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UH KIN 3304 - Mountain Physiology

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KIN 3304 1nd Edition Lecture 30Outline of Last Lecture I. Why Asthma Makes it Hard to BreathII. What is AsthmaIII. The Plugged Garden Hose AnalogyIV. Asthma-Related SymptomsV. Asthma StatisticsVI. Causes of AsthmaVII. Triggers includeVIII. The “Hygiene Hypothesis”IX. The Couch Potato HypothesisX. Hallmarks of Asthma PathogenesisXI. The Asthmatic LungXII. Asthma: A Two-phase Inflammatory Trigger ResponseXIII. What are the cell types implicated in the phases of asthmaXIV. Role of Mast Cells and IgE in AsthmaXV. Association of Atropy with AsthmaXVI. T-helper cells: Th1, Th2XVII. Asthma Susceptible GenesXVIII. FEV1/FVC Measurements in Asthma LungThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.XIX. Therapeutic Side EffectsOutline of Current Lecture I. What is High AltitudeII. Why Can’t We Breath?III. Getting Up ThereIV. Why is Going Up a Mountain (and coming down) so Dangerous?V. What Challenges Do We See?VI. Possible TQVII. Acute Mountain SicknessVIII. Another Possible TQIX. High Altitude Cerebral EdemaX. HACE continuedCurrent LectureI. What is High Altitudea. High Altitude: 5,000 – 8,000 b. Very High Altitude: 11,500 – 18,000 c. Extreme Altitude: 18,000 – 30,000II. Why Can’t We Breath?a. There is less partial pressure, not less O2III. Getting Up Therea. You are in a -70 degrees hurricaneb. In a picture, what see surrounding it is jet streamIV. Why is Going Up a Mountain (and coming down) so Dangerous?a. Acute Mountain Sickness (AMS)b. High-Altitude Cerebral Edema (HACE)c. High-Altitude Pulmonary Edema (HAPE)d. Other stuff: frostbite, avalanche, falls, stormsV. What Challenges Do We See?a. Locationb. Politicalc. CostVI. Possible TQ:a. Physiologically, why are you more likely to die going down a mountain than goingup the mountain?VII. Acute Mountain Sicknessa. Caused by decreased air pressure and O2i. Faster ascent = increased AMS (b/c less time to adjust)1. Increased risk if you live at lower elevation2. Increased risk if you’ve had AMS beforeb. Symptomsi. Poor sleep, dizzy, fatigue1. Decreased appetite 2. Shortness of breath3. Increased HR (b/c need more O2 to brain/body)c. More Severe AMSi. Cyanosis (people turn blue)ii. Cough up blood (vessels burst in lungs)iii. Confusioniv. Non-ambulatory (can’t walk right)d. Treatmenti. Descendii. Supplementary O21. Ventilator sometimes necessaryiii. Drugs1. Sildenafil (phosphodiesterase inhibitor)a. Increases blood flow to lungs2. Beta-Agonist a. Opens airwaysb. Diamox (drug)i. Helps with breathingii. Increases urinatione. Prognosisi. Mild cases (most are mild)1. Should be okay following descent 2. Severe cases: death is possible (HACE, HAPE)ii. Caveat: most high-altitude areas are very remote1. Hospital care unlikelyiii. Who will help you?1. Climbers wont turn back to helpf. Preventioni. Ascend slowly1. In high-altitude climbing, its unlikely to do soii. Frequent Stops1. Rest 1-2 days every 600m (2,000 ft.)iii. Supplemental O2 above 3000m (10,000 ft.)iv. Eat, drink water1. Hard to do without appetite VIII. Another Possible TQa. You’re suffering from moderately severe frostbite in your fingers with 3 days of climbing to go. Why is it better to keep them frozen?i. B/c as soon as you thaw them out, they’ll freeze againIX. High Altitude Cerebral Edema (HACE)a. Usually 2nd degree to AMSi. Climb K2, you will probably already have AMSb. Disturbances in consciousness c. Can progress rapidlyi. Psychiatric changes, gait changes, confusion, comad. Rare, but high morbidity, some mortalitye. Things he said about HACEi. At high altitude, you leak fluidii. Gets depositioned in brain cavityiii. Swells, constricts, wont get O2iv. Brain diesf. Can occur as low as 200mi. Most common in abrupt ascent above 3000mg. Can occur in well-acclimated climbers above 2000mh. More likely in those with HAPE (studies)i. Frequent Alps: 13% of patients with HAPE had stupor, comaii. Rockies: 1 in 7 with HAPE had HACE X. HACE continueda. Developmenti. AMS to HACE usually takes 24-36 hoursii. As little as a few hours at extreme altitudeb. Presentationi. Change in consciousness, gait1. Progressive AMS over 24-48 hoursii. Usually (not always) with headacheiii. Drowsiness appearsiv. Victim withdrawn, apatheticv. Inability to care for oneselfvi. Confusion1. Stripping off clothesvii. Anorexia (almost always), nausea, comaviii. “If patient seems mildly drunk at altitude”c. Treatmenti. If coma develops, they’re going to dieii. Similar to AMS – get them down1. O2, hyperbaric bag2. Large steroid dose (dexamethasome)3. Severe cases – decrease intracranial pressureiii. Hospitalization ASAP1. 4-5 days is


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UH KIN 3304 - Mountain Physiology

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