1

University of Pennsylvania
School of Nursing
Course Syllabus
Summer 2013
TITLE: N 681 Applied Physiology for Nurse Anesthetists I
COURE UNIT: 1 !u
CATALO" #ECRIPTION:
This course provides an indepth analysis of the anatomy! physiology and
pathophysiology of the respiratory system and related anesthesia implications" The
concepts of pulmonary mechanics! ventilation and perfusion as they relate to o#ygen and
anesthetic delivery and metabolism are e#amined" The effects of compromised
pulmonary function and implications for the patient and anesthesia plan are revie$ed"
The effect of surgery and anesthesia on the respiratory system $ill be emphasi%ed"
PLACE$ENT: u%%er I&II 'e(r I
)ACULT': *oseph R+ Li,on(ti- Ph+#+
Roo% 1.6/
T+ .10123614586
6li,on(t7nursing+upenn+edu
Lori Ann 8inner- $N- CRNA
Roo% 432
C+ 619121011522
T+ .10123614006
:iseley(7nursing+upenn+edu

PRE1RE;UIITE<=: Completion of undergraduate courses that include &iochemistry!
Nutrition! 'natomy and Physiology or permission of the instructor
CO1RE;UIITE<=: None
COURE O>ER>IE8:
(undamental concepts of pulmonary physiology from the cell to the organ level are
revie$ed! framing a foundation of normal physiology before proceeding to
pathophysiology content" 'dvanced )no$ledge of pulmonary system in health and
disease $ill be presented from the physiological perspective" Clinical application of this
)no$ledge $ill be integrated by anesthesia faculty"
2
COURE O/*ECTI>E:
1" To introduce students to the scientific principles underlying the advanced study of
respiratory physiology and pathophysiology"
2" To promote development of students* +uantitative and +ualitative problemsolving
s)ills and diagnostic reasoning based on pathophysiological principles"
3" To provide selfdirected learning e#periences that $ill e+uip the students $ith the
vocabulary and comprehension of respiratory physiology and alterations of
physiology in the conte#t of common respiratory disease processes"
," To integrate physiology and pathophysiology of the respiratory system $ith clinical
applications of this )no$ledge in anesthesia practice"
-" To analy%e the biophysical properties of the respiratory unit .lungs and chest $all/
$ith respect to static and dynamic compliance! lung volumes! air$ay resistance! and
alterations of these properties in health and disease"
0" To evaluate the principles underlying solubility of gas molecules in blood plasma and
transport of these molecules in the circulation! focusing on o#ygen and carbon
dio#ide as $ell as inhaled anesthetics"
TEAC?IN" $ET?O#:
1ecture! te#tboo) readings! discussion of research articles! audiovisual materials!
assignments! course handouts"
E>ALUATION $ET?O#:
2#am 31 33"34
2#am 32 33"34
2#am 33 33"34
"RA#IN" POLIC':
'5 67100 &5 8786 C5 7776 ( 006
' 6360 & 8380 C 7370
' 6062 & 8082 C 7072
9ounding $ill be done as follo$s:
;rades of "- and above $ill be rounded up to the ne#t $hole number
;rades of ", or less $ill be rounded do$n to the ne#t $hole number
hould ( student ,e found responsi,le for !he(ting in this !ourse- their gr(de for the
!ourse :ill ,e ( f(ilure+ The Uni@ersity Code of A!(de%i! integrity :ill ,e follo:ed
in this !ourse <see ,elo:=+ It is (lso (@(il(,le on /l(!A,o(rd (nd the student
h(nd,ooA+
3
Code of Academic Integrity
Since the University is an academic community! its fundamental purpose is the pursuit of
)no$ledge" 2ssential to the success of this educational mission is a commitment to the
principles of academic integrity" 2very member of the University community is
responsible for upholding the highest standards of honesty at all times" Students! as
members of the community! are also responsible for adhering to the principles and spirit
of the follo$ing Code of 'cademic <ntegrity"
A!(de%i! #ishonesty #efinitions
'ctivities that have the effect or intention of interfering $ith education! pursuit of
)no$ledge! or fair evaluation of a student=s performance are prohibited" 2#amples of
such activities include but are not limited to the follo$ing definitions:
'" Cheating: using or attempting to use unauthori%ed assistance! material! or study
aids in e#aminations or other academic $or) or preventing! or attempting to
prevent! another from using authori%ed assistance! material! or study aids"
2#ample: using a cheat sheet in a +ui% or e#am! altering a graded e#am and
resubmitting it for a better grade! etc"
&" Plagiarism: using the ideas! data! or language of another $ithout specific or
proper ac)no$ledgment" 2#ample: copying another person=s paper! article! or
computer $or) and submitting it for an assignment! cloning someone else=s ideas
$ithout attribution! failing to use +uotation mar)s $here appropriate! etc"
C" (abrication: submitting contrived or altered information in any academic
e#ercise" 2#ample: ma)ing up data for an e#periment! fudging data! citing
none#istent articles! contriving sources! etc"
>" ?ultiple submission: submitting! $ithout prior permission! any $or)
submitted to fulfill another academic re+uirement"
2" ?isrepresentation of academic records: misrepresenting or tampering $ith or
attempting to tamper $ith any portion of a student=s transcripts or academic
record! either before or after coming to the University of Pennsylvania" 2#ample:
forging a change of grade slip! tampering $ith computer records! falsifying
academic information on one=s resume! etc"
(" (acilitating academic dishonesty: )no$ingly helping or attempting to help
another violate any provision of the Code" 2#ample: $or)ing together on a ta)e
home e#am! etc"
;" Unfair advantage: attempting to gain unauthori%ed advantage over fello$
students in an academic e#ercise" 2#ample: gaining or providing unauthori%ed
access to e#amination materials! obstructing or interfering $ith another student=s
efforts in an academic e#ercise! lying about a need for an e#tension for an e#am
or paper! continuing to $rite even $hen time is up during an e#am! destroying or
)eeping library materials for one=s o$n use"! etc"
,
@ <f a student is unsure $hether his action.s/ constitute a violation of the Code of
'cademic <ntegrity! then it is that student=s responsibility to consult $ith the instructor to
clarify any ambiguities" .Source: Affice of the Provost! 1660/
http:BB$$$"vpul"upenn"eduBoslBpennboo)"html
RE;UIRE# TEBT:
9hoades! 9"'" C &ell! >"9" .2013/" ?edical Physiology: Principles for Clinical ?edicine
,
th
2dition" Philadelphia: 1ippincott! Dilliams! C Dil)ins"
Dest! E"&" .2012/" 9espiratory Physiology: The 2ssentials 6
th
2dition" Philadelphia:
1ippincott! Dilliams! C Dil)ins"
Nagelhout! E" C Faglanic%ny .2013/" Nurse 'nesthesia -
th
2dition" ?issouri: 2lsevier
Saunders"
&arash! P";"! Cullen! &"(" C Stoeling! 9"G" 2ds" .2013/" Clinical 'nesthesia 7
th
2dition"
Phila"! P': 1ippincott! Dilliams C Dil)ins"
RECO$$EN#E# TEBT:
?organ! 2";"! ?i)hail! ?" S"! C ?urray! ?"E" .2000/" Clinical 'nesthesiology ,
th
2d"
Ne$ Hor): 1ange ?edical >ivisionB?c;ra$Iill Companies! <nc"
?cPhee! S"E"! 1ingappa! J"9"! ;anong! D"("! 1ange! E">" Pathophysiology of >isease: 'n
<ntroduction to Clinical ?edicine! 0
th


