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- 1. Copyright © 2011by Saunders, an imprint of Elsevier Inc. APPLIED PART OF RESPIRATORY PHYSIOLOGY Dr.Charushila Rukadikar Assistant Professor Department of Physiology ZMCH,Dahod
- 2. Copyright © 2011by Saunders, an imprint of Elsevier Inc. • Specific learning Objectives: High altitude physiology Aviation physiology Deep-Sea Diving physiology
- 3. Copyright © 2011by Saunders, an imprint of Elsevier Inc. HIGH ALTITUDE PHYSIOLOGY
- 4. Copyright © 2011by Saunders, an imprint of Elsevier Inc. High Altitude Altitude Pressure PO2 (air) PO2 (alveoli) Saturation 0 760 159 100 97 10,000 523 110 67 90 20,000 349 73 40 73 30,000 226 47 18 24 Oxygen , carbon dioxide, nitogen Mount Everest is 29035 ft above sea level Above 40,000- ozone layer starts.
- 5. Copyright © 2011by Saunders, an imprint of Elsevier Inc. Hypoxia stages Stage of indifference – Po 2 above 60 mm of Hg - mild hypoxia Stage of reaction - Po 2 40 - 60 mm of Hg - moderate hypoxia, CVS, RS Stage of disturbance - Po 2 30 - 40 mm of Hg - severe hypoxia, CNS
- 6. Copyright © 2011by Saunders, an imprint of Elsevier Inc. PO2 Responses to High Altitude
- 7. Copyright © 2011by Saunders, an imprint of Elsevier Inc. Acclimatization 1. RS – 1. Increased ventilation –due to decreased PO2 –increase slowed by decreased PcO2
- 8. Copyright © 2011by Saunders, an imprint of Elsevier Inc. Low PO2 • 1- 2 day- Arterial chemoreceptor (Alveolar ventilation 1.65times) • (2-5 days)- Blow off CO 2 –PH increase- - inhibit brain stem respiratory center – oppose stimulation of respiration • After 5 days--- reduction in HCO3 ion in CSF, PH decrease –stimulate respiratory center Pulmonary ventilation 5 times
- 9. Copyright © 2011by Saunders, an imprint of Elsevier Inc. 2. BLOOD -Increased hematocrit (content)- • Hb, PCV, 2,3 DPG • Blood Volume 1. RS – 2. Increased diffusing capacity • due to pulmonary capillary blood volume • Pulmonary arterial blood pressure • Lung air volume • 3. PULMONARY HTN
- 10. Copyright © 2011by Saunders, an imprint of Elsevier Inc. 4. Increased capillarity- angiogenesis 5. Cellular level 6. CVS- CO, HR,FOC increase-Tachycardia 7. Work capacity
- 11. Copyright © 2011by Saunders, an imprint of Elsevier Inc.
- 12. Copyright © 2011by Saunders, an imprint of Elsevier Inc. Natures acclimatization
- 13. Copyright © 2011by Saunders, an imprint of Elsevier Inc. Mountain Sickness • Acute mountain sickness (1 -2 days) – Acute cerebral oedema local vasodilation of cerebral blood vessels, Autoregulation fails. – Acute pulmonary edema- 1. Pulmonary arteriole constrict much in some area- force blood- increase pressure– oedema occurs 2. Cold – vasoconstriction- increase PCHP – fluid outside- lung oedema Rx- steroid
- 14. Copyright © 2011by Saunders, an imprint of Elsevier Inc. • Chronic mountain sickness i. Increase in red cell mass - blood viscosity – tissue blood flow- oxygen supply ii. GIT – Expansion of gases- nausea, vomitting iii. Increase in pulmonary arterial pressure iv. Enlargement of right heart – HR, FOC v. Peripheral arterial pressure fall vi. CCF vii. Death Rx – oxygen supply
- 15. Copyright © 2011by Saunders, an imprint of Elsevier Inc. • During acclimatization to high altitude all of the following take place except a) Increase in minute ventilation b) Increase in sensitivity of central chemoreceptor c) Increase in sensitivity of carotid body d) Decreased heart rate
- 16. Copyright © 2011by Saunders, an imprint of Elsevier Inc. • During acclimatization to high altitude all of the following take place except a) Increase in minute ventilation b) Increase in sensitivity of central chemoreceptor c) Increase in sensitivity of carotid body d) Decreased heart rate
- 17. Copyright © 2011by Saunders, an imprint of Elsevier Inc. • A climber on high mountain reaches altitude of 5000 mt/ 16400 ft above sea level. What will happen to his arterial PCO2 and pH? a) Both will be more than normal b) pH will rise and PCO2 will fall c) Both will higher than normal due to physical exertion d) pH will fall and PCO2 will rise
- 18. Copyright © 2011by Saunders, an imprint of Elsevier Inc. • A climber on high mountain reaches altitude of 5000 mt/ 16400 ft above sea level. What will happen to his arterial PCO2 and pH? a) Both will be more than normal b) pH will rise and PCO2 will fall c) Both will higher than normal due to physical exertion d) pH will fall and PCO2 will rise
- 19. Copyright © 2011by Saunders, an imprint of Elsevier Inc. AVIATION PHYSIOLOGY
- 20. Copyright © 2011by Saunders, an imprint of Elsevier Inc. • Aviator is sitting in his seat, force with which he is pressing against seat results from pull of gravity and is equal to his weight. = +1 G • Increase the speed – positive G • If airplane goes through an outside loop so that person is held down by his seat belt, negative G is applied to his body = - 1 G. • Decrease the speed – negative G
- 21. Copyright © 2011by Saunders, an imprint of Elsevier Inc. Blood Pressure Responses to G Forces
- 22. Copyright © 2011by Saunders, an imprint of Elsevier Inc. Effects of positive G • Circulatory System– 5 G • Blackout of vision-- 4 to 6 G • Vertebrae– 20 G
- 23. Copyright © 2011by Saunders, an imprint of Elsevier Inc. EFFECT OF NEGATIVE G • Psychotic disturbance – (-4 TO -6 G) • Cerebral BP – 300-400 mm of Hg • Red out – eyes are not protected by cranium.
