SUBJECT: PHYSIOLOGY

TOPIC: Environmental Physiology

(Human Body and Environment)

LECTURER: DR. DEXTER SANTOS

DATE: MARCH 2011

This lecture will discuss the reaction of the human body And if you convert that into an inverted container full of air
when you go deep sea diving, go to higher altitudes, when at sea level, you will observe that as you go deeper, you
you board an aircraft, and when you go to outer space. compress the air even more.

Again, concepts involved are: At about 33 ft (10m) = 2 atm  You can see that you seem
to compress the air into ―half‖ of the container. This makes
 Deep sea dive the molecules of air come closer together.
 In high altitudes
 Aviation So what‘s the translation of this in terms of the human
 Go to space body?
Certain parts of your body are filled with air, such as your
DEEP SEA DIVING lungs, sinuses, etc. The gas laws come into play as well.

Deep sea diving is all about changes in pressure and the GAS LAWS
effect of that change in pressure on the human body.
1. BOYLE‘S LAW
 Sea Level “At constant temperature, there is inverse relation of
Normal atmospheric pressure and gas volume.”
1 atm = 760 mmHg
pressure at sea level  Therefore, if you increase the pressure, the
volume decreases.
This is the amount of force exerted by the entire
atmosphere at sea level. This all the way from the sea level
up to the very outer limits of atmosphere, bordering space. Pressure ≈ Volume

However, it‘s a different story underwater. At just 33 ft

(≈10m), you already double the pressure to 2 atm. At a 100
ft, you have 4 atm of pressure already. And at a 100 ft, or 2. HENRY‘S LAW
30+ meters, this is actually already the limit of recreational “At constant temperature, the amount of gas dissolved
diving. in a given type and volume of liquid is directly
proportional to the partial pressure of that gas in
 Underwater equilibrium with that liquid.”
33 ft (10 m) 2 atm
66 ft (20 m) 3 atm Or in a simpler way, “the mass of a gas which dissolves
100 ft (≈30 m) 4 atm in a volume of liquid is proportional to the pressure of
the gas.”
LIMIT OF RECREATIONAL DIVING!
(Though there are still other divers that go a lot deeper than this) Henry‘s Law and Scuba Diving:

At higher pressure our bodies will absorb more gases. At

great depths, the amount of nitrogen (and other gases)
absorbed into our blood and tissue is greater than the
amount absorbed at shallow depths. That is why a diver
going to 100' has a greater risk of decompression illness
than a diver who dives only 30 feet. Since the shallow
diver has absorbed less gas, it is less likely to come out
of solution in the body.

Taken from: http://www.thescubaguide.com/certification/henrys-

law.aspx (emphases by STD)

