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Transport of CO2 in blood - process CO2 dissociation curve Factors affecting CO2 Dissociation curve
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lecture 6 /2023-Respiratory Physiology - work of breathing , dead space.pdf
Respiratory system
Specific Learning Objective
Work of breathing & its measurement
Dead space
Oxygen transport
This document discusses oxygen transport from the atmosphere to tissues. It describes how oxygen is absorbed in the lungs and bound to hemoglobin to be carried by the blood. The oxyhemoglobin dissociation curve is explained, showing how hemoglobin releases oxygen in tissues. Factors affecting oxygen diffusion and binding such as partial pressure gradients, carbon dioxide levels, 2,3-DPG, and fetal hemoglobin are covered. The document also briefly discusses oxygen toxicity and ischemia-reperfusion injury.
Lung mechanics
1. The diaphragm and external intercostal muscles are the primary muscles of inspiration. Expiration is normally passive due to lung elasticity.
2. Lung compliance depends on factors like lung volume, blood volume, and disease processes. Surface tension forces from pulmonary surfactant reduce alveolar collapse.
3. Airway resistance arises from both laminar and turbulent gas flow. Increased resistance occurs from bronchospasm, secretions, and airway collapse related to low lung volume or forced exhalation.
Respiratory physiology on airway resistance
1. The document outlines the relationships between airflow, pressure, and resistance in the conducting airways and the effects of various substances.
2. Catecholamines like epinephrine cause bronchodilation through adrenergic receptors while cholinergic agonists like carbachol cause bronchoconstriction.
3. Histamine causes bronchoconstriction through H1 receptors by increasing mucus and vascular permeability. Prostaglandins have dual effects with prostacycline causing bronchodilation and PGE2 having both constricting and dilating effects.
Ventilation and Perfusion in different zones of lungs.
This powerpoint presentation will make you explore about the Perfusion and Ventilation in different zones of lungs with its co-relation with pulmonary tuberculosis.
Oxygen dissociation curve
Following induction of anesthesia, factors such as decreased functional residual capacity, increased ventilation/perfusion mismatching, and development of atelectasis can increase venous admixture from 1% to around 10%. Anesthetic agents also suppress hypoxic pulmonary vasoconstriction and decrease cardiac output, reducing oxygen delivery. However, anesthesia and artificial ventilation lower oxygen requirements by around 15-21% due to decreased metabolism and work of breathing. Oxygen is transported in the blood bound to hemoglobin or dissolved in plasma, and the oxygen dissociation curve illustrates hemoglobin's changing affinity for oxygen at different partial pressures. Multiple factors can shift this curve, facilitating either oxygen loading or unloading as needed.
Compliance Resistance & Work Of Breathing
This document discusses the mechanics of respiration and resistance to breathing. It covers:
1. Elastic resistance makes up around 65% of total resistance and is due to the elastic recoil of lung tissue and surface tension forces. Lung compliance measures a lung's elastic resistance.
2. Non-elastic resistance accounts for the remaining 35% and includes airway resistance. Dynamic compliance is lower than static compliance due to factors like airway obstruction.
3. Several lung diseases can decrease compliance by increasing elastic or non-elastic resistance, requiring more work from respiratory muscles. Surfactant reduces surface tension forces and the work of breathing.
Oxygen transport
This document discusses oxygen transport and delivery in the body. It covers:
1. Oxygen is transported bound to hemoglobin (97%) and dissolved in plasma (3%). Oxygen diffuses from alveoli into plasma and binds to hemoglobin in red blood cells.
2. Arterial oxygen content is determined by dissolved oxygen and oxygen bound to hemoglobin. Normal arterial content is 20 ml O2/100ml blood. Venous content is normally 15 ml O2/100ml blood.
3. Oxygen delivery depends on cardiac output and arterial oxygen content. Normal delivery is 1000 ml O2/min. Oxygen uptake by tissues is normally 250 ml O2/min.
