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Extreme Environments Final > Extreme Final > Flashcards

Extreme Final Flashcards

1
Q

Cold Injuries

A

NFCI and FCI

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2
Q

NFCI

A

Chilbaiin + Pernio -
Trenchfoot

Both damage local vasculature

but trenchfoot can be life altering and Cibain and pernio cause lesions

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3
Q

FCI

A

Frost Nip - cell death of epidermis
Frost bite - crystallization of the cells within our vasculature

Forst bite can lead to free radicals on the influx of O2 during reprofusion

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4
Q

States of Hypothermia

A

Mild 34-32 - increase blood pressure and max shivering

Moderate 32-29 - no more shivering - arythmiaas and unconsciousness

Severe <29 - decrease cardiac function and brain activity

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5
Q

Cardiovascular Effects of Hyporthermia

A

Initially we get tachycardia then progresses to brady cardia @ 34ºC (505 reduced HR)

<30 = afib
<25 = asystole

Increase in cold = vasocantriction , blood goes central, increase blood pressure- BRADYcardia slows the HR to combat this

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6
Q

Asytole - Not dead until Warm and Dead

A

As we get cold we decrease the amount of activation energy it takes for the enzymes to work. This means the metabolism is less while we are cold so the demands that it requires are also less. Therfore we can function with less blood supplying less nutrients.

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7
Q

1 degree drop in temp = 2% drop in hematocrit

Increasing our Hemoconcentration Why

A

This is due to decrease in coagulation enzyme function of up to 40%

Caused by

Cold Induced Spleenic Contraction - increase is contraction of the spleen to put out RBC. we do this to hold onto as much oxygen as possible but this increases the thickness of the blood

Cold Induced Diueris - loose less than hlaf plasma volume due to this.

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8
Q

Oxyhemoglobin Curve Respiratory in Cold

A

Decrease in temp makes hemoglobin hold onto oxygen more tightly, giving off less oxygen at the saem partial pressure.

We hold onto it to use it when it matters.

WE ARE STORING MORE OXYGEN .

Less oxygen giving to tissues + vasoconstriction ad low HR = ischemia - no oxygen

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9
Q

Cold and Brain

A

decreased nueral transmission
paradoxical undressing (cold inuced vasodialation) + dimnished mental capacity makes them take off their clothes
stiffness/lack of reflexes
<32 = amnesia
loss of consciousness

Terminal burriowing behaviour - trying to tuck under something

Cold deaths more than heat deaths

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10
Q

Steps to combat hypothermia

A
  1. prevent further heat loss by getting them out
  2. insulate ( space blanket0
  3. sweet drink - glucose is anti freeze and
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11
Q

Alcohol is a diuretic (COLD)

A

make us piss - lose heat - loose radiatiing fluid

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12
Q

passive v active rewarming

A

passive is immediate
active - wait until they get back up to 34 degrees - dont want to lose more heat if they are still too cold

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13
Q

DOnt exercise to warm up hypothermics why

A

exercise increases blood flow to periphery - loose heat to tissue and to enviroment and return cold blood

swewating - loose heat to evaporation

depletes energy - need energy to stay more

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14
Q

DONT do these for hypothermics

A
  • dont rub
  • dont thaw

all increase risk of reprofusion injuries

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15
Q

therapeutic hypothermia

A

droppinghte temperature for those with TBI or heart attacks -

reduce the metabolism = reduce the amount of blood needed in those areas

  • cranial vasoconstiction to stop swelling and pressure
  • supresses the inflamattory cascade and reprosuion radicals
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16
Q

is it ever too cold too exercise ?

A

No, not if you can get back to warmth.

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17
Q

Risk of Exercising in the cold

A

FCI - increased heat loss thorugh the elements but our body generates enough heat to combat this

Airway Damage - cold dry air irriatae alveoli inducing imflammaotyr cells (eicosanoid) - and when we exercise we increrase the rate of breathing so even riskier.

EIB

Cardiovascular Strain just from the cold - increase blood pressure and increase hearate then you add exercise casuing more strain

Slipping and not getting back home

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18
Q

EIB

A

exercise induced bronchospasms

restriction of airflow formt he contration of bronchiotubes

less airflow means less oxyegn for exhcnage = less co2 removal

sympotoms - tight chest, dyspnea, wheezing, coughing

26% of non asthmatic people get this

EIB goes away when we stop running because we decrease the ventilation and can catch up to the amount of oxygen uptake.

