic methods * clinical measurement: calibration and minimum equipment specifications for gas analysers, volume or flow meters and plethysmographs * minimum patient performance criteria, prediction equations and quality control issues Module 2: Alveolar gas transfer * physiologic basis of membrane diffusion and blood gas transport * clinical measurement: calibration and minimum equipment specifications for gas transfer including single breath and steady state methods * minimum patient performance criteria, prediction equations and quality control issues Module 3: Distribution of ventilation and perfusion * physiological basis of anatomical, alveolar and physiological dead space; closing volume, closing capacity, pulmonary perfusion, anatomical and physiological shunt and ventilation-perfusion matching. * clinical measurement: calibration and minimum equioment specifications for the single breath (Fowler's method) and multiple breath nitrogen washout tests including gas analysers, and pulmonary artery catheters. * minimum patient performance criteria, prediction equations and quality control issues. Module 4: Blood gas analysis * physiological basis of hypoventilation, heterogeneity of ventilation (V) and perfusion (Q) and V/Q mismatch. * clinical measurement: standard protocols for blood sample procurement. * tests of respiratory function employing blood gas determination: ideal alveolar gas equation, pulmonary shunt, anatomical shunt, Bohr equation. * arterial blood gas interpretation; oxygen therapy, assisted mechanical ventilation and assisted ventilation therapy, including CPAP, PEEP * noninvasive estimates of blood gases: oximetry, capnography, transcutaneous monitors, expired gas analysis. * minimum patient performance criteria, prediction equations and quality control issues. Module 5: Challenge tests *physiological basis of bronchial hypersensitivity, hyper-reactivity and hyper-responsiveness. * challenge protocols: direct (histamine and methacholine) and indirect (cold/dry/isocapnic hyperventilation, exercise, osmotic - hypertonic saline and mannitol), nebulisers * clinical measurement: calibration and minimum equipment specifications, airflow limitation indices, dosage (cumulative dose versus concentration) * quality control issues Module 6 Special studies A. Exercise testing * physiologic basis: cardiorespiratory regulation and response to exercise. * interpretation: cardiorespiratory indices. B. Sleep disordered breathing * physiologic basis: respiratory control, sleep staging, inspiratory flow limitation. * interpretation: EEG, ECG, EMG data, sleep disturbance, apnoea/hypopnea index. Module 7: Laboratory quality assurance * quality control concepts * statistical methods * statistics for quality assurance in the pulmonary function laboratory
The information contained in the 2013 CSU Handbook was accurate at the date of publication: 24 April 2013. The University reserves the right to vary the information at any time without notice.