Practical work of students

Typical forms of water dysbalance.

Hypohydration: causes, types, mechanisms of development, manifestations, consequences, and pronciples of treatment.

Overhydration: causes, types, mechanisms of development, manifestations, consequences, and pronciples of treatment.

Edema: definition, types, the main factors of development, principles of treatment.

Edema during cradiac failure: etiology, pathogenesis, and manifestations.

Pulmonary edema: etiology, pathogenesis, manifestations, and consequences.

Renal edema: etiology, pathogenesis, manifestations, and consequences.

Disorders of sodium, potassium, calcium, manganese, and phosphate metabolism: causes, manifestations, and mechanisms of develpment.

Methods of teaching

Discussion the major issues among students with and under the supervision of a teacher, discussion of videos and results of the experiment.

6.6.5. THE LIST OF LITERATURE:

The basic

1. Litvitsky P.F., Pirozhkov S.V., Tezikov E.B. Concise lectures and tests on pathophysiology E-tekstbook. – ГЭОТАР-Медиа, 2007

2. Pathologic basis of disease. Hemodynamic disorders. EdemaV. Kumar, A.K. Abbas, S.N. Fausto, 8th edition, 2010.- P. 119-122

3. Basic Pathology. Endocrine pancreas. Hemodynamic disorders. EdemaVinay Kumar, Ramsi S. Cotran, Stanley L. Robbins. 9^th edition, 2013.- P. 61-63.

Additional

4. Textbook of pathology. Harsh Mohan. Body fluid and circulatory disturbances. 4rd edition, Delhi, 2004.-P. 87- 100.

Methods of control

Oral questioning, checking conclusions on experiment, pathogenetic schemes, testing

The approximate timing of class

№	Steps of the class	Time (min)
	Organizational part. Roll Call, reading the goals and objectives of the class, distribution of demonstration material
	Discussion the questions №№ 1, 2
	Creation of pathogenetic schemes, task 1
	Discussion the questions №№3, 4
	Перерыв
	Tasks №№ 2-4 and their discussion
	Discussion the questions №№ 5, 6,
	Task 5
	Test
	Summarizing the classroom work, assessment of competencies

Practical work of students

Task № 1. Create pathogenetic schemes of hypoosmolal and hyperosmolal hypohydration

Task № 2.

Study the role of tissue osmotic pressure in development of edema.

Two frogs of approximately identical weight are injected 2 ml of physiological solution into back lymphatic sac to one frog and 2 ml of 20 % solution of sodium chloride to another. The frogs are weighed and placed in jars with water. After 50-60 minutes the frogs are weighed again. The received data are written to the report. Make the conclusions.

The protocol

Animal	The injected solutions	Weight of frogs (g)
Initial	After 1 hour
Frog 1	2,0 ml of physiological solution
Frog 2	2.0 ml of 20 % solution of sodium chloride

Task № 3.

Study the role of hemodynamic factor in development of edema (Fisher's experiment).

Technique: Tie a tourniquet to a back limb of a frog some hours prior the class work. At the class mark the changes of limb’s color and a degree of the limb’s volume increase. Pierce a needle the place of edema, observe the excretion of edemic fluid. Explain the mechanism of development of the edema.

Task № 4.

Study the role of blood oncotic pressure reduction in pathogenesis of edema (Starling’s experiment).

Technique: Open thoracis and abdominal cavities of a fixed frog, delete a pericardium, make an incision in an aorta and in the direction to periphery insert a canule with a rubber tube dressed on it which is connected with the balloon containing 0,5 % NaCl solution. The solution perfuses the frog’s vascular system and flows out of the cut in aorta. Suspend the frog for the lower jaw to a quick balance. In 15-30 minutes after the beginning of perfusion mark change of weight, development of edema. Explain the pathogenesis of hyperhydration of the frog.

Task № 5.

I. Make the pathogenetic schemes of edema at ü heart failure ü renal failure ü starvation