Recommended
lecture 6 /2023-Respiratory Physiology - work of breathing , dead space.pdf
Respiratory system
Specific Learning Objective
Work of breathing & its measurement
Dead space
Oxygen transport
This document discusses oxygen transport from the atmosphere to tissues. It describes how oxygen is absorbed in the lungs and bound to hemoglobin to be carried by the blood. The oxyhemoglobin dissociation curve is explained, showing how hemoglobin releases oxygen in tissues. Factors affecting oxygen diffusion and binding such as partial pressure gradients, carbon dioxide levels, 2,3-DPG, and fetal hemoglobin are covered. The document also briefly discusses oxygen toxicity and ischemia-reperfusion injury.
Lung mechanics
1. The diaphragm and external intercostal muscles are the primary muscles of inspiration. Expiration is normally passive due to lung elasticity.
2. Lung compliance depends on factors like lung volume, blood volume, and disease processes. Surface tension forces from pulmonary surfactant reduce alveolar collapse.
3. Airway resistance arises from both laminar and turbulent gas flow. Increased resistance occurs from bronchospasm, secretions, and airway collapse related to low lung volume or forced exhalation.
Respiratory physiology on airway resistance
1. The document outlines the relationships between airflow, pressure, and resistance in the conducting airways and the effects of various substances.
2. Catecholamines like epinephrine cause bronchodilation through adrenergic receptors while cholinergic agonists like carbachol cause bronchoconstriction.
3. Histamine causes bronchoconstriction through H1 receptors by increasing mucus and vascular permeability. Prostaglandins have dual effects with prostacycline causing bronchodilation and PGE2 having both constricting and dilating effects.
Ventilation and Perfusion in different zones of lungs.
This powerpoint presentation will make you explore about the Perfusion and Ventilation in different zones of lungs with its co-relation with pulmonary tuberculosis.
Oxygen dissociation curve
Following induction of anesthesia, factors such as decreased functional residual capacity, increased ventilation/perfusion mismatching, and development of atelectasis can increase venous admixture from 1% to around 10%. Anesthetic agents also suppress hypoxic pulmonary vasoconstriction and decrease cardiac output, reducing oxygen delivery. However, anesthesia and artificial ventilation lower oxygen requirements by around 15-21% due to decreased metabolism and work of breathing. Oxygen is transported in the blood bound to hemoglobin or dissolved in plasma, and the oxygen dissociation curve illustrates hemoglobin's changing affinity for oxygen at different partial pressures. Multiple factors can shift this curve, facilitating either oxygen loading or unloading as needed.
Compliance Resistance & Work Of Breathing
This document discusses the mechanics of respiration and resistance to breathing. It covers:
1. Elastic resistance makes up around 65% of total resistance and is due to the elastic recoil of lung tissue and surface tension forces. Lung compliance measures a lung's elastic resistance.
2. Non-elastic resistance accounts for the remaining 35% and includes airway resistance. Dynamic compliance is lower than static compliance due to factors like airway obstruction.
3. Several lung diseases can decrease compliance by increasing elastic or non-elastic resistance, requiring more work from respiratory muscles. Surfactant reduces surface tension forces and the work of breathing.
Oxygen transport
This document discusses oxygen transport and delivery in the body. It covers:
1. Oxygen is transported bound to hemoglobin (97%) and dissolved in plasma (3%). Oxygen diffuses from alveoli into plasma and binds to hemoglobin in red blood cells.
2. Arterial oxygen content is determined by dissolved oxygen and oxygen bound to hemoglobin. Normal arterial content is 20 ml O2/100ml blood. Venous content is normally 15 ml O2/100ml blood.
3. Oxygen delivery depends on cardiac output and arterial oxygen content. Normal delivery is 1000 ml O2/min. Oxygen uptake by tissues is normally 250 ml O2/min.