2d"! Ne$ Hor)! 1ange ?edical &oo)sB?c;ra$
Iill! 2000" <S&N: 0071,,1-6K"
Netter! ("I"! C Ianson! E"T" .2010/" 'tlas of Iuman 'natomy" -th 2dition" ?issouri:
2lsevier Saunders"
-
Tuesday 1p-4p
8EECL' TOPICAL OUTLINE:
>ayBTime Topic AbLectives 9eadings
8eeA 1
?ay 21! 2013

Dinner
Delcome >ay
Course Avervie$ $ith Syllabus
Simulation sessions information
8eeA .
?ay 28! 2013
1ibonati
Dinner
&reathingB?etabolism Avervie$
?echanics of &reathing
&reathing 9esistance
Compliance
Clinical Correlations:
9espiratory failure
10
Nagelhout Ch" 22
C 20

Dest Ch" 2 C 7
8eeA 4
Eune ,! 2013
1ibonati
Dinner
Pathophysiological alterations in
lung biophysics
Pulmonary function tests
Clinical Correlations:
Perioperative &ronchospasm! Care
of Patient $ith 2mphysema under
'nesthesia
10 Nagelhout Ch" 22
C 20
Dest Ch" 7 C 10
8eeA 3
Eune 11! 2013
Dinner
ED(% E 1
Simulation Lab (following Eam!
A#ygenation C Jentilation
10
2#amcontent
covered in $ee)s
23"
?aterial provided"
8eeA 0
Eune 18! 2013
1ibonati
Dinner
Neural control of ventilation
Clinical Correlations: Neurologic
'ssessment of Jentilator
>ependent Patient
10
Nagelhout Ch" 22
C 20
Dest Ch" 8
0
8eeA 6
Eune 2-! 2013
1ibonati
Dinner
Chemoreceptors
>iffusion of gases
Clinical Correlations:
<nhalational agents and their
effects
10 Nagelhout Ch" 8!
22 C 20
Dest Ch" 3
8eeA 2
Euly 2! 2013
5(13p
Dinner
ED(% E .
1ecture:
1ung anatomy
<nnervation of the air$ays
Simulation Lab (following Eam!
<nhalational agents
Jentilatory modes
2mergence from 'nesthesia
10
2#am content
covered in $ee)s
,0"
Nagelhout Ch" 22
C 20
Dest Ch" 1
8eeA 8
Euly 6! 2013
5(13p
1ibonati
Dinner
9egulation pulmonary blood flo$
Fones of the lung
1ung ventilation and perfusion
>ead space! shunt
JBM matching
Clinical Correlation: 1 Pulmonary
Iypertension
10
Nagelhout Ch" 8!
17! 22 C 20
Dest Ch" ,! -! C 0
8eeA 5
Euly 10! 2013
1ibonati
Dinner
;as transport in the blood
'cidbase balance
<ntegration of concepts
Clinical Correlations: 'cid B&ase
scenario in A1J
10 Nagelhout Ch" 8!
22 C 20
Dest Ch" 0
8eeA 19
Euly 23! 2013
Dinner
ED(% E 4
2#am content
covered in $ee)s
7! 8 C 6"
8eeA 11
Euly 30! 2013
Dinner
OR Orient(tion 8eeA
Simulation Lab
7
8eeA 1.
'ugust 6! 2013
e%ester End <No !l(ss=
AANA N(tion(l $eeting
August 19113th
TOTAL NU$/ER O) T?EOR' ?OUR: 30
TOTAL NU$/ER O) CLINICAL ?OUR: 9