SPACE PHYSIOLOGY

med2016sectionb/Dra. Carina Gomez

BAROMETRIC PRESSURE (SEA LEVEL) - 760 mm Hg PARTIAL PRESSURES OF DIFFERENT GASES OXYGEN - 21% - 159 mmHg (160) CARBON DIOXIDE - 0.04 % - 0.3 mmHg NITROGEN - 78 % - 593 mmHg OTHERS - 0.92 % 7 mmHg Normal Alveolar Oxygen = 104 mmHg (in the blood, 95 97 mmHg) As you go up, the barometric pressure decreases, and so as the saturation. (Some values were mentioned unfortunately I do not have a copy of the table.) Water Vapor Pressure (37C ) = 47 mmHg PCO2 = 40 mmHg (unacclimatized ) = 7 mmHg (acclimatized)

POTENTIAL PROBLEMS in high altitude: Low oxygen pressure Acceleratory forces Weightlessness According to Boyles law, when you decrease the volume, the pressure increases (Deep sea physiology). In Space physiology since the volume increases, the pressure decreases. ALTITUDE BAROMETRIC PRESSURE PO2 ALVEOLAR O2

HYPOXIA As you increase the altitude, barometric pressure decreases. Since PO2 is taken from barometric pressure (plus fractional gas concentration), PO2 also decreases. If po2 in the atmospheric air is decreased (not only the oxygen but also all other gases like nitrogen, but the decrease in nitrogen does not have a deleterious effect on the body unlike the oxygen which has a serious effect), the oxygen is decreased. So when you decrease the oxygen in the alveolar area, according to Henrys Law, the oxygen level in the blood is also decreased (a condition known as hypoxemia). If in low altitude the major problem is oxygen toxicity, in high altitude, the major problem is HYPOXIA. For every 5, 500 miles, you decrease the barometric pressure by . Therefore, if the atmospheric air at sea level is 760 mmHg, at 5,500 miles increased in altitude, the pressure becomes 380 mmHg. Another 5,500 miles, it becomes 190 mmHg and so on Note: In deep sea physiology, for every 10 meters, theres an increase in the barometric pressure by 1.

EX: Top of Mount Everest ( 29,028 ft. ) Barometric pressure = 253 mmHg
Unacclimatized Person Acclimatized Person 253 mmHg Acclimatization mmHg because it can increase the 253 is important alveolar PaO2 up to 40 mmHg, thereby lowering the
effect of hypoxia. ACUTE EFFECTS OF HYPOXIA Severity depends on the height. As you increase the height, manifestations become severe. 12,000 ft. a. b. c. d. drowsiness lassitude mental and muscle fatigue headache , nausea and euphoria ( occasional )

18,000 ft. ( above ) a. twitchings med2016sectionb 1

b. seizures Effects of Decreased Barometric Pressure 23,000 ft. ( above ) a. coma ( unacclimatized ) Other important effects of hypoxia b. ( mental proficiency ) c. decreased judgment d. decreased memory e. decreased motor movements (Decrease work capacity) ACCLIMATIZATION TO LOW PO2 (Means, you have to increase tolerance to hypoxia same as ing altitude tolerance. It should be done slowly.) Acclimatization Processes: 1. increase in pulmonary ventilation 2. increase in red blood cells and hemoglobin 3. increase diffusing capacity of the lungs 4. increase capillarity; increase tissue vascularity (angiogenesis) 5. cellular acclimatization Increase in Pulmonary Ventilation hypoxic stimulation of peripheral chemoreceptors increasing respiratory stimulatory activity of respiratory center

PO2

barometric pressure

increase in alveolar ventilation ( 65 % ). Why not 100 %? You cannot increase or double it because when you hyperventilate you blow off co2. If you blow off co2, you decrease the H+ and you increase the ph, and this will counteract the effect of hypoxia. In fact, theres a day you inhibit the respiratory center about 25 days, you cannot increase to 100% because it is prevented by this level. Why only 2-5 days? Because renal has a long term effect. Kidneys will excrete bicarbonates to normalize the pH. reduction in PCO2 and increasing pH

Hypoxia means low oxygen level; oxygen can only act at peripheral chemoreceptors thats why it is the least potent, causing increase ventilation. Increase in Red Blood Cells and Hemoglobin Concentration average increase in hemoglobin concentration from 15 g/dL to 20 g/dL increase in hematocrit 40 to 60 increase in blood volume by 20 30 % ( Hgb )

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Definitely, the major reason is the increase in pressure in the lungs because of the increase in lung volume and capillary blood volume.