TRANSPORT OF CARBON DIOXIDE
Dr. Nilesh Kate's document discusses the transport of carbon dioxide in the body. It describes how CO2 moves from cells to blood through diffusion down a partial pressure gradient, and is transported in the blood in three forms: dissolved, bicarbonate, and carbamino compounds. The document outlines the roles of hemoglobin, oxygen levels, and temperature in facilitating CO2 transport from tissues to the lungs, where it diffuses into the alveolar air and is exhaled. Key factors like pH regulation and the respiratory quotient are also briefly covered.
Voluntary control of respiration, respiratory reflexes
Afferent impulses to respiratory center from higher centers.
Afferent impulses to respiratory center from non-chemical receptors
Pulmonary stretch receptors (Hering–Breuer inflation reflex)
J-receptors
Irritant receptors in respiratory tract –
a. Cough reflex b. Sneezing reflex
c. Hering–Breuer deflation reflex d. Deglutition reflex
Proprioceptors
Chest wall stretch receptors
Baroreceptors
Thermoreceptors
Coronary chemoreceptor
Ventilation perfusion ratio (The guyton and hall physiology)
Ventilation perfusion ratio is :
“The ratio of alveolar ventilation and the amount of blood that perfuse the alveoli”.
FORMULA
It is expressed as VA/Q.
VA is alveolar ventilation
Q is the blood flow (perfusion)
Normal value of ventilation perfusion ratio is about
0.8
VA is 4.2 L /min
Q is 5.5 L/min (Same as Cardiac output)
So VA/Q = 4.2/5.5 = 0.8
If VA becomes zero ratio becomes zero
If Q becomes zero ratio becomes infinite.
If ratio becomes zero or infinite then there is no gaseous exchange. So this ratio indicates the efficiency of gaseous exchange in lungs.
In standing or sitting position this ratio is not uniform in all parts of the lungs.
In standing position, in upper parts of lungs there is almost no blood flow so normally in upper parts of lungs the ratio is higher may be near 3.
In lower part of lungs, there is more blood flow so the ratio is decreased may be 0.6.
In certain diseases the VA/Q ratio is higher which means perfusion is inadequate i.e. in some parts of lungs the alveoli are non functional or partially functional. This is seen in cases of pulmonary thrombosis or embolism.
When there is higher VA/Q ratio, PO2 and PCO2 in the alveolar air resembles the values in the inspired air.
When exchange is not occurring because of lack of perfusion, inspired air goes to alveoli, as there is no exchange occurring so the same values of PCO2 and PO2 as in inspired air.
Compliance of lung
The document discusses lung elastance, compliance, and work of breathing. It defines key terms like elastance, compliance, and surface tension. It describes the elastance of the thoracic cage and lungs, the role of pulmonary surfactant in reducing surface tension, and how compliance is measured. It also explains the different components of work of breathing, including overcoming elastic, viscous, and airway resistance, and how work of breathing is affected in restrictive and obstructive lung diseases.
Chemical control of respiration
The document summarizes the chemical control of respiration through respiratory chemoreceptors. There are three types of chemoreceptors: peripheral chemoreceptors located in the carotid bodies and aortic bodies that detect changes in arterial pCO2, pO2, and pH; central or medullary chemoreceptors located in the brainstem that are stimulated by increased hydrogen ion concentration in cerebrospinal fluid; and both peripheral and central chemoreceptors work together to maintain homeostasis and stimulate respiration in response to changes in oxygen, carbon dioxide, and hydrogen ion levels in order to regulate respiration.
Oxygen dissociation curve
The document discusses the oxygen-hemoglobin dissociation curve, which plots the percentage of hemoglobin in its oxygen-saturated form against the partial pressure of oxygen. It shows how hemoglobin binds to oxygen in the lungs and releases it in tissues. The curve has a plateau section in the lungs where oxygen binding is not greatly affected by changes in pressure, and a steep section in tissues where small pressure drops release large amounts of oxygen. The P50 value indicates the partial pressure at which hemoglobin is 50% saturated and can shift based on conditions affecting hemoglobin's oxygen affinity.
Bohr and haldane effect
Bohr’s effect- The Bohr effect is a physiological phenomenon first described by Danish physiological Christian Bohr, stating that the “oxygen binding affinity of hemoglobin is inversely related to the concentration of carbon dioxide and hydrogen ion.