*see following text for explanation

PHYSIOLOGY: Human Body and Environment 1

EFFECTS ON THE BODY (Minor Systems)
1, Air trapped in the ears:
(Especially the air trapped in the middle ear!)
As you go deeper, that pressure exerted on the
tympanic membrane compresses the air inside the
middle ear. This must be equalized by opening the
Eustachian tube, which you do by swallowing or by
pinching the nostrils then exhaling forcefully. This
is what divers do.
2. ―Tooth Squeeze‖
For those who had some procedures done on their
teeth. For example, a pasta done years ago and
right now the seals are no longer in tact, so there is
air inside the teeth. This is what we call a tooth
squeeze. Once you go underwater, you will feel
pain in your teeth.
3. Colds (or Upper Respiratory Tract Infections)
There is impaired opening and closing of the
Eustachian tube. Thus, you feel pain pressing on
your ears because of the pressure.
4. Sinuses
These are also air-filled parts of the body.
So it‘s a rule for divers that:
Don‘t dive if with Upper Respiratory Tract Infections.
Because you will just feel pain in all your air-filled spaces
(e.g. sinuses, middle ear) and it can also be dangerous
underwater.
EFFECT ON THE BODY (Major System)
The main system in focus here is the Respiratory System.
Above sea level (normal state), the normal pressure of
Oxygen is 159, and the normal pressure of Nitrogen is
around 600. And once this translates to the bloodstream,
you have a pO2 of 60, whereas the Nitrogen remains the
same because it equilibrates much more readily as
compared to oxygen.
At the (Equivalent in) the
Alveolus Bloodstream
Normal pressure of oxygen
(pO2)= 159 pO2= 60
Normal pressure of nitrogen
(pN2)= 601 pN2= 601
(just the same as alveolus)
But let‘s say that you had a recreational diving at 100 ft,
therefore:
At 100 ft: 4 atm, you now have a pO2 of 620 instead of
159 (so approximately 4x that of normal pO2 as well). The
level of oxygen in the blood stays the same or at a
normal range. However, the nitrogen increases because
there is no mechanism for buffering nitrogen in the blood.
PHYSIOLOGY: Human Body and Environment
So what happens is that the nitrogen gets dissolved in the
bloodstream. (You have nitrogen floating around).
But as you go beyond recreational diving, say about 250 ft
(≈8.5 atm), then you have more pressures of the gases.
Alveolus Bloodstream
Normal pressure of oxygen
(pO2)= 1400 pO2= >120
Normal pressure of nitrogen
(pN2)= 4970 pN2= 4970
When the buffering mechanism of your oxygen also fails
(especially beyond 4 atm), you will have dangerously high
levels of oxygen and nitrogen in the bloodstream. This will
lead to a state called Nitrogen Narcosis.
 Nitrogen Narcosis
Caused by too much nitrogen dissolved in your blood and it
gets dissolved in the fatty substances of neuronal
membranes therefore altering the conduction and
excitability.
 Symptoms of this include:
o Drowsiness
o Loss of strength
o Clumsiness
o Loss of consciousness (if you stay
there much longer)
Nitrogen Narcosis is common in individuals who rapidly
descend during diving. Because of this, ROS (Reactive
Oxygen Species) are formed, especially in deep waters.
As for oxygen, recall that you now also have dangerously
high levels of oxygen in the blood too. This leads to the
formation of reactive oxygen species (ROS). The
hemoglobin can buffer the excess oxygen initially, but if
your oxygen levels keep increasing, your hemoglobin will
not be able to accommodate this anymore. This will result
to oxygen getting dissolved in the blood directly, rather than
it being carried by hemoglobin. = Oxygen Toxicity.
Quantity of oxygen dissolved in the fluid of the blood and in combination
with hemoglobin at very high PO2s.
2
 Oxygen Toxicity
Due to the formation of reactive oxygen species (aka free
radicals) and this oxidizes lipid membranes.
 Symptoms include:
o Nausea
o Muscle twitching
o Dizziness
o Seizures
o Coma
The buffering of ROS by enzymes fails above 2 atm of pO2..
You can also have pulmonary edema and atelectasis
(collapse of the lungs) due to the direct effect of high
oxygen pressure.
The No Decompression Dive Table This shows the depth in
These rarely happen if you just stay at the level of meters and the number of minutes that you are allowed to
recreational diving (100 ft). BUT even in recreational diving, stay in such depth. This just shows how much time you‟re
you can experience a lot of problems: allowed at each depth. This is already quite obsolete!
Because gizmos (guide computers) are now being used.
Case 1. Let‘s say you lingered at a hundred feet down for
about a few minutes and your nitrogen gets dissolved in Conditions for No Decompression Dives
your bloodstream. Suddenly, there is an undercurrent that (This means a “very safe” dive.)
took you to the surface from 100 ft (4 atm) to suddenly  Stay within recreational limits
ascend to sea level (1 atm).  Never hold your breath
Continuous breathing is the only way for you to
So what will happen now? get rid of your excess gases.
 Ascend slowly (1ft/s)
The pressure that is exerting on the body (which dissolved  Perform safety stops
the nitrogen in the first place) suddenly decreases. What Wherein you stop at prescribed depths (about
happens is that you did not allow enough time for the 5 mins at 5-6 meters) just to eliminate the
nitrogen in the body to be exhaled, thus forming nitrogen excess gases.
bubbles. This can consequently cause decompression  Plan your dives (deepest dives first)
sickness.  Buy a dive computer

