The approximate timing of classes

№	Steps of the class	Time (min)
1	Organizational part. Roll Call, reading the goals and objectives of the class, distribution of demonstration material	5
2	Discussion the questions, task № 1,2	45
3	Break	10
4	Task № 3	35
5	Test	10
6	Summarizing the classroom work, assessment of competencies	5

Practical work of students

Task № 1.

Study logic structures of the theme.

№ 1

Respiratory acidosis

Compensated

Decompensated

Types

Etiology

Respiratory insufficiency

High level of CO₂ in inspired air

High level of CO₂ in fluids

Pathogenesis

Vasoconstriction Vasodilation of brain vessels High irritability of n. Vagus

High level of intracranial pressure

bronchospasm

Elevation of blood pressure

bradicardia

Decreased urine formation

Restoration of acid-base balance

Mechanisms of compensation

• Function of buffer systems (decrease H⁺)

• Ionic exchange

Activation of acidogenesis (increase renal secretion of H⁺, decrease reabsorption HCO₃^-

№

Compensated

Decompensated

2

Non respiratory acidosis

Metabolic acidosis

Formation of excessive quantities of metabolic acids in the body (Diabetes mellitus, starvation, hypoxia)

Excretion acidosis

• Renal failure. Kidneys can't excrete the metabolic acids normally formed in the body.

• Loss of base from the body fluids (Diarrhea). The intestinal secretions normally contain large amounts of NaHCO3

Exogenous acidosis

• administration of acids

The main pathogenetic factor:

high level of organic acids

Compensatory mechanisms:

1. Buffer systems. The mane role is belonged to the bicarbonate buffer system

There is the fall in plasma bicarbonate levels

2. Respiratory mechanism: H⁺ ions stimulate the Respiratory center so that the breathing is deep and rapid

3. Renal mechanisms: activation of acidogenesis and ammoniumgenesis

4. Ionic exchange

Organism's disorders

1. Disorders of electrolyte homeostasis: elevation of blood Na⁺, K⁺, Ca⁺⁺



cardiac arrhythmia

bone demineralization

depression of neuro-muscular irritability

2. Fall in blood CO₂  depression of vascular tone

№ 3

Respiratory alkalosis

Decompensated

Compensated

Causes:

hyperventilation of the lungs  excess removal of CO₂

• hysterical overbreathing,

• working at high temperature, at high altitude,

• meningitis, encephalitis)

The main pathogenetic factor is low blood level of CO₂

Compensatory mechanisms:

1. Buffer systems. The main role is belonged to the protein buffer system

2. Renal mechanisms: inhibition of acidogenesis and ammoniumgenesis high urine pH

3. Ionic exchange H⁺ moves out off cell, Ca⁺⁺, K⁺ move into cells  Low blood level of Ca⁺⁺ and K⁺ overexcitability of the nervous system

Organism's disorders

• Low vascular tone

• High neuro-muscular excitability

• Cardiac arrhythmias

№ 4