#An increase in blood CO2 concentration which leads to decrease in blood pH will results in hemoglobin proteins releasing their oxygen load.
#One of the factor that Bohr discovered was pH. He found that if the pH is lower than the normal, then hemoglobin does not bind oxygen.
#And this effect of CO2 on oxygen dissociation curve is known as Bohr effect.
Haldane effect- The Haldane effect is first discovered by John Scott Haldane.
#The Haldane effect describe the phenomenon by which binding of oxygen to hemoglobin promotes the release of carbon dioxide.
#Haldane effect is the mirror image of Bohr effect.
#The decrease in carbon dioxide leads to increase in the pH, which result in hemoglobin picking up more oxygen.
#This is a helpful biochemical feature which facilitates exchange of carbon dioxide for oxygen in the pulmonary and peripheral circulations.
Cardiac reflex
Cardiac reflexes involve afferent and efferent nerve pathways between the heart and central nervous system that help regulate cardiac function and homeostasis. Key reflexes discussed include the baroreceptor reflex, which helps maintain blood pressure, and the Bezold-Jarisch reflex, which causes hypotension, bradycardia, and coronary artery dilation in response to ventricular stimuli. Preventing or treating reflex cardiovascular changes during surgery may involve atropine, local anesthesia, lignocaine infusion, or adjusting anesthesia depth.
ASA recommended monitoring
This document discusses the history and evolution of anesthesia monitoring standards from the early days of visual monitoring through the development of electronic monitors. It outlines key events that improved safety such as the establishment of the Anesthesia Patient Safety Foundation in 1985 and the development of monitoring standards in 1985 and 1986. The standards require continual evaluation of oxygenation, ventilation, circulation and temperature during all anesthetics using minimum monitoring equipment including pulse oximetry, capnography and ECG. The techniques and limitations of various monitors are reviewed.
Lesson 2 ventilation and gas exchange
This document defines key terms related to gas exchange and ventilation in the lungs. It discusses functional residual capacity, residual volume, vital capacity, and inspiratory capacity. It defines serial and physiological dead space and how they are measured. It describes how to calculate alveolar ventilation rate given pulmonary ventilation rate, dead space volume, and respiratory rate. It explains the processes of ventilation, perfusion, and the ventilation/perfusion ratio in the lungs.
Cardiac reflexes & Anaesthetic Implications
The document discusses several cardiac reflexes that contribute to regulating cardiac function and maintaining homeostasis. It describes the baroreceptor reflex, which senses changes in blood pressure via stretch receptors in the carotid sinus and aortic arch. When pressure is high, it decreases heart rate and contractility. The chemoreceptor reflex senses low oxygen or acidosis via carotid and aortic bodies and increases ventilation and heart rate. Other reflexes discussed include the Brainstem reflex, Bezold-Jarisch reflex, Valsalva maneuver, Cushing reflex, and occulocardiac reflex.
physiological dead space and its measurements
This document defines and describes the different types of dead space in the lungs, including anatomical, physiological, alveolar, and apparatus dead space. It explains that physiological dead space is greater than anatomical dead space due to the inclusion of alveolar dead space. The document also outlines methods to measure anatomical and physiological dead space, such as Fowler's method and Bohr's equation. Factors that can influence the amounts of anatomical and alveolar dead space are also discussed.
Anatomy & physiology of neuromuscular junction & monitoring
The document summarizes key aspects of the neuromuscular junction (NMJ). It discusses how the NMJ functions as a synapse to transmit signals from motor neurons to muscles. It describes the anatomy of the NMJ, including the presynaptic membrane, synaptic cleft, postsynaptic membrane, and contractile apparatus. It also explains the roles of acetylcholine, acetylcholinesterase, and ion channels in the signal transmission and muscle contraction processes at the NMJ.