Decompression Sickness For very deep dives:

Caused by nitrogen bubbles forming in the blood vessels,
so they block the vessels and thus cause tissue ischemia
and tissue death.
The symptoms can range from very painful joint pains
(called ‗the bends‘) and dizziness to unconsciousness and
fatal pulmonary edema (called ‗the chokes‘).
(Such as what they use in the navy.)
 Use a helium-oxygen mixture because helium
equilibrates rapidly and gets expelled much more
rapidly compared to nitrogen. Moreover, you
receive less oxygen percentage to avoid oxygen
toxicity as well.

**Some divers long ago, before the advent of high-tech

diving gear, get the bends to the point of being paralyzed
because the joints get destroyed by the tissue ischemia.

The dissolved nitrogen in the body needs to be excreted!

But how?
1. Breathe. Just breathe it out.
2. Give it enough time.
This is also why there is a “No fly” time,
wherein you cannot board an aircraft for
24 hours after the dive because low
pressure in the atmosphere (even if that‟s
a pressurized chamber) can trigger more
nitrogen bubbles to form.
Treatment:
- Inhaling 100% oxygen Decompression Chamber. Divers spend much time in the
- Go to a decompression chamber chamber after a dive to prevent abrupt changes in pressure
and to prevent accumulation of Nitrogen Bubbles.

