Clements - Hyper And Hypobaric Respiration

Question 1

High pressure environments that are encountered regularly

Answer 1

Hyperbaric chambers for treatment of some diseases (gaseous gangrene)

Wet pressure (SCUBA)

Construction workers - making tunnels under rivers , use caissons (pressurized workrooms)

Question 2

Pressure increases by 1 atmosphere every _____ you go deeper under water

Answer 2

10 meters

Question 3

Mask squeeze

Answer 3

Negative pressure in mask can cause capillary rupture and conjunctiva hemorrhage

Question 4

What three things do you have to worry about with compression on descent with scuba?

Answer 4

Mask squeeze

Ear drum rupture

Middle ear squeeze

Question 5

Ear drum rupture happens when?

Answer 5

Canal blocked by cerumen or ear plugs, increased pressure due to compression on descent

Question 6

Most common problem with divers?

Answer 6

Failure to exhale during ascent

Question 7

If a diver holds their breath during a rapid ascent from 10 meters, the air in the lungs will ?

Answer 7

Double in volume

Question 8

Oxygen toxicity: in high doses, O2 can cause ?

Answer 8

Alveolar and endothelial membrane damage.

Question 9

Anesthetic effects in the CNS, causing divers to act drunk.

Very poor decision-making, up to not caring that the tank is empty.

Answer 9

Nitrogen toxicity

Question 10

Caused by nitrogen under pressure

Too rapid of an ascent causes the created of nitrogen bubbles in places that you dont want them

S/s: pain, dyspnea, progression can lead to death.

Treatment: immediate recompression w/ gradual drop in pressure to allow the gas to dissolve slowly

Answer 10

Bends

Decompression sickness

Question 11

Low PAO2 stimulates peripheral chemoreceptors so that __________ increases and _________ decreases

Answer 11

Alveolar ventilation

PACO2

Question 12

Acute increase in ventilation in altitude adaptation is a response to _________

Answer 12

Acute hypoxia, sense by peripheral chemoreceptors

Question 13

What are the 4 main ways the body acclimates to altitude

Answer 13

Hyperventilation

Increased hematocrit and blood volume

Increased capillary growth in tissue

Plasma volume decreases

Question 14

5 hours to 5 days at altitudes over 8000 feet

S/s: headaches, nausea, insomnia, weakness, dyspnea.

Symptoms decrease over several days

Associated fluid retention, usually treated w/ diuretic

Answer 14

Acute mountain sickness

Question 15

Ataxia & inability to walk heel-to-toe is significant warning sign of impending problems.

Swelling causing brain ischemia and herniation

Answer 15

High altitude cerebral edema

Question 16

most serious of
all the altitude pathology, highest mortality. Aggravated by physical exercise, most commonly seen in athletic young males. Mandates return to lower altitude by most expeditious means.

Answer 16

High Altitude Pulmonary Edema (HAPE)

Question 17

Primary mechanism of injury in hyperbaric situations

Answer 17

Barotrauma caused by the creation of pressure differentials during ascent and during diving

Question 18

Primary mechanism of injury in hypobaric situation?

Answer 18

Hypoxia and physiologic changes that deal with body’s attempt to adapt

Question 19

Zone 1 increases with?

Answer 19

Anemia, hemorrhage, and positive pressure ventilation

Question 20

Output from the dorsal respiratory group travels -_____

Answer 20

Via the phrenic nerve to the diaphragm

Question 21

Problems associated with failure to exhale on ascent?

Answer 21

Pneumothorax, dissection of mediastinum, gas emboli, death

Question 22

Symptoms of expansion on ascent due to failure to exhale (remember PV = PV)

Answer 22

Dyspnea, cough, bloody sputum, chest pain, subcutaneous air.

Question 23

What do you do for a patient that is having expansion on ascent?

Answer 23

Immediate recompression and life support