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Презентация на тему Hypoxia

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2. ParametersClassification, etiology and mechanism of hypoxiaAlterations of
3. parametersPO2CO2maxCO2SO2P50
4. PO2 partial pressure of oxygenPO2 is the
5. CO2max oxygen binding capacity of hemoglobinCO2max
6. CO2 oxygen contentCO2 includes oxygen that is
7. SO2 oxygen saturationSO2 is the percentage of
8. The relation between oxygen partial pressure and
9. P50 means the oxygen partial pressure required
10. Classification, etiology, mechanism of hypoxiaHypotonic hypoxiaHemic hypoxiaCirculatory hypoxiaHistogenous hypoxia
11. Hypotonic hypoxia
12. Etiology and mechanismDecreased PO2 of inspired air
13. Characteristics of blood oxygenPaO2↓, SaO2↓, CaO2 ↓,
14. Hemic hypoxia
15. Etiology and mechanism AnemiaCarbon monoxide poisoning
16. Methemoglobinemia The ferrous state (Fe2+) in
17. when a lot of pickled vegetables containing
18. High affinity of Hb for O2Alkaline solutionDepot blood
19. Characteristics of blood oxygenPaO2 N, SaO2N, CaO2
20. Circulatory hypoxia
21. Etiology and mechanismTissue ischemia shock, left
22. PaO2N, SaO2N, CaO2 N, CO2max N, CaO2-CvO2
23. Histogenous hypoxiaHistogenous hypoxia refers to the tissue
24. Etiology and mechanism Inhibition of oxidative phosphorylation
25. Characteristics of blood oxygenPaO2 N, SaO2N, CaO2
26. Alterations of metabolism and functionRespiratory systemCirculatory systemHematologic systemCentral nervous system Tissues and cells
27. Respiratory systemCompensatory responseLow PaO2 stimulates the chemoreceptor
28. High altitude pulmonary edemaCentral respiratory failure
29. Circulatory systemCompensatory responseIncreased cardiac output
30. Redistribution of blood vasodilatation :
31. Injury manifestationPulmonary hypertensionDecreased diastolic and systolic myocardial
32. Hematologic systemCompensatory responseIncrease in the amount of
33. Plasma viscosity↑, blood flow resistance ↑, afterload
34. Central nervous systemAcute hypoxia: headache, agitation,
35. Tissues and cellsCompensatory responseEnhanced cell capacity for
36. Injury manifestation Cell membrane injury
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ParametersClassification, etiology and mechanism of hypoxiaAlterations of metabolism and function in the bodyPathophysiological basis of prevention and treatment

HypoxiaHypoxia is defined as a deficiency in either the delivery or the

PO2 partial pressure of oxygenPO2 is the tension produced by the oxygen

CO2max oxygen binding capacity of hemoglobinCO2max refers to the maximal amount

CO2 oxygen contentCO2 includes oxygen that is bound to hemoglobin and physically

SO2 oxygen saturationSO2 is the percentage of hemoglobin present as oxyhemoglobin .Normal

The relation between oxygen partial pressure and oxygen saturation is shown as

P50 means the oxygen partial pressure required to saturate 50% of the

Classification, etiology, mechanism of hypoxiaHypotonic hypoxiaHemic hypoxiaCirculatory hypoxiaHistogenous hypoxia

Etiology and mechanismDecreased PO2 of inspired air high altitudeExternal respiratory

Characteristics of blood oxygenPaO2↓, SaO2↓, CaO2 ↓, CO2max N, CaO2-CvO2 ↓/NCyanosis refers

Etiology and mechanism AnemiaCarbon monoxide poisoning CO can react with

Methemoglobinemia The ferrous state (Fe2+) in Hb may be oxidized to

when a lot of pickled vegetables containing nitrate are taken, the reabsorbed

High affinity of Hb for O2Alkaline solutionDepot blood

Characteristics of blood oxygenPaO2 N, SaO2N, CaO2 ↓/N, CO2max ↓/N, CaO2-CvO2 ↓CaO2-CvO2

