1

University of Pennsylvania
School of Nursing
Course Syllabus
Fall 2013
TITLE: N 682 Applied Physiology for Nurse Anesthesia II
COU!E UNIT!: " #u
CATALO$ %E!CIPTION:
This course provides an indepth analysis of the anato!y" physiology and
pathophysiology of the cardiac" circulatory" renal" hepatic" he!atologic" #
i!!unological syste!s $ith focus on anesthesia i!plications% &!phasis $ill be
placed on assess!ent of the patient" adult and gerontological" $ith co!!on
disorders of these syste!s%
PLACE&ENT: 'all( )ear I
'ACULT): *oseph + Li,onati( Ph+%+
oo- "26.
T+ 2"/012603486
5li,onat6nursing+upenn+edu
Lori Ann 7inner( &!N( CNA
oo- 321
C+6"801"/0"411
T+ 2"/012603//6
9iseleya6nursing+upenn+edu
PE0E:UI!ITE ;!<: N 681 Ad=an#ed Physiology and Pathophysiology
N 68" Applied Physiology for Nurse Anesthesia I
CO0E:UI!ITE ;!<: None
COU!E O>E>IE7:
This course focuses on an indepth analysis of anato!y" physiology and
pathophysiology of the cardiac" circulatory" renal" # neurological syste!s $ith
related anesthesia i!plications% Co!!on effects of co!pro!ised cardiac"
circulatory" renal" # neurological function and related i!plications for patient care
and the anesthesia plan are discussed%
COU!E O.*ECTI>E!:
1% 'efine the cellular electrophysiology underlying the t$o types of cardiac
!uscle tissue" pace!a(er and nonpace!a(er tissue%
2
2% 'eter!ine the effects of plas!a electrolyte alterations on auto!aticity and
the action potential%
3% 'escribe the cellular basis of auto!atic control of heart rate and contractile
state%
)% Understand basic concepts of arrhyth!ia pathogenesis and
phar!acological !anipulations that e*acerbate or a!eliorate abnor!al
auto!aticity and conduction%
+% ,ntegrate concepts of !yocyte calciu! handling $ith physiology and
pathophysiology of cellular contraction and rela*ation%
-% Correlate the cardiac cycle $ith pressurevolu!e analysis of !yocardial
function in health and disease" including abnor!al function of the cardiac
valves%
.% Critically e*a!ine the deter!inants of !yocardial function and their
regulation%
/% 'efine the factors that regulate pressure and resistance as deter!inants of
cardiac output%
0% 'ifferentiate bet$een systolic and diastolic dysfunction of the !yocardiu!%
10% ,dentify factors involved in local control of arterial perfusion in health and
disease%
11% Co!pare and contrast adaptive !echanis!s to !aintain blood pressure in
circulatory versus he!orrhagic shoc(%
12% 1ist the properties of healthy endotheliu! and describe alterations in
endothelial function in atherosclerosis%
13% ,dentify the ris( factors for atherosclerosis and their relationship to the
develop!ent of disease%
1)% 'escribe !echanis!s of autoregulation of blood flo$ to the brain" heart
and (idney%
1+% &*a!ine the anato!y of the (idney" nephron" bo$!an2s capsule" and loop
of henle%
1-% 'iscuss renal blood flo$" 3F4" and urine for!ation%
1.% &*a!ine renal regulation of fluids" p5" and electrolyte balance%
1/% 'iscuss alterations in renal function%
10% &*a!ine tests to !onitor renal function%
20% 'escribe anesthetic effects on renal function%
21% 'iscuss hepatobiliary function
22% 'iscuss hepatic function $ith relation to drug !etabolis!
23% 'iscuss the relationship bet$een liver function and coagulation%
2)% &*a!ine the genesis and function of the red blood cell%
2+% &*a!ine the genesis and function of the platelet%
2-% &*a!ine the for!ation of a platelet plug to !aintain ho!eostasis%
2.% &*a!ine the changes in physiology associated $ith the geriatric
population%
2/% 'iscuss the function of the i!!une syste!%
20% 'iscuss types of i!!unity%
30% 'ifferentiate bet$een anaphylactic reactions and anaphylactoid reactions%
3
31% &*a!ine the concept of cross sensitivity related to organis!s and
antibiotics%
32% &*plore 1ate* allergies%
TEAC?IN$ &ET?O%!:
1ecture # group discussion
E>ALUATION &ET?O%!