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19
Q

4 phases of cold water immersion

A
  1. Cold shock - 0-2min
  2. Muscle/ Swimming Failure (2-15min)
  3. Hypothermia15-30
  4. Post rescue collapse
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20
Q

co,d water defined as

A

less than 25 degrees, worse effects at less than 15 degrees

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21
Q

Cold Shock

A

when first immersed in the cold, we gasp

we increasse - vent rate and inspiratory volume

and we increase our heartrate form vasoconstriction

cold core and sucking in water to lungs are not good.

Gradual immersion can shorten the effects of cold shock once habituating , and increaseing our breath hold times

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22
Q

Diving response

A

head first submersion triggers the trigeminal nerve in our face closing the epiglottis to protect against influx of water and cold air nto lungs

lessens the immediate cold shock and reduces our hr more than regualr cold shock

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23
Q

People who will survie a boat sinking

A

fat people - more insulation and more buoynat save energy

women - more fat insulating

  1. Insulation jacket floating thing
    Help position
  2. Huddle
  3. PDF
    4 Treading water
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24
Q

survival tactic in water

A

if more than 800m assume huddle

if less than self rescue

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25
Q

Post Rescue Collapse

A

Afterdrop causing loss of more heat even after out of the water

due to
blood flow and thermodynamics

lose heat in blood and recool the core

thermo - lose heat through migration through the tissues

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26
Q

hihg altitude basics

A

less air particles
less pressure exerted

colder becasue less particles to warm up

less pressrue in air casues less of a driving force of oxygen into us

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27
Q

why decreased water vapour pressure in high altidue

A

cold climates hold lesss water and their are less particles in the air = less water vapour pressure

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28
Q

respiratory response at altitude

A

increase tidal volume and breathing frequecy trying to increase the pressure of oxygen

tidal volume - alwasy breath the saem amount but becasue less o2 we get less drive - low hypoxic drive

breathing frequency - breathing faster expels co2 quicker to make rooom for oxygen

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29
Q

respiratory alkalosis

A

at altitide the increased tidal volume and breathinf frequency makes us expel c02 much more, this takes hydrogen ions away nad makes our body become more basic

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30
Q

oxyhemoglobin at altitude

A

because of low c02 in our blood

we try to add mroe co2 with bicarbonate equation.

when we have less c02 our body begins to hold onto oxygen more tightly (hemoglobin) allwoing us to store more 02 for later

up and to the left

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31
Q

Loss of blood volume at altitude why

A
  • breathe out water
  • cold and altiitude induced diuresis

loose blod volume we decrease edv and SV so we increase hr to maintain cariac output but we also see the blood more viscous because of increased hematocrit (good when its near the alveoli, more o2 carrying capacity)

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32
Q

Altitidue iduced diuresis

A
  • increase pressure in thorax cuases increase BP making us lower HR and piss more
  • also casue due to respiratory alkaloissi
  • getting too much bicarbonate so we reomve it thorugh urine
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33
Q

V02 at altitude

A

hr x sv x a-v02

hr increases as we increase blood pressure
sv decreases as we los volume of blood

a-v o2 decreases as we old oxygen more tightly as we are becoming more cold and basic(harder to extract)

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34
Q

enduracne sports in altitude

A

v02 is down

in altidue becasue we have less oxygen supply/drive we begin to rely less on aerobic and more on anaerobic

even thought aanaerobic doesnt use oxygen we still need to repay the systems that were used.

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35
Q

lactate paradox

A

we increase reliance on our anaerobic metabolism during altitude.

so we should see more lactate being produced inthose who are those who are native to the area but we dont

36
Q

metabolic changes at altitude

A

increased basal metabolic rate
due to thyroid oroducing catachollmines and thyroid hormone from non shivering thrermogenies

increased reliance on carbs since we rely more on anaerobic meatbaolism

decreased appetite acutely casue we cant get food

37
Q

altitude response chornically to low oxygen

A

becuase of the decrease oxygen carrying capacity and and low 02 in blood, over time our body begins to increase epo (RBC) to tim more rbc fromt he liver to help increase 02 carrying capacity (increasing the a in a-v02 diff)