Etiology and mechanismTissue ischemia shock, left heart failure, thrombosis, arterial stenosis

PaO2N, SaO2N, CaO2 N, CO2max N, CaO2-CvO2 ↑Characteristics of blood oxygenBecause the

Histogenous hypoxiaHistogenous hypoxia refers to the tissue cells can not make use

Etiology and mechanism Inhibition of oxidative phosphorylation

Characteristics of blood oxygenPaO2 N, SaO2N, CaO2 N, CO2max N, CaO2-CvO2 ↓Oxygen

Alterations of metabolism and functionRespiratory systemCirculatory systemHematologic systemCentral nervous system Tissues and cells

Respiratory systemCompensatory responseLow PaO2 stimulates the chemoreceptor in carotid and aortic body,

High altitude pulmonary edemaCentral respiratory failure respiratory inhibition, irregular respiratory rhythm

Circulatory systemCompensatory responseIncreased cardiac output hyperventilation and pulmonary expansion stimulate

Redistribution of blood vasodilatation : heart and brain

Injury manifestationPulmonary hypertensionDecreased diastolic and systolic myocardial functionArrhythmia

Hematologic systemCompensatory responseIncrease in the amount of RBCs and Hb

Plasma viscosity↑, blood flow resistance ↑, afterload of heart ↑When PO2 is

Central nervous systemAcute hypoxia: headache, agitation, poor faculty of memory, inability

Tissues and cellsCompensatory responseEnhanced cell capacity for use of oxygen

Injury manifestation Cell membrane injury Na+ influx cell swelling

Pathophysiological basis of prevention and treatmentEliminating causesOxygen therapyHyperbaric oxygen therapy

Слайды презентации

Слайд 2 Parameters
Classification, etiology and mechanism of hypoxia
Alterations of metabolism

ParametersClassification, etiology and mechanism of hypoxiaAlterations of metabolism and function in

and function in the body
Pathophysiological basis of prevention and

treatment

Слайд 3 parameters
PO2
CO2max
CO2
SO2
P50

Слайд 4 PO2 partial pressure of oxygen
PO2 is the tension

PO2 partial pressure of oxygenPO2 is the tension produced by the

produced by the oxygen molecules physically dissolved in plasma.
Normal

PaO2: 100mmHg
PvO2: 40mmHg

Determined by PiO2 and pulmonary function

Слайд 5 CO2max oxygen binding capacity of hemoglobin
CO2max refers

to the maximal amount of oxygen that could be

bound by the hemoglobin, which reflects the ability of hemoglobin carrying oxygen.

Normal value: 20ml/dl

Determined by quantity and quality of Hb

Слайд 6 CO2 oxygen content
CO2 includes oxygen that is bound

CO2 oxygen contentCO2 includes oxygen that is bound to hemoglobin and

to hemoglobin and physically dissolved in the blood (0.3ml/dl).
Normal

value: CaO2:19ml/dl
CvO2:14ml/dl

The arteriovenous oxygen content difference (CaO2-CvO2) reflects the oxygen volume of tissue uptake.

Determined by PO2 and CO2max

Слайд 7 SO2 oxygen saturation
SO2 is the percentage of hemoglobin

SO2 oxygen saturationSO2 is the percentage of hemoglobin present as oxyhemoglobin

present as oxyhemoglobin .
Normal value: SaO2: 95%

SvO2: 75%

Слайд 8 The relation between oxygen partial pressure and oxygen

The relation between oxygen partial pressure and oxygen saturation is shown

saturation is shown as oxygen dissociation curve (ODC).
An increase

in 2,3-diphosphoglyceric acid (2,3-DPG), H+, PCO2 and temperature will shift the curve to the right, in turn to the left.