&*a! 61 Cardiovascular )07
&*a! 62 3erontology" 1iver" # 5e!atology 307
&*a! 63 ,!!unology # 4enal 307
$A%IN$ POLIC):
89 0.100 :9 /./0 C9 ...0 F 0-0
8 030- : /3/- C .3.-
8 0002 : /0/2 C .0.2
4ounding $ill be done as follo$s;
3rades of %+ and above $ill be rounded up to the ne*t $hole nu!ber
3rades of %) or less $ill be rounded do$n to the ne*t $hole nu!ber
Code of A#ade-i# Integrity
Since the University is an acade!ic co!!unity" its funda!ental purpose is the
pursuit of (no$ledge% &ssential to the success of this educational !ission is a
co!!it!ent to the principles of acade!ic integrity% &very !e!ber of the
University co!!unity is responsible for upholding the highest standards of
honesty at all ti!es% Students" as !e!bers of the co!!unity" are also
responsible for adhering to the principles and spirit of the follo$ing Code of
8cade!ic ,ntegrity%
A#ade-i# %ishonesty %efinitions
8ctivities" $hich have the effect or intention of interfering $ith education" pursuit
of (no$ledge" or fair evaluation of a student2s perfor!ance are prohibited%
&*a!ples of such activities include but are not li!ited to the follo$ing definitions;
8% Cheating; using or atte!pting to use unauthori<ed assistance" !aterial"
or study aids in e*a!inations or other acade!ic $or( or preventing" or
atte!pting to prevent" another fro! using authori<ed assistance" !aterial"
or study aids% &*a!ple; using a cheat sheet in a =ui< or e*a!" altering a
graded e*a! and resub!itting it for a better grade" etc%
:% Plagiaris!; using the ideas" data" or language of another $ithout
specific or proper ac(no$ledg!ent% &*a!ple; copying another person2s
paper" article" or co!puter $or( and sub!itting it for an assign!ent"
4
cloning so!eone else2s ideas $ithout attribution" failing to use =uotation
!ar(s $here appropriate" etc%
C% Fabrication; sub!itting contrived or altered infor!ation in any acade!ic
e*ercise% &*a!ple; !a(ing up data for an e*peri!ent" fudging data" citing
none*istent articles" contriving sources" etc%
'% >ultiple sub!issions; sub!itting" $ithout prior per!ission" any $or(
sub!itted to fulfill another acade!ic re=uire!ent%
&% >isrepresentation of acade!ic records; !isrepresenting or ta!pering
$ith or atte!pting to ta!per $ith any portion of a student2s transcripts or
acade!ic record" either before or after co!ing to the University of
Pennsylvania% &*a!ple; forging a change of grade slip" ta!pering $ith
co!puter records" falsifying acade!ic infor!ation on one2s resu!e" etc%
F% Facilitating acade!ic dishonesty; (no$ingly helping or atte!pting to
help another violate any provision of the Code% &*a!ple; $or(ing together
on a ta(eho!e e*a!" etc%
3% Unfair advantage; atte!pting to gain unauthori<ed advantage over
fello$ students in an acade!ic e*ercise% &*a!ple; gaining or providing
unauthori<ed access to e*a!ination !aterials" obstructing or interfering
$ith another student2s efforts in an acade!ic e*ercise" lying about a need
for an e*tension for an e*a! or paper" continuing to $rite even $hen ti!e
is up during an e*a!" destroying or (eeping library !aterials for one2s o$n
use%" etc%
? ,f a student is unsure $hether his action@sA constitute a violation of the Code of
8cade!ic ,ntegrity" then it is that student2s responsibility to consult $ith the
instructor to clarify any a!biguities%
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5
E:UIE% TE@T!:
4hoades" 4%8% # :ell" '%4% @2013A% >edical Physiology; Principles for Clinical
>edicine )
th
&dition% Philadelphia; 1ippincott" Cillia!s" # Cil(ins%
Nagelhout" D% # Eaglanic<ny @2013A% Nurse 8nesthesia +
th
&dition% >issouri;
&lsevier Saunders%
:arash" P%3%" Cullen" :%F% # Stoeling" 4%F% &ds% @2013A% Clinical 8nesthesia .