Cerebral Blood Flow and its Regulation
This document discusses cerebral blood flow and its regulation. It begins with an introduction to the components inside the skull and the Monro-Kellie doctrine. It then covers the anatomy of brain circulation discovered by Willis in 1664, including the anterior and posterior circulations and collateral pathways. Regulation of cerebral blood flow is achieved through hemodynamic autoregulation, metabolic and chemical mediators, neural control, and circulatory peptides. Clinical measurement techniques include laser Doppler flowmetry, transcranial Doppler, and imaging modalities like CT, MRI, PET, and SPECT. Factors like age, hypertension, and failure of autoregulation can impact cerebral blood flow and its regulation.
Oxygen cascade & therapy
An brief illustration of physiological oxygenation Cascade, different oxygenation technique & their appropriate usage
Respiratory physiology h.o.d.
This document provides an overview of respiratory physiology, including:
1. It describes the functional anatomy of the respiratory system from the nose to the alveoli.
2. It defines and explains various lung volumes and capacities that are measured by spirometry, such as tidal volume, functional residual capacity, and closing capacity.
3. It covers topics related to gas exchange including the roles of surfactant and preoxygenation in increasing oxygen stores in the lungs.
4. It discusses the concepts of ventilation, dead space, and the measurement of physiological dead space using the Bohr equation.
Cardiac Cycle and Anaesthetic Implications
The cardiac cycle begins with an electrical impulse from the sinoatrial node that causes atrial contraction. This is followed by a delayed impulse from the atrioventricular node that causes ventricular contraction. The cycle involves electrical and mechanical events represented by the ECG. Cardiac function is controlled by the autonomic nervous system and hormones. Parasympathetic stimulation decreases heart rate while sympathetic stimulation increases it. Important cardiac reflexes maintain homeostasis by regulating heart rate and contractility in response to pressure and chemical sensors.
Capillary circulation
The document discusses capillary circulation and microcirculation. It covers the structure of capillaries including their thin endothelial cell walls allowing for exchange of nutrients, wastes, and fluid. It describes the Starling forces that govern fluid filtration and exchange between blood and tissues, including capillary pressure, plasma and interstitial fluid oncotic pressures, and other factors. It also discusses edema, the accumulation of excess fluid in tissues, which can occur intracellularly or extracellularly due to various causes that impact capillary permeability or lymph flow.
final ppt sjjjj - Copy - Copy.pptx
1. Factors affecting uptake and distribution of inhalational anesthetic agents include inspired concentration, alveolar concentration, blood:gas partition coefficient, cardiac output, and ventilation.
2. Factors affecting alveolar concentration include solubility, alveolar blood flow, and tissue uptake. Minute ventilation and agent solubility also impact alveolar concentration.
3. Arterial concentration depends on ventilation-perfusion matching and dead space.
The document discusses the pharmacokinetics and pharmacodynamics of inhalational anesthetic agents in detail.
Transportation of oxygen and co2
This document summarizes the mechanisms of oxygen and carbon dioxide transportation in the body. It explains that oxygen is transported primarily bound to hemoglobin in red blood cells (98.5%), while carbon dioxide is transported through dissolved, chemically bound, and bicarbonate ion forms. Key aspects covered include cooperative binding of oxygen to hemoglobin, the oxygen dissociation curve, and factors like pH, temperature, and carbon dioxide levels that affect oxygen unloading from hemoglobin in tissues. The roles of carbonic acid, bicarbonate ions, and carbaminohemoglobin in carbon dioxide transport are also described, as well as the interacting Bohr and Haldane effects.
Lecture 10/2023 Respiratory Physiology : transport of oxygen II.pdf
O2 dissociation curve
Factors influencing O2 dissociation curve - Right sided shift of curve, Left sided shift of curve
P50
lecture 9/ 2023 -Respiratory Physiology - transport of oxygen I.pdf
Transport of O2 in blood –
Uptake process,
Transport of O2 into arterial blood,
Release of O2
More Related Content
What's hot
TRANSPORT OF CARBON DIOXIDE
Dr. Nilesh Kate's document discusses the transport of carbon dioxide in the body. It describes how CO2 moves from cells to blood through diffusion down a partial pressure gradient, and is transported in the blood in three forms: dissolved, bicarbonate, and carbamino compounds. The document outlines the roles of hemoglobin, oxygen levels, and temperature in facilitating CO2 transport from tissues to the lungs, where it diffuses into the alveolar air and is exhaled. Key factors like pH regulation and the respiratory quotient are also briefly covered.
