Exam 4 - Lecture 2

Question 1

What is the ATM in space?

Answer 1

0

Question 2

The highest point on earth is ____ per lecture? (place and meters)

Answer 2

Mt Everest, 9000m or 9km

Question 3

What is the atmospheric pressure in mmHg and what is the PO2 at the peak of mt everest?

Answer 3

253mmHg; 43mmHg (make sure you include water vapor)

Question 4

21% FiO2 doesnt really change unless?

Answer 4

We are really close to outerspace (he didnt expand on this, and research tells me its 21% no matter what?)

Question 5

How long can most humans on the planet tolerate a PO2 of 43mmHg?

Answer 5

A couple hours

Question 6

How do we compensate for exposure of high altitude, at first?

Answer 6

Hyperventilate, takes a few days to compensate

Question 7

How do we end up with more HCT a few days after being at a high altitude?

Answer 7

Low PO2 means less oxygen going to kidneys, the inner medulla detects this, produces more EPO and then stimulates bone marrow to to produce more RBC -> increased HCT

Question 8

How do the lungs change if youre born at a higher altitude?

Answer 8

Significantly more surface area for gas exchange (more alveoli)

This is why ethiopians and kenyans be winnin them damn marathons

Question 9

What is usually the limiting factor in sports? Why?

Answer 9

Heart, because we typically have 3x the amount of lungs more than needed to keep up with the heart, thats why you can smoke for 3-4 years before seeing negative effects.

Question 10

Lowest place on earth according to schmidt? (its accurate for the US….)

Answer 10

death valley

Question 11

A depth of 500 feet underwater will increase our pressure by how much?

Answer 11

16x

Question 12

Whats the ratio between how many feet of water to 1 ATM increase?

Answer 12

33 feet/10m of water is equivalent to 1 ATM increase

e.g. 33 feet deep is 2 ATM or 1,520mmHg

Question 13

Whats the barometric pressure at 66 feet or 20 meters underwater?

Answer 13

2,280mmHg or 3 ATM

Question 14

During descent, the divers are subjected to increasingly high external pressures, and these pressures will __________, and then the gas pressures are applied to the ___________. This is more of a problem with what gas?

Answer 14

compress gas in the lungs; entire body; nitrogen

Question 15

nitrogen is relatively soluble or insoluble?

Answer 15

insoluble

Question 16

what is the main concern with deep diving?

Answer 16

Rapidly resurfacing, because we will have extraordinary amounts of nitrogen and when you surface too quickly the nitrogen can form massive air emboli because its trying to escape quickly.

Question 17

Diving tanks are usually filled with what gas? Why?

Answer 17

just atmospheric because its cheaper and dont have to worry about explosions and shit

Question 18

Nitrogen is relatively insoluble at surface pressure but?

Answer 18

becomes more soluble at high pressures, dissolving into the blood and tissues.

Question 19

Whats another reason that divers dont use pure oxygen in tanks?

Answer 19

Pure oxygen at high pressures causes oxygen toxicity

Question 20

whats the movie that he mentioned in class with nitrogen?

Answer 20

Total recall with arnold schwarzenegger

They were on mars and had a decompression in the space station, showed the skin bubbling, which was nitrogen coming out of solution causing the bubbling.

Question 21

How can we tell if someone is pre-disposed to altitude sickness?

Answer 21

You dont know, just gone go ahead and figure it out when they die on mt everest cause they try to push through usually!

typically genetic

Question 22

What camp will people usually figure out that they cant handle the altitude change?

Answer 22

Camp 3!

Question 23

air emboli can form together and create

Answer 23

a larger embolus; ESPECIALLY DEADLY IN LCA

Question 24

standard academic hospital hyperbaric chambers can increase the pressure to? Who uses more?

Answer 24

3 ATM or 2,280mmHg

military or professional divers may use more pressure.

Question 25

What is different about the chambers for oil rigs out in the gulf?

Answer 25

May have physical hyperbaric rooms that divers live in, that way they never have to adjust because theyre in deep depths so often.