th

&dition% Phila%" P8; 1ippincott" Cillia!s # Cil(ins%
ECO&&EN%E% TE@T!:
>organ" &%3%" >i(hail" >% S%" # >urray" >%D% @200-A% Clinical 8nesthesiology )
th

&d% Ne$ Gor(; 1ange >edical 'ivisionB>c3ra$5ill Co!panies" ,nc%
>cPhee" S%D%" 1ingappa" H%4%" 3anong" C%F%" 1ange" D%'% Pathophysiology of
'isease; 8n ,ntroduction to Clinical >edicine" -
th


&d%" Ne$ Gor(" 1ange >edical
:oo(sB>c3ra$5ill" 200-% ,S:N; 00.1))1+0I%
Netter" F%5%" # 5anson" D%T% @2010A% 8tlas of 5u!an 8nato!y% +th &dition%
>issouri; &lsevier Saunders%
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7EEAL) TOPICAL OUTLINE:
'ayBTi!e Topic JbKective 4eadings
7eeB "
0B0B2013
D% 1ibonati
Cardiac electrophysiology 11) 4#: Ch% 1112%
N#P Ch% 23%
:arash Ch% 10%
7eeB 2
0B1-B2013
D% 1ibonati
&*citationcontraction
coupling
11) N#P Ch% 23%
4#: Ch% 131)%
:arash Ch% 10%
7eeB 3
0B23B2013
D% 1ibonati
Hascular Physiology"
>icrocirculations
11) N#P Ch% 2)2-%
4#: Ch% 1+1.%
:arash Ch% 10%
7eeB 2
0B30B2013
D% 1ibonati
Hascular Physiology"
Special circulations
11) N#P Ch% 23%
4#: Ch% 1+1.%
:arash Ch% 10%
7eeB /
10B.B2013
1% Cinner
ECa- D" ;C> Physiology< ,nfor!ation fro!
$ee(s 1)%
7eeB 6
10B1)B2013
1% Cinner
3erontology 1ecture 2. :arash Ch% 33%
>#> Ch% )+%
N#P Ch% )0%
7eeB 1
10B21B2013
4% 1ynn
1iver Physiology 1ecture 2123 N#P Ch% 30%
4#: Ch% 2.%
:arash Ch% )+%
7eeB 8
10B2/B2013
F% Ciltse
Nicely
5e!atology 1ecture 232- N#P Ch% 3)%
4#: Ch% 0%
:arash Ch% 1-%
7eeB 4
11B)B2013
1% Cinner
'% :ent
ECa- D2 ;$erontology(
Li=er( and ?e-atology<
,!!unology 1ecture 2/32
,nfor!ation fro!
$ee(s -/%
N#P Ch% )1%
4#: Ch% 10%
:arash Ch% 13%
7
7eeB "8
11B11B2013
>% 8!es
Connor
For!ation of urine"
3F4" and the factors that
influence it%
1)20 >#> Ch% 31%
N#P Ch% 20%
:arash Ch% )0%
4#: Ch% 222)%
7eeB ""
11B1/B2013
4a02p
'r% 3aiser
>uscle 4ela*ants @N+/0A ,nfor!ation on
N+/0 syllabus
,nfor!ation on
N+/0 syllabus
7eeB "2
11B2+B2013
>% 8!es
Connor
4enal regulation of Fluid"
p5" and electrolytes
1)20 >#> Ch% 31%
N#P Ch% 20%
:arash Ch% )0%
4#: Ch% 222)%
7eeB "3
12B2B2013
8ugoustides
1% Cinner
Case 'iscussions N-/2 #
4evie$ of Cardiovascular
se!ester content fro!
N+/0
,nfor!ation on
N+/0 and N-/2
syllabus
7eeB "2
12B0B2013
ECa- D3 ;I--unology E
enal<
,nfor!ation fro!
$ee(s 013%
7eeB "/
12B1112 B
2013
eading %ays
7eeB "6
"2F"30
28F28"3
'inal ECa-s
TOTAL NU&.E O' T?EO) ?OU!: 2/
TOTAL NU&.E O' CLINICAL ?OU!: 8