Increase in Diffusing Capacity increase pulmonary capillary blood volume and lung volume

Increase in Tissue Capillarity Increase in CO by 30 % but this decreases back to normal as Hct increases. increased capillarity = increase in the number of systemic circulatory capillaries in the nonpulmonary tissue ( R ventricle ) brought about by angiogenesis Cellular Acclimatization increase in the number of mitochondria increase in myoglobin that facilitates the movement of O2 in tissues. increase in tissue content of cytochrome oxidase (involved in oxidative phosphorylation) Other changes: o increase in chest size (those living in high altitude have increased AP diameter of the chest) o right ventricular hypertrophy (hypoxiavasodilatation in all areas except in the lungs- vasoconstriction in the lungs increased TPR-increased lung pressurehigh afterload in the lungs increased thickness of the RV----RVH) ACUTE MOUNTAIN SICKNESS AND HIGH-ALTITUDE PULMONARY EDEMA ( HAPE ) acute because it develops 8 24 hours after rapid ascent to high altitude and lasts 4 8 days. Increased vasodilatation means increased capillary permeability causing edema. Brain is most commonly affected (cerebral edema). characterized by: o headache o nausea and vomiting o irritability o insomia o breathlessness

increase surface area for oxygen diffusion increase pulmonary arterial pressure

Diffusing capacity of O2: 21 ml/mmHg/min at a pressure of 104 mmHg (alveolar pressure). In the blood you have 40, so a gradient of 64. The major factor that determines the diffusing capacity of oxygen is the gradient. The problem is, the partial pressure is decreased, so the pressure gradient is also decreased. Normally, not all capillary beds are open. In case of hypoxia, you expand the blood volume. Increasing the blood volume will open some of the closed capillaries. If you increase the perfusion, diffusion will increase. Increased capillary blood volume and lung volume are the primary reasons why theres an increase in diffusing capacity.

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 altitude

Acceleratory forces due to rapid changes in velocity and direction of motion in airplane and spacecraft. types: o linear accelaration o deceleration o centrifugal accereleration (if you are rotating in an orbit)

Why do you have pulmonary edema when in fact you have vasoconstriction? It is because: FIRST, vasoconstriction happens only to those that are hypoxic. Some of the alveoli are not hypoxic, therefore blood will be diverted to them causing localized edema . SECOND, it is due to increase pressure due to pulmonary hypertension increasing the CHP, promoting filtration. Therefore, the MAJOR PROBLEM could be either Cerebral Edema or Pulmonary Edema HAPE is the most severe form of acute mountain sickness

mv2 Centrifugal acceleratory forces = ---------R This is the force that is equal to mass times the square velocity over radius. This means that when you are rotating in a smaller area, the greater the force; the greater the mass and velocity, the greater the force.

measured in G forces + 1G + 2G + 3G

= weight = - 1G = 2X = - 2G = 3X = - 3G

CHRONIC MOUNTAIN SICKNESS -exposure to hypoxia for a long time Features: red cell mass and hematocrit become exceptionally high - blood viscosity increase resistance - tissue blood flow (ischemia) hypoxia- pulmonary vasoconstriction -elevation of pulmonary arterial pressure - hypoxic pulmonary vasoconstriction Right side of the heart greatly enlarged - pulmonary arterial pressurepulmonary hypertension right ventricular enlargement Peripheral arterial pressure begins to fallleading to systemic hypotension due to vasodilation secondary from hypoxia Congestive heart failure ensues Then, Death EFFECTS OF ACCELERATORY FORCES ON THE BODY med2016sectionb

If you go up and are pushed towards a chair, that is positive G. if you are pulled, then that is equivalent to negative G.

Effects of Centrifugal Force on the Body

hypoxic stimulation of the chemoreceptor

If you suddenly ascend, by gravity, blood will be pulled down. Blood is translocated in the lower extremityies increasing the CHP, causing pedal edema. Blood flow to the head is decreased resulting to blackout of vision and neurologic manifestations.

pulmonary ventilation

If you are on earth, the tone of the muscle in the lower part of the body is higher than the upper part of the body. If you go up, the peripheral pooling of blood/body fluids will be in the upper extremities since the tone of the muscle in the lower part of the body is still higher than the upper part of the body.

Why damaging? Because if you go down suddenly, by inertia, blood will be translocated upward causing high pressure in the brain resulting to cerebral edema and redout which may progress to permanent blindness (jaymart: nagrered yung vision? Oh my god!!!)

decrease physical activity-you basically cannot move normally, this would result to: Decrease blood volume Decrease cardiac output Decrease Ca++ and PO4(immobility osteoporosis) Decrease ABP Constipation

PROTECTION from acceleratory forces tightening of the abdominal muscle ( +G ) use anti G suits ( + G ) used by astronauts making them protected from G forces. They are also in reclining position when going up, which prevents translocation of blood in the lower limbs. (jaymart: aaahhh talaga????) Effects of Linear Acceleratory Forces deleterious effects are prevented by semireclining position.

WEIGHTLESSNESS experienced when a person is in orbiting satellite or a non propelled spacecraft. person is not drawn to the bottom, sides or top of the spacecraft but simply float inside the chamber. cause is not due to failure of gravity to pull on the body Problems: o motion sickness- major problem o translocation of fluids in the body-even if theres no gravity, fluid is translocated at the UPPER PART of the body med2016sectionb 5