38
Q

AAS/AMS diagnosis

A

acute altitdue sickness

  1. changed altitdues within the past 4 days
  2. have a headeache
  3. have one or moer of thease syptoms
    - loss of coordination
    - insomnia
    -GI distress etc

starts at around 2500m 15-40% of people get it

LAke Lois Questionaire

50A% of people get it at 4000m

can avoid it if we ascend gradually 9 acclimate then climb )

combat with oxygen or descent

39
Q

HACE

A

swellling (liquid) in cranial cavity

recognizing low 02 in the bloood so the body increases blood flow to the brain. increasees pressure in capillaries that can leak out fuid . increases blood into the brian
and increases permeability of blood brain barrier whihc causes more blood allowed into brian swelling

if not displaced with cerbro spinal fluid then we can get the full affects of HACE

HACE SYMPTOMS

ataxia,lethargy, confusion

can progress to death becasue of the other sympotms of AAS and occurs around 4300 m

40
Q

HAPE

A

liquid in the lungs

low 02 in the blood our body tells us to maximmizze the contat that it makes with the well aerated regions of the lungs, this vasoconstricts the poorly aerated regions of the lungs increasing the pressure ofblood their whihc can leak into to the lungs

symptoms includ cchest tightness, coughing, confuison, blu elip s

if there is pressrue on the capillaries it can casue endothelial damge which causes endothelyial dysfucntion which causes increased blood presssure and it will cycle or cause infection

41
Q

respiratory adaptations ot altitude

A
  • inrease resting ventilattion at rest by 40
  • iubmaximal vet will platuea at 50% higher
42
Q

blood adaptations to altitude

A

increase red blood cells
increase plasma volmue - due to increasesing the hormine to conserve water when we stay there linger
increase hemoglobin -oxygen carrying capacity

43
Q

muscle adaptations to altitude

A
  • decrease muscle csa
  • decrease glycolyti and mitochondirial c enzymes (casue lsot muscle mass)
  • angiogenisis - to increase more 02
44
Q

cardiovascular adaptations to altitude

A

decrease v02
work capacity increased

45
Q

hard to tell if sea level or altidue traingn is benefical why

A

casue we increase all this stuff when you jsut train and becasue intensity and volume of trainng is reduced at altitidue

and hard ot bring up equipmetn

46
Q

Increased perfomrance on gorund from Hypoxic envirometn

A
  • increase HIF-1 (allows for more genes that increase epo and angiogeneissi and glucose transport to the cells) an idividual difference
  • increased epo
  • increase hyperventilatory response which causeses increase in looading of oxygen on the oxyhemoglobin curve
  • increased economy of movemtn since less particels in the air
47
Q

take into account when moving ot altitude

A

a;titude is calssified at 2000m or above

have to deal withthe negative psychological and psyhiological effects of altitude

12-16 hr a day of traiing adn w can lose adaptations in 2 weeks

takes long to see the adaptations

48
Q

live low train high

A

acute syptoms will occur in trianing casuing less of a traing stimulus buyt symptoms may be reduced

49
Q

live high train high

A

goes either way-

cant accoutn for periodization

50
Q

live high train low

A

increased hypoxic effects when we are resting at altitiude

and better trainng stimulus when we are trianing at low altitdue

increased v02, epo, hemoglobin , perfomrance

this is the best

51
Q

Hyper baric basics

A

air is compressable , water is not

eery 10 m belwo sea levels is 1 atmoisphere of pressrue

boyle law - increase in pressure is a result of decrease in volum eand decreease in volume increases pressure

52
Q

how do we combat the pressure compressing the air in us

A

we inspire dense air in order to push back against the pressurefrom the water until it is equal

53
Q

respiratory challeng to hyperbaric

A

increased dead space not participating in gas exchange so we need a respirator

hihg dednsity of gases form the respoirator as pressure increases will dissolve reater into our tissue

air temp we inhale is low os its hard to thermoregualte when we continuously are cooling

54
Q

henrys law

A

more pressure = more dissolved a gas into our tissue
helium then nitrogen then oxygen

55
Q

lung colllapse/ squeeze

A

imncreasaeing outside pressrue as we descend increases pressure on the lungs which have lower relative pressure indie them, this will force the ari out of the lungsand close the lung to resiudual volume which can damge the alveoli at this spot

56
Q

mask squueze

A

putting a mask on outside of the water traps the atmospher air, this is lower than the pressure of water at certain levels and pressrue exerted onto the mask can ccasue rupturing of blood vessels in the eyes,

to prevent this we canput the mask on outside of the water or breathe dense air from our nose inot the mask to equal pressure