Voluntary control of respiration, respiratory reflexes
Afferent impulses to respiratory center from higher centers.
Afferent impulses to respiratory center from non-chemical receptors
Pulmonary stretch receptors (Hering–Breuer inflation reflex)
J-receptors
Irritant receptors in respiratory tract –
a. Cough reflex b. Sneezing reflex
c. Hering–Breuer deflation reflex d. Deglutition reflex
Proprioceptors
Chest wall stretch receptors
Baroreceptors
Thermoreceptors
Coronary chemoreceptor
Ventilation perfusion ratio (The guyton and hall physiology)
Ventilation perfusion ratio is :
“The ratio of alveolar ventilation and the amount of blood that perfuse the alveoli”.
FORMULA
It is expressed as VA/Q.
VA is alveolar ventilation
Q is the blood flow (perfusion)
Normal value of ventilation perfusion ratio is about
0.8
VA is 4.2 L /min
Q is 5.5 L/min (Same as Cardiac output)
So VA/Q = 4.2/5.5 = 0.8
If VA becomes zero ratio becomes zero
If Q becomes zero ratio becomes infinite.
If ratio becomes zero or infinite then there is no gaseous exchange. So this ratio indicates the efficiency of gaseous exchange in lungs.
In standing or sitting position this ratio is not uniform in all parts of the lungs.
In standing position, in upper parts of lungs there is almost no blood flow so normally in upper parts of lungs the ratio is higher may be near 3.
In lower part of lungs, there is more blood flow so the ratio is decreased may be 0.6.
In certain diseases the VA/Q ratio is higher which means perfusion is inadequate i.e. in some parts of lungs the alveoli are non functional or partially functional. This is seen in cases of pulmonary thrombosis or embolism.
When there is higher VA/Q ratio, PO2 and PCO2 in the alveolar air resembles the values in the inspired air.
When exchange is not occurring because of lack of perfusion, inspired air goes to alveoli, as there is no exchange occurring so the same values of PCO2 and PO2 as in inspired air.
Compliance of lung
The document discusses lung elastance, compliance, and work of breathing. It defines key terms like elastance, compliance, and surface tension. It describes the elastance of the thoracic cage and lungs, the role of pulmonary surfactant in reducing surface tension, and how compliance is measured. It also explains the different components of work of breathing, including overcoming elastic, viscous, and airway resistance, and how work of breathing is affected in restrictive and obstructive lung diseases.
Chemical control of respiration
The document summarizes the chemical control of respiration through respiratory chemoreceptors. There are three types of chemoreceptors: peripheral chemoreceptors located in the carotid bodies and aortic bodies that detect changes in arterial pCO2, pO2, and pH; central or medullary chemoreceptors located in the brainstem that are stimulated by increased hydrogen ion concentration in cerebrospinal fluid; and both peripheral and central chemoreceptors work together to maintain homeostasis and stimulate respiration in response to changes in oxygen, carbon dioxide, and hydrogen ion levels in order to regulate respiration.
Oxygen dissociation curve
The document discusses the oxygen-hemoglobin dissociation curve, which plots the percentage of hemoglobin in its oxygen-saturated form against the partial pressure of oxygen. It shows how hemoglobin binds to oxygen in the lungs and releases it in tissues. The curve has a plateau section in the lungs where oxygen binding is not greatly affected by changes in pressure, and a steep section in tissues where small pressure drops release large amounts of oxygen. The P50 value indicates the partial pressure at which hemoglobin is 50% saturated and can shift based on conditions affecting hemoglobin's oxygen affinity.
