Description:

This course will provide a comprehensive study of neuroanatomy and physiology and normal sleep mechanisms. It will also provide an overview of the cardiovascular and respiratory anatomy and physiology as it relates to sleep medicine. This includes ECG interpretation, oxygenation and ventilation assessment, and mechanisms and basic management of breathing and upper airway collapse. 3 hrs. lecture/wk.

Supplies: Refer to the instructor's course syllabus for details about any supplies that may be required.

Textbook(s): For information see - http://bookstore.jccc.net

Course Fees: NONE

Course Objectives:

Upon successful completion of this course the student should be able to:

1. Describe the neuroanatomy and physiology and facets of normal sleep mechanisms.
2. Describe the major concepts and mechanisms of respiratory and cardiovascular anatomy and physiology.
3. Relate oxygen transport, carbon dioxide transport, and acid-base regulation to normal and abnormal conditions.
4. Relate the electrical conduction within the heart to normal and abnormal electrocardiographic (ECG or EKG) impulses.
5. Analyze clinical situations including arterial blood gas (ABG) and electrocardiographic (ECG or EKG) data and recommend appropriate management.

Content Outline & Competencies:

I. Neuroanatomy and Physiology and Normal Sleep Mechanisms
   A. Review the normal structure and function of the nervous system and
the associated voluntary and involuntary controlled responses.
   B. Explain brain structure and function as it relates to the generation
of sleep, including  circadian sleep/wake rhythms and the electrical brain
wave/eye movement activity seen during sleep
   C. Describe the neurological control of breathing and the heart.
   D. Identify the stages of normal sleep
   E. Describe the characteristics of normal sleep architecture
   F. Summarize the benefits of sleep and consequences of sleep
deprivation
   G. Give examples of age-specific sleep patterns
   H. Identify normal and abnormal EEG patterns.

II. Respiratory Anatomy and Physiology
   A. Review the respiratory anatomy and physiology of breathing
   B. Describe physiologic humidification of inspired gas.
   C. Define capacity as it relates to lung volumes and identify the lung
volumes included in each lung capacity.
   D. Explain the significance of functional residual capacity (FRC) and
describe the impact of an increased or decreased FRC.
   E. Describe the mechanics of normal inspiration and expiration which
result in gas flow into and out of the thorax.
   F. Describe the changes in lung volumes and capacities and expiratory
flows with restrictive or obstructive lung disease.
   G. Explain the physiology of the hypoxic and hypercapnic mechanisms of
ventilatory drive
   H. Explain the mechanics of breathing and mechanisms of upper airway
collapse.
   I. Describe normal and abnormal breathing patterns.

III. Cardiovascular Anatomy and Physiology
   A. Review the structures and function of the cardiovascular system.
   B. Describe pulmonary and systemic responses to hypoxia, hypocapnea and
hypercapnea.
   C. Describe the function of the erythrocytes, leukocytes and
thrombocytes of the plasma.
   D. Describe how blood volume affects blood pressure, stroke volume,
heart rate, and cardiac output.
   E. Describe the components of the pulmonary and systemic vascular
systems.
   F. Trace blood flow beginning at the superior and inferior vena cavae
through the valves and chambers of the heart.
   G. Explain the relationship of systole and diastole to the cardiac
cycle.
   H. Describe sympathetic and parasympathetic effects as they relate to
the heart.
   I. Briefly describe the electrical forces involved in membrane
potentials of the heart.

IV. Gas Transport and Acid-base Regulation
   A. Describe internal and external gas exchange.
   B. Describe oxygen and carbon dioxide transport.
   C. Describe the four types of hypoxia and explain potential causes of
each.
   D. Differentiate between PaO2 and CaO2 and discuss their respective
roles in oxygen delivery.
   E. Relate oxygen saturation with oxygen partial pressure using the
oxyhemoglobin dissociation curve (OHDC). 
   F. List factors causing the OHDC to shift left or right and identify
the changes in O2 and Hb affinity that occur with as associated shift. 
   G. Define acidosis and alkalosis; acid and base; and buffers.
   H. Describe how H+ and HCO3 are regulated by the kidney in acid-base
states.
   I. Identify the four types of acid-base disturbance and state
representative causes for each type.
   J. Describe how the respiratory and renal systems each compensate for
an imbalance in pH.
   K. Interpret arterial blood gas studies for acid-base balance and
oxygenation status.
   L. Associate possible causes for identified ABGs based on ABG
interpretation and patient history.
   M. Determine the appropriate therapeutic action (s) given a clinical
situation.

V. Electrocardiography Recognition and Management
   A. Describe the electrical conduction within the heart and relate this
conduction to the resultant EKG impulses.
   B. Describe the placement of electrodes for 12 lead EKG, and for
monitoring leads.
   C. Determine the cardiac rate and recognize normal sinus rhythms and
arrhythmias, including:
      1. atrial
      2. junctional or nodal
      3. heart blocks
      4. ventricular
      5. pulseless electrical activity
      6. asystole
      7. pacemaker
      8. specific changes associated with certain conditions 
   D. Differentiate between life threatening and non-life threatening
cardiac rhythms.
   E. Determine the appropriate therapeutic action (s), (BCLS, electrical
and pharmacological), given a clinical situation and rhythm.

Methods of Evaluation of Competencies:

Evaluation of student mastery of course competencies will be accomplished using the following methods:

Written examinations					70-90% of total grade
Assignments						10-30% of total grade

Grading Scale:

A  =   92-100%  	
B  =   83-91%  	
C  =   75-82%*	
D  =   67-74%	
F  =    0 - 66%

*minimum required to continue in program

Caveats:

1. Students are expected to comply with the JCCC Student Code of Conduct as detailed in the JCCC College Catalog. Failure to comply may result in a faculty decision regarding program promotion and constitute a reason to fail the course.
2. A grade of “C” or better is required for the course for program promotion to subsequent polysomnography course work.

Disabilities:

If you are a student with a disability, and if you will be requesting accommodations, it is your responsibility to contact Access Services. Access Services will recommend any appropriate accommodations to your professor and his/her director. The professor and director will identify for you which accommodations will be arranged.

JCCC provides a range of services to allow persons with disabilities to participate in educational programs and activities. If you desire support services, contact the office of Access Services for Students With Disabilities (913) 469-8500, ext. 3521 or TDD (913) 469-3885. The Access Services office is located in the Success Center on the second floor of the Student Center.