57
Q

pneumo thorax

A

when the plural sack ruptures

as we decreas the pressure exerted from the water onto our lungs but happen to have too much high dense gases in our lungs at the wrong time, we can have pressrue from the lungs expand outwrds (greater than that of the water around us) and burst the like a ballon, this will get rid of the suction from the plural sack to the lung and influx ocygen here,

oxygen here cancreate air embolisms which are bubbbles which may be move to ither areas of the blood in the body

to reduce this we breath out whil ewe are ascending to reduce pressrue in the lungs

58
Q

hood squuze

A

increase pressrue durig descent from the outside into or low pressrue ear canals can rupture tympanic membranes

this can affect heearing, balance and orientation which are senses that are needed to get out of riskyy enviorments

get rid of this will the valsva manuever or, swallowing

59
Q

aerotitis

A

hihg pressrue outside onto low pressrue ear inflammes the middle ear

60
Q

aerosinitus

A

during ascnet, ikf we get air trapped in our sinuses from the high pressrue enviroment/ gases due to cloggred onose or something, we can iexert pressrue from the sinus on the mucous lined walls of the causing immflamaition or capillary ruptrue in the sinus

61
Q

On gassing

A

increasing the pressure in our lungs throuhg high desnity gasses, casues the gases in the lungs to absorb into the blood/tissues

62
Q

ON Gassing Problems

A

Inert Gas Narcosis and Oxygen toxicicyt

63
Q

Inerert gas narcosis

A

when too much nitrogen absorbs into our blood, cna be reversed, vcausng euphoroia, imparired judgement, loss of consciousness

noticed @ 100 ft with compressed air

ffeeling mildly intoxicated

high pressrue more absorbs (henry)

64
Q

HPNS

A

HiHg Pressure Nervous Syndrome occurs in descent

greater than 400 ft

dizziness trauma cause vomiting muscle twitching stomach cramps

ususally we want to take out nitrgogen because of the narcosis effect but in the case of HPNS we add 5-10% nitrogen back into the mix in order to combat the effects of Narcotic

65
Q

COmbat On Gassing

A

decreasey of the gas in order to allow for less dissolving into our tissues to elimiante narcosis
notriox shallow
heliox deep
trimix very deeps

dont need c02 casue we produced the co2 into the tank

66
Q

Oxygen toxicity

A

too much oxygen can suck up electron create super oxicdce anion which leads to the creating of freee radical swhich abosorb electrons from other tissues /decreaing cellular function

67
Q

Off Gassing

A

reducing hte pressure reduces the gases that are dissolved in the tissue

low pressure in the lungs will have the gas in the tissue move to the lungs

decreaseing ambient presssrue so high pressure has to go somewhere

68
Q

Off Gassing Problems

A

the bends
pneumonia thorax
aerosinitus

69
Q

fst and slow tissues

A

take on and left off gasses quicker or slower

if its slow tissue then we need to stay their longer for the gases to absorb

70
Q

the bends (decompression sickness)

A

when we increase ascent too wuickly the gases in our blood and tissues need to go somehwere as they will now be high pressure and the enviroment will be low, gases from the tissues push into the apillaries and can create bubbles that block block from going downstream (ischemic tissues) the bubblecan also irritate the tissues insode the capillary and casue leakage and imflammation (wbc cause clottign = blockage)

71
Q

determinants of the bends

A

depth - deep mor on gassing
time - time more the time
ascent rate - too fast
multiple dives - residual gasses no fully gone

72
Q

How would treat decompression sickness?

A

Recompress them in a hyperbaric chamber @ 60 ft of sea water fsw. and can use pure oxygen without the risk of oxygen toxicicity since the pressure (60 ft ) is much less than deep dives so lower risk of oxygen toxicicity ( less drive of oxygen dissolving into blood)

73
Q

G- Forces

A

force of gravity or acceleration on the body

high gravity.