Слайд 9 P50 means the oxygen partial pressure required to

P50 means the oxygen partial pressure required to saturate 50% of

saturate 50% of the hemoglobin, which reflects the affinity

of hemoglobin for oxygen.

Normal value P50:26-27mmHg

P50

Слайд 10 Classification, etiology, mechanism of hypoxia
Hypotonic hypoxia
Hemic hypoxia
Circulatory hypoxia
Histogenous

hypoxia

Слайд 11 Hypotonic hypoxia

hypoxic hypoxia
Hypotonic hypoxia is characterized

by the decrease of PaO2(less than 60mmHg).

Слайд 12 Etiology and mechanism
Decreased PO2 of inspired air

high altitude
External respiratory dysfunction
hypoventilation

impaired diffusion
partial ventilation-perfusion imbalcance
Venous-to-arterial shunt
congenital heart disease, Tetralogy of Fallot

Слайд 13 Characteristics of blood oxygen
PaO2↓, SaO2↓, CaO2 ↓, CO2max

Characteristics of blood oxygenPaO2↓, SaO2↓, CaO2 ↓, CO2max N, CaO2-CvO2 ↓/NCyanosis

N, CaO2-CvO2 ↓/N
Cyanosis refers to the bluish color of

skin, nails, lips and mucous membranes when the deoxyhemoglobin concentration of the blood in the capillaries is more than 5g/dl.

Слайд 14 Hemic hypoxia

Hemic hypoxia isotonic hypoxiaHemic hypoxia refers

isotonic hypoxia
Hemic hypoxia refers to

the altered affinity of Hb for oxygen or decrease in amount of Hb in the blood.

Слайд 15 Etiology and mechanism
Anemia
Carbon monoxide poisoning

CO can react with Hb to form carboxyhemoglobin which

can not take up oxygen. So there is a deficiency of Hb that can carry oxygen.
CO can inhibit glycolysis in RBC, which reduces the production of 2,3-DPG and shifts the ODC to the left, decreasing the amount of oxygen released.

Слайд 16 Methemoglobinemia

The ferrous state (Fe2+) in

Methemoglobinemia The ferrous state (Fe2+) in Hb may be oxidized

Hb may be oxidized to the ferric state (Fe3+)

under the action of oxidizers, e.g. nitrite and nitrobenzene, to form methemoglobin (HbFe3+OH), which loses the ability to carry oxygen.

Methemoglobin can also make the ODC of normal HbO2 shift to the left.

Слайд 17 when a lot of pickled vegetables containing nitrate

when a lot of pickled vegetables containing nitrate are taken, the

are taken, the reabsorbed nitrite reacts with HbFe2+ to

form HbFe3+. The skin appears to coffee color. This phenomenon is called enterogenous cyanosis.

Enterogenous cyanosis

Слайд 18 High affinity of Hb for O2
Alkaline solution
Depot blood

Слайд 19 Characteristics of blood oxygen
PaO2 N, SaO2N, CaO2 ↓/N,

Characteristics of blood oxygenPaO2 N, SaO2N, CaO2 ↓/N, CO2max ↓/N, CaO2-CvO2

CO2max ↓/N, CaO2-CvO2 ↓
CaO2-CvO2 is below normal because PO2

in the capillary is declined rapidly due to reduced CaO2.

Severe anemia : pallor
CO poisoning : cherry red
Methemoglobinemia: coffee color

Слайд 20 Circulatory hypoxia

hypokinetic hypoxia
Circulatory hypoxia refers

to inadequate blood flow leading to inadequate oxygenation of the tissues, which is also called hypokinetic hypoxia.

Слайд 21 Etiology and mechanism
Tissue ischemia
shock, left heart

failure, thrombosis, arterial stenosis
Tissue congestion
shock, right

heart failure

Слайд 22 PaO2N, SaO2N, CaO2 N, CO2max N, CaO2-CvO2 ↑
Characteristics

PaO2N, SaO2N, CaO2 N, CO2max N, CaO2-CvO2 ↑Characteristics of blood oxygenBecause

of blood oxygen
Because the blood flows slowly in the

capillary due to ischemia or congestion, the tissues will take more oxygen from unit volume blood.