- 24. Copyright © 2011by Saunders, an imprint of Elsevier Inc. Prevention • Anti G suits • Abdominal belts
- 25. Copyright © 2011by Saunders, an imprint of Elsevier Inc. • Gravity act both on spacecraft and person Weightlessness
- 26. Copyright © 2011by Saunders, an imprint of Elsevier Inc. • Effects on Cardiovascular Systems and Kidneys 1. fluid shift. 2. No gravity, blood moves from lower part to upper part - enlargement of heart 3. accumulation of body fluids in upper part. Compensatory mechanism - • Excreting of fluid through kidneys. • Along with water, kidneys excrete electrolytes • osmolarity of body fluids is not altered,So thirst center is not stimulated , astronauts do not feel thirsty during space travel.
- 27. Copyright © 2011by Saunders, an imprint of Elsevier Inc. 2. Effects on Blood • Plasma volume decreases due to excretion of fluid through urine. RBC count decreases (space anemia) 3. Effects on Musculoskeletal System • Because of microgravity in space, muscles need not support the body against gravity. Astronauts move by floating instead of using their legs. This leads to decrease in muscle mass and muscle strength. Endurance decreases. • Bones become weak-Osteoclastic activity increases during space travel. • Calcium removed from bone is excreted
- 28. Copyright © 2011by Saunders, an imprint of Elsevier Inc. 4. Effects on Immune System -suppression 5. Space Motion Sickness • nausea, vomiting, headache and malaise (generalized feeling of discomfort or lack of wellbeing or illness that is associated with sensation of exhaustion). • occurs due to abnormal stimulation of vestibular apparatus and fluid shift
- 29. Copyright © 2011by Saunders, an imprint of Elsevier Inc. PHYSIOLOGY OF DEEP-SEA DIVING
- 30. Copyright © 2011by Saunders, an imprint of Elsevier Inc. Barometric Pressure and Volume Changes below Sea Level Effect of Pressure on Volume Changes
- 31. Copyright © 2011by Saunders, an imprint of Elsevier Inc. Deep Sea Diving • 33 ft = 1 atm Nitrogen • 120 ft - confusion • 150-200- drowsy • 200- 250- weaning of strength • Above 250- narcosis, repture of death • Soluble in fat , as deep sea come nitogen dissolve in fat of various part of body. (neuronal membrane) like anesthetic agent. • Reduces excitibility TREATMENT - HELIUM
- 32. Copyright © 2011by Saunders, an imprint of Elsevier Inc. • Oxygen – 1. acute toxicity – free radicles, brain dysfunction, seizures, coma 2. chronic toxicity- lung congestion, pulmonary odema • Carbon Dioxide – 1. no toxicity 2. Co 2 production rate not increased, co 2 formed this is exhaled.
- 33. Copyright © 2011by Saunders, an imprint of Elsevier Inc. Decompression sickness (caissons (pressure chembers) disease) • Mainly nitrogen 1. Bends –joint muscle pain, myline sheath 2. Numbness, tingling, itching 3. Divers palsy- paralysis of muscle motor nerve fiber 4. MI 5. Neurological symptom 6. Air embolism – Bubbles 7. Unconsciousness- death
- 34. Copyright © 2011by Saunders, an imprint of Elsevier Inc. Prevention 1. Use of breathing apparatus E.g. Self contained underwater breathing apparatus (SCUBA) Air nesessory for inspiration enter the mask and expired air exhaled out of mask Disadvantage- short time stay 150 ft below only for few minutes
- 35. Copyright © 2011by Saunders, an imprint of Elsevier Inc. 2. Breathing mixtures (Helium and low oxygen) 3. Slow ascent 4. Decompression tank HYPERBARIC Oxygen therapy
- 36. Copyright © 2011by Saunders, an imprint of Elsevier Inc. SUMMARY • High altitude • Acclimatization • Mountain sickness • Aviation • Positive G & Negative G effect • Weightlessness • Deep sea diving- decompression sickness
- 37. Copyright © 2011by Saunders, an imprint of Elsevier Inc. QUESTIONS…. SHORT NOTES: 1. Changes Occurred During Acclimatization 2. Chronic Motion Sickness 3. Effects Of Positive And Negative G 4. Oxygen toxicity
- 38. Copyright © 2011by Saunders, an imprint of Elsevier Inc. DR.CHARUSHILA