Gx - anteroposterior
Gy - horizontal
Gz - vertical

74
Q

Positive G z responses

A
  • head to foot

blood rushing from head to foot, we increase our heart rate and force in order to get cirulated blood around the body

  • increase vascular tone in head to keep blood there

without being able to get blood back to the head, we can loose vision and begin to go unconscious (GLOC)

slwly narrow tunnel vission to the point of GLOC greyout then blackout

75
Q

negative Gz forces

A

foot to head

too much blood goes to the head, less blood out of the head and we can get red out where the capillaries fill with blood and we cant see then we can also go unconscious becasue the blood that there is pooling but not doing gas exchange

76
Q

neurovestibular responses to microgravity

A

have fluid in our canals in the ear.

in space we cant sense orientation with no gravity but after a few days we can be unconfused as what are eyes sees catches up with what are brain is senseing

motion sicknesss is conflicting imformation of our senses

  1. crista - semicircular canals
  • sense angular motion, not really effected in micro gravity
  1. Maccula in the Saccules
    - sense linear motion and as our bodies accelerate in the linear direction otoliths embedded in the fluid of the ear canals get sent forward or backward triggeringthe hairs to sense this

70% of astronauts get the nausesa nd vomiting and disorientation but it onyl catches up with us in a few days so if the mission is shrot than we cant really do a lot of productive stuff

77
Q

cardiovascular responses to micro gravity

A

in micro gravity fluid is not pulled down to the legs but floats throught the body dispersing around, this can fill sinuses which can cause a headache and will generally make our faces puffy

Micro gravity induced diuresis - the shifting of fluid causes the kidney to get rid of excess fluid so we piss so plasma volume decreases ,, kidney also reduces epo and wbc making most astronauts anemic as early as 4 days ( 15% plassma loss ion 3 months

exposure can cause 22% loss of blood volume

we dont get as thirsty

78
Q

myocardial tissue resposne to micro gravity

A

since we are losing blood volume and we are also reducing the amount of work the heart has to do to fight gravity, we decrease the cost of moving which detrains the heart making it smaller and weaker

79
Q

cardiovascular when we return to earth

A

orthostatic intolerance and presyncope

since we have a reduced cardiac work in space and reducesblood volume then we add gravity pulling pulling down the blood back to our legs

orthosttic intolerance- when we cant commabt the effects of gravity when we stand ( getting light headed when we stand up)

presyncope - reduced blood pressure casuing light headed ness dizziness feeling faint

addd on top of it the suits trying to cool us off so we lose mroe fluid

80
Q

how to combat return to earth cardiac effects

A

Low body negative pressure- putting our legs in a vaccum to drive the pressrue out adn from the upper body down to the legs

orthostatic intolerance can be combatted with lots of fluid and salt because water follows salt in order to drive up blood volume or cool them down to vasoconstrict adn drive blood back up centrally / g suit - increases pressure int he legs to drive blood back up centrally

81
Q

respiratory in space

A

space is a vaccum so we neeed to mek artificaila pressure in the space station

this can casue high pressrue inside and no pressure outside meaning decrompression sickness wehn we go outside

thats why we pressurize the suits or else the suits would be stiff, but if we can add pressure in them we can maintain mobility and

to combat the decompression sickness they use pure O2 because the pressure is low so no need for oxygen, any pressure will be enough to drive oxygen into the blood eliminating the risk of inert gas narcosis

82
Q

thermoregulation in space

A

hot when facing the sun and freezign when not facing the sun

no atmosphere so increasesd heat transfer from thermal radition and fluid loss (hot in space suit for vasodialation adn fluid loss)

fromt he space suit it over cools

we are protected by the earths magnetic field low earth orbit

83
Q

muscle in space

A

muscles atrophy because we arent using them 5% a week in atrophy

30% decrease in myotcytes

lose slow fibres
lose actin more than myosin
lose structural proteins
more relaince on muscle glycognen thatn fat metabolism

all lead to lack of endurance and fatigue

84
Q

bone in space

A

wiehgt bearing bones lose much less

arms still used to fly around so we see only 1-2% loss a motnth 0.3% calcium

kidney stones may occur because as we lose the calcium in our ou rbone it has to go somwhere so it goes to the blood increasing blood ca concentration ultimatley leading to increase output to kidney and kidney sotne formation (also due chewed up bone by osteoclasts)

85
Q

direct and indirect effects of radiation in space

A

direct effects - radiation changing dna and cellular componetns that we need for survival

indirect - hihg chance of breaking down water into hydroxylz that can create free radicals which can casue tissue damage

86
Q

risk to radiation depends on

A

type of radiation, dose , energy , dose rate, absorbed dose

liver is low risk

eyes are high risk

kidneys spleen gall moderate risk

best defences is to limit duration adn amoun t of exposre

87
Q

RADS and exposure to low dose radiation

A

radiation absorbed dose
space close to 200 rads

genetic - radiation changing ameetes and sex cell s

somatic - radiation carcinogenic effects

in utero. - mutation in fetus

Extreme Environments Final (1 decks)

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