Patient with circulatory hypoxia may appear cyanosis.

Слайд 23 Histogenous hypoxia
Histogenous hypoxia refers to the tissue cells

Histogenous hypoxiaHistogenous hypoxia refers to the tissue cells can not make

can not make use of the oxygen supplied to

them, though the amount of oxygen delivered to them is adequate.

Слайд 24 Etiology and mechanism
Inhibition of oxidative phosphorylation

- tissue intoxicity
cyanides, sulphuret, rotenone,
( cytochrome oxidase)
Mitochondria injury
bacteriotoxin, radiation, free radical
Absence of Vitamin
Vit B1, Vit B2, Vit PP co-enzyme

Слайд 25 Characteristics of blood oxygen
PaO2 N, SaO2N, CaO2 N,

CO2max N, CaO2-CvO2 ↓
Oxygen content in vein increased because

cells utilize less oxygen. The color of skin and mucous membrane are pink red flush.

Слайд 26 Alterations of metabolism and function
Respiratory system
Circulatory system
Hematologic system
Central

nervous system
Tissues and cells

Слайд 27 Respiratory system
Compensatory response
Low PaO2 stimulates the chemoreceptor in

Respiratory systemCompensatory responseLow PaO2 stimulates the chemoreceptor in carotid and aortic

carotid and aortic body, which reflexly causes ventilation to

increase.

Слайд 28 High altitude pulmonary edema
Central respiratory failure
respiratory

inhibition, irregular respiratory rhythm and frequency, hypoventilation, e.g. periodic

breathing, Cheyne-Stoke respiration, Biot’s breathing

Injury manifestation

Слайд 29 Circulatory system
Compensatory response
Increased cardiac output

hyperventilation and pulmonary expansion stimulate lung stretch receptors, which

reflexly excite sympathetic nerve.
Pulmonary vasoconstriction
Ca2+ influx↑, the action of vasoconstrictive substances and SN

Слайд 30 Redistribution of blood
vasodilatation : heart

Redistribution of blood vasodilatation : heart and brain hypoxia

and brain
hypoxia metabolites, lactic acid,

adenosine
Ca2+ influx↓
vasoconstriction : skin, kidney,
gastrointestinal tract

Capillary hyperplasia
HIF→VEGF

Слайд 31 Injury manifestation
Pulmonary hypertension
Decreased diastolic and systolic myocardial function
Arrhythmia

Vagus Nerve
Decreased

venous return to heart
severe hypoxia

Слайд 32 Hematologic system
Compensatory response
Increase in the amount of RBCs

and Hb
More EPO produced and released

by kidney
Improved RBC oxygen release capability
More 2,3-DPG produced from glycolysis process

Слайд 33 Plasma viscosity↑, blood flow resistance ↑, afterload of

Plasma viscosity↑, blood flow resistance ↑, afterload of heart ↑When PO2

heart ↑
When PO2 is low markedly, 2,3-DPG will cause

CaO2 to decrease.

Injury manifestation

Слайд 34 Central nervous system
Acute hypoxia: headache, agitation, poor

faculty of memory, inability to make judgment, depress or

loss of coordination
Chronic hypoxia: impaired concentration, fatigue, drowsiness
cerebral edema and neuron injury

Слайд 35 Tissues and cells
Compensatory response
Enhanced cell capacity for use

of oxygen
number and membrane surface of

mitochondria↑
activity of succinic dehydrogenase and cyt-oxidase ↑
Enhanced anaerobic glycolysis
ATP↓ and ATP/ADP ↓→phosphofructokinase ↑
Enhanced myoglobin
Low metabolic state