MIS 2 Flashcards
Hyperventilation
A pattern of over breathing, where the depth and rate are in excess of the metabolic needs of the body at that time. Hyperventilation eliminates CO2 at a faster pace resulting in a fall in PaCO2 below normal. As CO2 in the body decreases, this alters the body’s pH, increasing alkalinity and so triggering a variety of adaptive changes that produce negative symptoms. Hyperventilation causes respiratory alkalosis. Respiratory alkalosis is a condition marked by a low level of carbon dioxide in the blood due to breathing excessively.
Hypocapnia
Deficiency of CO2 in the blood resulting from hyperventilation, leading to respiratory alkalosis. A fall in PaCO2 below normal due to fast CO2 elimination.
Respiratory Alkalosis
Respiratory alkalosis occurs when the CO2 level of the blood drops below normal and the pH of the blood becomes too high. The difference between respiratory alkalosis and hypocapnia is that hypocapnia leads to respiratory alkalosis. Both are similar in that the carbon dioxide falls below normal in the blood. But hypocapnia is a condition where the CO2 level in the blood drops below normal, whereas respiratory alkalosis is that AND the pH of the blood becomes too high.
Hypoxia
reduction of oxygen (O2) supply to tissue, below physiological levels, despite adequate perfusion of the tissue by blood.
Normal range of alkaline in the blood
Normal range: 7.3 - 7.5
When the blood becomes more acidic due to hyperventilation, the alkaline level can become narrower, resting around 7.4
Hyperventilation and sleep issues
Hyperventilation causes the narrowing of airways, limiting body’s ability to oxygenate and the constricting of blood vessels, leading to reduced blood flow to the heart and other organs and muscles.
Ghrelin
Hunger hormone. People feel hungry when this hormone is produced. Signals the brain that the stomach is empty and it’s time to eat.
Leptin
Satiety hormone. People feel full and satisfied when this hormone is produced.
Bohr Effect
The Bohr effect is a phenomenon first described in 1904 by the Danish physiologist Christian Bohr. Hemoglobin’s oxygen binding affinity (see oxygen–hemoglobin dissociation curve) is inversely related both to acidity and to the concentration of carbon dioxide. That is, the Bohr effect refers to the shift in the oxygen dissociation curve caused by changes in the concentration of carbon dioxide or the pH of the environment. Since carbon dioxide reacts with water to form carbonic acid, an increase in CO2 results in a decrease in blood pH, resulting in hemoglobin proteins releasing their load of oxygen. Conversely, a decrease in carbon dioxide provokes an increase in pH, which results in hemoglobin picking up more oxygen.
Relationship of hyperventilation and Bohr Effect
As you breath more, you lose more CO2, which makes your blood more alkaline.
* More breathing leads to higher concentration of oxygen in the blood * This simultaneously results in loss of carbon dioxide * Because there is less carbon dioxide, the hemoglobin in the blood holds on to oxygen more tightly * Because the hemoglobin holds the oxygen more tightly, it does not give oxygen to muscles as much. Less oxygen exchange between the blood and muscles.
Kidney’s reaction to hyperventilation
To balance pH, bicarbonate (base) is excreted via the kidneys, leading to imbalance of calcium and magnesium in the system. In other words, kidney start to excrete HCO3- and retain H+ in order to lower pH.
Levels of pH and carbon dioxide in hypocapnia
pH > 7.45
PaCO2 < 35mmHg
Effects of Respiratory Alkalosis to the body
• Hyperventilation (breath rate and depth goes up)
• Tachycardia
○ 심박 급속증
• Decrease or normal BP
• Hypokalemia (칼륨 감소혈 혹은 저칼륨증)
• Numbness & Tingling of extremities
• Hyper reflexes & muscle cramping
• Seizures
• Anxiety
• Irritability
• Causes:
○ Hyperventilation (Anxiety, PE, Fear)
○ Mechanical ventilation
○ Hypoxia
○ Sepsis
○ Central Nervous System Disorders (e.g. stroke, infections)
○ Salicylate Toxicity - salicylates stimulate respiratory centers in the CNS
○ Lung disease (interstitial lung disease)
○ Pregnancy
○ Hepatic encephalopathy
• Increase pH
• Increases sympathetic response & anxiousness
• Increases sympathetic adrenaline activity & hypersensitivity to light & sound
• Restricts circulation in cerebral cortex and extremities (cold hands and feet)
Shunts blood flow peripherally and decrease O2 in tissues
Metabolic Acidosis
• Headache • Decreased blood pressure • Hyperkalemia • 고칼륨혈, 칼륨 과잉혈 • Muscle Twitching • Warm, flushed skin • Nausea, vomiting • Decreased muscle tone, decreased reflexes • Confusion, drowsiness goes up • Kussmaul Respirations • Compensatory Hyperventilation • Causes: • Increased hydrogen production ○ (DKA, hypermetabolism • Decreased hydrogen elimination ○ Renal failure • Decreased HCO3 production ○ Dehydration, liver failure • Increased HCO3 elimination Diarrhea, fistulas
Stress and Immune System
When we are chronically stressed out, it stimulates cortisol synthesis and release from adrenal gland, which increases inflammation and decrease immune system.
Factors that affect posture and pattern
asymmetry of the body
kinetic & potential muscle chain system
primary respiratory system
Autonomic Nervous System
Pressure
Vision
Hearing
Environment
Habits (Repetitive Movement patterns)
Lower Kinetic Chain (LKC)
diaphragm
Psoas
Iliacus
TFL
Rectus Femoris
Vastus Laterals
Upper Kinetic Chain (UKC)
SCM
Scalene
Deltoids
Pectoralis (Major and minor)
Triangularis Sterni
Anterior & lateral Intercostal
Diaphragm
Diaphragm - Position and Size
Right leaflet is larger in diameter, it has a thicker and larger central tendon, its dome is higher and it is better supported than the left by the liver beneath it and by strong right abdominal activity
Diaphragm - Attachment
Right crura anchors to L1-3 on the right and the left crura to L1-2 on the left (pg 44 on part 2.pdf)
Diaphragm leaflets also insert into the fascia overlying quadratus lumborum and the psoas muscles via the arcuate ligaments, creating a strong functional linkage between these muscles .
Diaphragm is innervated (supply movement) by a right and left phrenic nerve. Phrenic nerve is the only nerve in your nervous system that provides motor (movement) function to your diaphragm. It sends signals that cause your diaphragm to expand and contract. These movements allow your lungs to inhale and exhale air.
