Hyperbaric Flashcards

1
Q

hyperbaric:

A

gas at high pressure

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2
Q

Dalton law

A

the total pressure of a mixture of gases is the sum of their individual partial pressures

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3
Q

composition of air, dry and wet at standard atmospheric pressure of

A

760mmHg

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4
Q

Dry air: Gas partial pressures =

A
N2 = 593
O2 = 160 
CO2 = 0.23
Ar = 7
H2O = 0 

ALL IN mmHG

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5
Q

Wet air: Gas partial pressures

A
N2 = 557
O2 = 150 
CO2 = 0.21
Ar = 6.6
H2O = 47 

ALL IN mmHg

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6
Q

concentration of a gas dissolved in a solution can be determined using

A

Henrys Law

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7
Q

Henrys Law =

A

[Gas]dis = s X Pgas

s = solubility of coefficient (mM/mmHg) 
P  = partial pressure of the gas
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8
Q

oxygen-haemoglobin dissociation curve at room pressure

A
  • partial pressure of O2 = 100mmHg

- O2 content 20 mlO2/dl blood

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9
Q

every ten metres you dive down barometric pressure increases by

A

1atm

  • so at ten metres down u have 2 times of gas
    N2 –>~600mmHg to ~1200mmHG

O2 –> ~160mmHg to ~320mmHg

These gases will dissolve more into the blood

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10
Q

who’s law explains why more gas will dissolve into blood at deep depths

A

Henrys Law

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11
Q

problems of diving arise when

A

you come back up

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12
Q

normally partial pressure of CO2 in mixed venous blood =

A

~46mmHg

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13
Q

following gas exchange pp of CO2 and O2 in alveolar air and at ten metres

A
CO2 = ~40mmHg 
O2 = ~100mmHg 

they double, so CO2 from the lungs will start to diffuse back into the body, causes increase in arterial CO2

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14
Q

at ten metres down there is a ___ of pressure in the gas in the lungs and ___ in volume

A

doubling

reduction

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15
Q

At ten metres due to CO2 diffuse back into lungs and metabolic production elevate arterial CO2 this acts on

A

respiratory centre –> increases urger to breathe. However O2 levels still high enough so compensation to triggered

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16
Q

During return to surface from dive

A
  • pressure in lungs returns to normal
  • fall in alveolar CO2 and O2
  • causes rapid fall in arterial CO2 and O2
  • drop in cerebral O2 can lead to a blackout! (deep water blackout)
17
Q

in short main problem to avoid in diving

A

damage to lungs as gas expands, breath out as you rise

18
Q

__ areas of body are relatively resistant to effects of high pressure

A

liquid

19
Q

where do problems with pressure on the body arise:

A

air spaces: there are no issues if the gas pressures can equilibrate (Barotrauma)

20
Q

Barotrauma:

A

injury arising from pressure changes, lungs and ear

21
Q

ears and pressure:

A

problems arise if eustachian tube is blocked and doesnt allow gas movements between throat and middle tube

  • as u dive down water pressure increases and pushes on ear drum
  • ear drum/blood vessels may burst
22
Q

sinuses and pressure:

A
  • air filled chambers in your head tubes connecting them to throat
  • pathways blocked = can’t equilibrate = build up of pressure
  • possible bleeding into sinuses
23
Q

over inflation of the lungs: (coming up and u don’t breath out)

A
  • rupture of alveoli so gas can escape from lungs into the body
  • arterial gas embolism
  • pneumothorax
  • mediastinal and subcutaneous emphysema
24
Q

pneumothorax =

A
  • collapsed lung due to gas escaping lungs and rests outside lungs and chest wall (normally plasma there)
  • expansion of lungs and chest wall is disrupted
25
Q

arterial gas embolism:

A

-air can pass into blood vessels, so bubbles of gas in blood = dangerous (brain –> blocks arteriole = stroke / go to heart blocking coronary artery)

26
Q

Mediastinal Emphysema:

A
  • air bubbles in the tissue around the heart/trachea/large blood vessels
  • if this gas expands increase pressure around these organs/vessels
27
Q

subcutaneous emphysema:

A

gas bubbles form in the neck, effect blood vessels going to the brain/head

28
Q

nitrogen narcosis:

A
  • nitrogen almost acting as anaesthetic & alters ion conductance
  • symptoms appear at 30m deep, get worse deeper u go, fatal at 90m
  • as depths increase the concentration of nitrogen N2 in the blood increases
  • N2 higher solubility in lipid than blood
  • being ‘drunk’ symptoms
  • ‘martini’ effect
29
Q

prevention of nitrogen narcosis:

A
  • limit depth and duration of dive

- change in gas composition: use gas mixture replacing N2 with helium

30
Q

oxygen toxicity:

A
  • at atmospheric pressure Hb is almost fully saturated, increasing pressure an extra O2 is dissolved in the plasma
  • depths of 40m (5atm) oxygen pp is roughly equivalent to breathing 100% O2 at sea level
  • short term = OK
  • -long term = respiratory tract damage & CNS problems
  • problems linked to increased levels of free radicals
31
Q

Oxygen toxicity breathing air at 90m (10atm) can lead to

A

seizures and coma

32
Q

oxygen toxicity solution:

A

reduce the oxygen concentration in the mixture

33
Q

decompression sickness:

A

build up of N2 in tissues with time at depth

  • if return to sea level too quickly this gas comes out of solution and forms bubbles
  • overcome by slow return to normal pressures
34
Q

types of decompression sickness:

A

two main classes:

  • Type 1 DCS: linked to pains produced by bubbles forming in muscles and joints
  • Type 2 DCS: more serious: bubbles in CNS, lungs and CVS