ppt课件-a c u t e e f f e c t s o f h i g h a l t i t u d e( h y p o b a r i a)（一个c u t e e f f e c t s o f h g h l t i t u d e(h p o b r我)）.pptVIP

下载本文档

10
0
约1.21万字
约 63页
2017-01-25 发布于四川
举报
版权申诉

ppt课件-a c u t e e f f e c t s o f h i g h a l t i t u d e( h y p o b a r i a)（一个c u t e e f f e c t s o f h g h l t i t u d e(h p o b r我)）.ppt

1、原创力文档（book118）网站文档一经付费（服务费），不意味着购买了该文档的版权，仅供个人/单位学习、研究之用，不得用于商业用途，未经授权，严禁复制、发行、汇编、翻译或者网络传播等，侵权必究。。
2、本站所有内容均由合作方或网友上传，本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺！文档内容仅供研究参考，付费前请自行鉴别。如您付费，意味着您自己接受本站规则且自行承担风险，本站不退款、不进行额外附加服务；查看《如何避免下载的几个坑》。如果您已付费下载过本站文档，您可以点击这里二次下载。
3、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等，请点击“版权申诉”（推荐），也可以打举报电话：400-050-0827(电话支持时间：9:00-18:30)。
4、该文档为VIP文档，如果想要下载，成为VIP会员后，下载免费。
5、成为VIP后，下载本文档将扣除1次下载权益。下载后，不支持退款、换文档。如有疑问请联系我们。
6、成为VIP后，您将拥有八大权益，权益包括：VIP文档下载权益、阅读免打扰、文档格式转换、高级专利检索、专属身份标志、高级客服、多端互通、版权登记。
7、VIP文档为合作方或网友上传，每下载1次，网站将根据用户上传文档的质量评分、类型等，对文档贡献者给予高额补贴、流量扶持。如果你也想贡献VIP文档。上传文档

QUESTIONS?? ARTERIAL OXYGEN SATURATION (SaO2) DURING EXERCISE DURING HEAVY EXERCISE AT SEA LEVEL, NO EFFECTS ON SaO2 SaO2 IS INVERSELY RELATED TO ALTITUDE (INCREASE IN ALTITUDE, DECREASE IN SaO2) ARTERIAL DESATURATION AT ALTITUDE IS DUE TO: 1. DIFFUSION LIMITATION AS TIME REQUIRED FOR DIFFUSION OF 02 INCREASES AT ALTITUDE (FIGURE 12-2) 2. DECREASE OR WORSENING OF THE VA-Q MATCHING 3. INCREASED SHUNTING OF BLOOD AWAY FROM THE LUNGS (??); IF THIS OCCURS, IT MAY BE RELATED TO INCREASED SYMPATHETIC NERVOUS SYSTEM ACTIVITY AND HENCE, INCREASED CIRCULATING NOREPINEPHRINE LEVELS THAT CAUSES VASOCONSTRICTION OF THE ALVEOLAR CAPILLARIES; HOWEVER, THIS IS NOT LIKELY AS CATECHOLAMLINES GENERALLY CAUSE VASODILATION OF ALVEOLAR CAPILLARIES OXYGEN TRANSPORT Hb-O2 DISSOCIATION CURVE 99% OF O2 IS TRANSPORTED BY Hb FROM THE LUNGS TO THE MUSCLE TISSUE %Hb SATURATION WITH O2 IS DIRECTLY RELATED TO PO2 IN THE BLOOD; A DECREASE IN PaO2 AT ALTITUDE WOULD DECREASE THE SATURATION OF HEMOGLOBIN WITH OXYGEN AN INCREASE IN PC02, TEMP, 2,3-DPG OR A DECREASE IN pH WILL SHIFT CURVE TO THE RIGHT; BECAUSE OF THE SIGMOIDAL SHAPE OF THE CURVE, THE SHIFT TO THE RIGHT DOES NOT AFFECT O2 LOADING TO Hb IN THE LUNGS BUT O2UNLOADING FROM Hb IN THE MUSCLE TISSUE IS INCREASED THEREBY INCREASING O2 AVAILABILITY TO THE MUSCLE TISSUE ALTITUDE WILL FURTHER ACCENTUATE THE INCREASE IN PCO2, TEMP, AND 2,3-DPG AND THE DECREASE IN pH DURING EXERCISE HOWEVER, BECAUSE ALTITUDE WILL DECREASE PIO2 AND PA02, SaO2 IS REDUCED AS PREVIOUSLY DISCUSSED AND OVERALL THERE IS A SUBSTANTIAL DECREASE IN OXYGEN EXTRACTION Hb-O2 DISSOCIATION CURVE IS SIGMOIDAL SHAPED BECAUSE Hb IS AN ALLOSTERIC PROTEIN WHICH: 1. WORKS IN CONJUNCTION WITH DIFFUSION GRADIENT TO INCREASE 02 AVAILABILITY BY 2-FOLD 2. IMPLIES COOPERATIVITY (I.E., BINDING OF 02 TO 1 HEME ENHANCES THE BINDING OF 02 TO OTHER HEMES AND THE UNLOADING OF 02 FROM 1 HEME ENHANCES THE UNLOADING OF 02