Bohr and haldane effect
Bohr’s effect- The Bohr effect is a physiological phenomenon first described by Danish physiological Christian Bohr, stating that the “oxygen binding affinity of hemoglobin is inversely related to the concentration of carbon dioxide and hydrogen ion.
#An increase in blood CO2 concentration which leads to decrease in blood pH will results in hemoglobin proteins releasing their oxygen load.
#One of the factor that Bohr discovered was pH. He found that if the pH is lower than the normal, then hemoglobin does not bind oxygen.
#And this effect of CO2 on oxygen dissociation curve is known as Bohr effect.
Haldane effect- The Haldane effect is first discovered by John Scott Haldane.
#The Haldane effect describe the phenomenon by which binding of oxygen to hemoglobin promotes the release of carbon dioxide.
#Haldane effect is the mirror image of Bohr effect.
#The decrease in carbon dioxide leads to increase in the pH, which result in hemoglobin picking up more oxygen.
#This is a helpful biochemical feature which facilitates exchange of carbon dioxide for oxygen in the pulmonary and peripheral circulations.
Cardiac reflex
Cardiac reflexes involve afferent and efferent nerve pathways between the heart and central nervous system that help regulate cardiac function and homeostasis. Key reflexes discussed include the baroreceptor reflex, which helps maintain blood pressure, and the Bezold-Jarisch reflex, which causes hypotension, bradycardia, and coronary artery dilation in response to ventricular stimuli. Preventing or treating reflex cardiovascular changes during surgery may involve atropine, local anesthesia, lignocaine infusion, or adjusting anesthesia depth.
ASA recommended monitoring
This document discusses the history and evolution of anesthesia monitoring standards from the early days of visual monitoring through the development of electronic monitors. It outlines key events that improved safety such as the establishment of the Anesthesia Patient Safety Foundation in 1985 and the development of monitoring standards in 1985 and 1986. The standards require continual evaluation of oxygenation, ventilation, circulation and temperature during all anesthetics using minimum monitoring equipment including pulse oximetry, capnography and ECG. The techniques and limitations of various monitors are reviewed.
Lesson 2 ventilation and gas exchange
This document defines key terms related to gas exchange and ventilation in the lungs. It discusses functional residual capacity, residual volume, vital capacity, and inspiratory capacity. It defines serial and physiological dead space and how they are measured. It describes how to calculate alveolar ventilation rate given pulmonary ventilation rate, dead space volume, and respiratory rate. It explains the processes of ventilation, perfusion, and the ventilation/perfusion ratio in the lungs.
Cardiac reflexes & Anaesthetic Implications
The document discusses several cardiac reflexes that contribute to regulating cardiac function and maintaining homeostasis. It describes the baroreceptor reflex, which senses changes in blood pressure via stretch receptors in the carotid sinus and aortic arch. When pressure is high, it decreases heart rate and contractility. The chemoreceptor reflex senses low oxygen or acidosis via carotid and aortic bodies and increases ventilation and heart rate. Other reflexes discussed include the Brainstem reflex, Bezold-Jarisch reflex, Valsalva maneuver, Cushing reflex, and occulocardiac reflex.
physiological dead space and its measurements
This document defines and describes the different types of dead space in the lungs, including anatomical, physiological, alveolar, and apparatus dead space. It explains that physiological dead space is greater than anatomical dead space due to the inclusion of alveolar dead space. The document also outlines methods to measure anatomical and physiological dead space, such as Fowler's method and Bohr's equation. Factors that can influence the amounts of anatomical and alveolar dead space are also discussed.
Anatomy & physiology of neuromuscular junction & monitoring
The document summarizes key aspects of the neuromuscular junction (NMJ). It discusses how the NMJ functions as a synapse to transmit signals from motor neurons to muscles. It describes the anatomy of the NMJ, including the presynaptic membrane, synaptic cleft, postsynaptic membrane, and contractile apparatus. It also explains the roles of acetylcholine, acetylcholinesterase, and ion channels in the signal transmission and muscle contraction processes at the NMJ.