Question 26

How does hyperbaric chamber therapy benefit wound healing?

Answer 26

The chamber can force more oxygen into blood to heal damaged vessels that normally have poor circulation, especially for diabetics who had sticky vessels that the immune system destroyed. *immune system is also exhausted from damaging these vessels so now theyre more prone to infections*

Question 27

Who had a hyperbaric chamber in their house? (along with some other shit... hint hint.....)

Answer 27

Michael "diddler" Jackson

Question 28

What is the safest way to have increased FiO2 in hyperbaric chambers?

Answer 28

little bubbles around head attached to oxygen hoses. Its cheaper than using oxygen for the whole chamber and safer cause its explosive!

Question 29

What are the only 2 ways to increase soluble oxygen?

Answer 29

Increased PAO2 through increased FiO2 or hyperbaric chamber (or both)

Question 30

Any additional oxygen the patient receives from hyperbaric chamber will be in what form?

Answer 30

dissolved in blood.. Hb has a plateau, a max that it can carry, while dissolved oxygen does not plateau on the graph.

Question 31

What % oxygen will we normally use in OR, and why?

Answer 31

30% cause we are fucking up normal lung physiology (airway reactivity, HPV, surfactant)

Question 32

What is ROS?

Answer 32

Dangerous oxygen molecules called Reactive Oxygen Species

Question 33

ROS: O2-

Answer 33

superoxide, has an extra electron and is super reactive.

Question 34

how is O2- broken down?

Answer 34

Superoxide dismutase

Question 35

ROS: NO

Answer 35

nitric oxide Can react with other molecules and create extremely dangerous molecules, such as OONO-

Question 36

ROS: OONO-

Answer 36

Peroxynitrite Can destroy DNA, combination of superoxide and nitric oxide, leads to cancer.

Question 37

ROS: N2O2

Answer 37

hydrogen peroxide Aseptic substance, body has these in controlled amounts in specific places such as macrophages or immune killer cells, will generate this and insert them into things they want to degrade.

Question 38

Typical levels of N2O2 are regulated by

Answer 38

Peroxidases, catalase, acetylcysteines

Question 39

What is N Acetylcysteine S? What special thing did he say about it?

Answer 39

Cuts down on liver damage from tylenol overdose FDA is trying to make it prescription only, probably because its a supplement that actually fucking works and god forbid we have that on the open market.

Question 40

Who was the guy in dallas that died recently with the iron lung? how lung was he on it? what degree did he get? What caused his disease? What hospital took care of him?

Answer 40

Paul Alexander, 50 years, Law degree, Polio (google actually says 70 years... but he said 50) Parkland (representtttt)

Question 41

What decade did polio outbreak occur?

Answer 41

1960's (lol again, google says paul got it in 1952..)

Question 42

Polio: destroys what?

Answer 42

ability of nervous system to communicate with skeletal muscles

Question 43

How did the iron lung work?

Answer 43

A cylinder with cap on end with rubber/leather diaphragm that they fit around patients upper body/neck to create pressure seal between tank and outside environment. The pulley pulls the cap which creates a negative environment… Reduces pressure inside container, pulling air into patient. simulates negative pressure breathing!

Question 44

Iron lung is better than PPV because its less ____, closer mimics normal body environment of utilizing negative pressure.

Answer 44

trauma

Question 45

With iron lung, its closer to how body works. It pulls air in in a __________ manner.

Answer 45

very even

Question 46

Negative pressure breathing: Alveoli ________________________ will fill first, since thats closest to the negative environment pulling on lung, which will THEN lead to __________________

Answer 46

closest to superficial borders of lung tissue; deeper alveoli stretching and filling as well

Question 47

Positive pressure breathing: The inner alveoli expand first (closest to ____), then pushes on the ___________ that expand last (those closest to the _____________).

Answer 47

inner alveoli; closest to large airways; most superficial alveoli; border of the lung

Question 48

Who was on PPV and did not last 50 years, died of pulmonary issues.

Answer 48

Christopher Reeves