Cerebral Blood Flow and its Regulation
This document discusses cerebral blood flow and its regulation. It begins with an introduction to the components inside the skull and the Monro-Kellie doctrine. It then covers the anatomy of brain circulation discovered by Willis in 1664, including the anterior and posterior circulations and collateral pathways. Regulation of cerebral blood flow is achieved through hemodynamic autoregulation, metabolic and chemical mediators, neural control, and circulatory peptides. Clinical measurement techniques include laser Doppler flowmetry, transcranial Doppler, and imaging modalities like CT, MRI, PET, and SPECT. Factors like age, hypertension, and failure of autoregulation can impact cerebral blood flow and its regulation.
Oxygen cascade & therapy
An brief illustration of physiological oxygenation Cascade, different oxygenation technique & their appropriate usage
Respiratory physiology h.o.d.
This document provides an overview of respiratory physiology, including:
1. It describes the functional anatomy of the respiratory system from the nose to the alveoli.
2. It defines and explains various lung volumes and capacities that are measured by spirometry, such as tidal volume, functional residual capacity, and closing capacity.
3. It covers topics related to gas exchange including the roles of surfactant and preoxygenation in increasing oxygen stores in the lungs.
4. It discusses the concepts of ventilation, dead space, and the measurement of physiological dead space using the Bohr equation.
Cardiac Cycle and Anaesthetic Implications
The cardiac cycle begins with an electrical impulse from the sinoatrial node that causes atrial contraction. This is followed by a delayed impulse from the atrioventricular node that causes ventricular contraction. The cycle involves electrical and mechanical events represented by the ECG. Cardiac function is controlled by the autonomic nervous system and hormones. Parasympathetic stimulation decreases heart rate while sympathetic stimulation increases it. Important cardiac reflexes maintain homeostasis by regulating heart rate and contractility in response to pressure and chemical sensors.
Capillary circulation
The document discusses capillary circulation and microcirculation. It covers the structure of capillaries including their thin endothelial cell walls allowing for exchange of nutrients, wastes, and fluid. It describes the Starling forces that govern fluid filtration and exchange between blood and tissues, including capillary pressure, plasma and interstitial fluid oncotic pressures, and other factors. It also discusses edema, the accumulation of excess fluid in tissues, which can occur intracellularly or extracellularly due to various causes that impact capillary permeability or lymph flow.
final ppt sjjjj - Copy - Copy.pptx
1. Factors affecting uptake and distribution of inhalational anesthetic agents include inspired concentration, alveolar concentration, blood:gas partition coefficient, cardiac output, and ventilation.
2. Factors affecting alveolar concentration include solubility, alveolar blood flow, and tissue uptake. Minute ventilation and agent solubility also impact alveolar concentration.
3. Arterial concentration depends on ventilation-perfusion matching and dead space.
The document discusses the pharmacokinetics and pharmacodynamics of inhalational anesthetic agents in detail.
Transportation of oxygen and co2
This document summarizes the mechanisms of oxygen and carbon dioxide transportation in the body. It explains that oxygen is transported primarily bound to hemoglobin in red blood cells (98.5%), while carbon dioxide is transported through dissolved, chemically bound, and bicarbonate ion forms. Key aspects covered include cooperative binding of oxygen to hemoglobin, the oxygen dissociation curve, and factors like pH, temperature, and carbon dioxide levels that affect oxygen unloading from hemoglobin in tissues. The roles of carbonic acid, bicarbonate ions, and carbaminohemoglobin in carbon dioxide transport are also described, as well as the interacting Bohr and Haldane effects.
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Physiology of vision
Visual pathway
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Physiology of vision
Processing & transmission of visual impulse in the retina
Horizontal cell
Bipolar cell
Amacrine cell
Ganglion cell
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Phototransduction-
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Steps in detail (light & dark)
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Vision 2
Physiology of vision –
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Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
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9. Define mean electrical vector (axis) of the heart and give the normal range
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13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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