PHYSIOLOGY: Human Body and Environment 3

This is usually most useful or applicable in rescue or
emergency situations wherein one has to ascend rapidly
and safety stops cannot be observed anymore. Once the
diver is inside the decompression chamber, they once
again increase the pressure or mimic the pressure beneath
the water, and slowly decrease the pressure as time goes
by. This procedure somewhat „mimics‟ the gradual ascend
that you should have done in the first place. Again, this
eliminates the chances of nitrogen bubbles forming.
(It must be remembered that rapid ascents must be
avoided as much as possible so as to prevent nitrogen
bubbles from occurring.)
Carbon Dioxide
The pCO2 in the alveoli remains constant (at 40mmHg)
 Standard dive equipment:
So you have the mask + breathing apparatus. But
what actually happens when you exhale is that you
exhale the carbon dioxide so that it will not
accumulate. However, there are masks such as
this:
The primeval dive equipment that is attached to a
hose to the surface. This has a closed-circuit setup
and this can have a danger of CO2 accumulation.
Even modern dive equipment such as the
rebreathing apparatus can pose a risk.
What is the rebreathing apparatus for?
There are some divers who do not like bubbles
when they dive (e.g. photographers, water
videographers); they do not want their exhaled
bubbles to get in the way of their craft. So they
wear these rebreathers. They recycle the air, wear
smaller tanks so that they‘re more mobile. This can
also pose a risk for carbon dioxide accumulation.
 Again, Special masks, rebreather masks, 1st
generation dive helmets: Dangerous accumulation
of CO2 (80 mmHg)
CO2 accumulation can result to Respiratory Acidosis
o Signs: Lethargy, narcosis, anesthesia, and
eventually respiratory depression
SUBMARINES
 Escaping from submerged submarines (such as
those seen in old James Bond films)
o Possible at 300 feet without assistance
PHYSIOLOGY: Human Body and Environment
o Possible at 600 feet with rebreathing
apparatus
o Continually exhale to prevent lung
overexpansion
 If you don‘t exhale, your lungs will
burst! Because when in the
submarine, your lungs are
actually holding about 5 to 6x
more air than if you were at sea
level (due to the pressure present
in the sub). So if you suddenly
escape from that, you have about
6x more air than normal in your
lungs! If you don‘t exhale it, your
lungs will burst by the time you
get up. (Events such as
pneumothorax may occur).
 Inside the submarine:
o Danger of radiation
o Danger of accumulation of gases:
 Carbon Monoxide
 Freon
HYPERBARIC OXYGEN THERAPY
High oxygen pressure is not all bad news. We actually use
this to treat certain diseases such as gas gangrene, which
involves anaerobic organisms. Anaerobic, meaning they
thrive on low oxygen environment. Therefore, when you give
high doses of oxygen, they die.
 Administered in pO2 of 2-3 atm
 Medically used in treatment of:
o Gas gangrene
o Decompression sickness
o Carbon monoxide poisoning
o Osteomyelitis
o Myocardial infarction
HIGH ALTITUDE PHYSIOLOGY
This is like the opposite of ‗underwater‘. This time, you go
very high up, such as in the mountains. Again, this is all
about pressure.
 Air pressure changes
 Physiologic effects of low air pressure on the body
 Diseases that can arise from low air pressure
environment
If underwater the problem was high pressure, ―up‖ there,
the problem is low pressure.
 At sea level,760 mmHg (pO2 = 159 mmHg)
By 10,000 ft, 523 mmHg (pO2 = 110 mmHg)
At 30,000 ft, 226 mmHg (pO2 = 47 mmHg)
At 30, 000 ft, which is about the height of Everest, you only
get just a little less of a third of what you should normally
breathe when you‟re at sea level. This is usually where the
problem arises for low oxygen tension.
ALTITUDE AND ARTERIAL OXYGEN
As we go higher, the amount of oxygen in the blood
dramatically decreases. This is why mountain climbers wear
rebreather masks and oxygen tanks – so that even at 30,
4
000 ft, they can have a very good oxygen saturation in their chemoreceptor neurons. Once this happens, you will have
blood. full respiratory stimulation. (So you‘ll breathe deeper, you
can breathe much faster, you‘ll recruit more alveoli, and in
Increase in height Decrease in oxygen in the total increase your pulmonary ventilation).
blood
Recap:

EFFECTS OF LOW ARTERIAL OXYGEN TENSION

 At 12,000 ft:
 Drowsiness, headaches
 Mental and muscle fatigue

 18,000 feet
 Seizures and muscle twitching

 23,000 feet (wherein you have only about 60% O2

saturation)
 Coma and death  Increase in RBCs and Hemoglobin Levels
o Develop this if you have hypoxia for
Other symptoms: Poor judgment, poor memory, and poor weeks; Haematocrit and hemoglobin
mental proficiency increases
 Increase in oxygen diffusing capacity
Why do a lot of people live in the mountains?
o Increase in pulmonary capillaries
Acclimatization
o Increase in pulmonary arterial blood
The process of physiologically adapting to the low
pressure
oxygen environment.
So what is the mechanism behind your increase in
So as you go up, you have an increase in pulmonary
hemoglobin/ RBCs?
ventilation. This means you breathe much deeper and you
recruit more alveoli. To some point, you also increase your
respiratory rate, and increase RBC counts. There is also an
increase in the vascularity of your tissues.

When you have more blood vessels in your tissues, you

increase the capability of that organ to extract oxygen from
the low oxygen environment.

Increase in Pulmonary Ventilation:

 Takes about 5 days for lungs to adapt.

For example, on the 1st day you have about 1.6x the normal
amount of ventilation (breathing rate, etc). The low pO2 is
then actually sensed by the receptors, therefore increasing
ventilation. BUT if you increase ventilation, remember that
you also consequently blow off carbon dioxide. This low Hormone responsible is your erythropoietin. The main
carbon dioxide environment inhibits your oxygen sensors so trigger for its release is hypoxia or low oxygen. This is
that your ventilation gets subdued. However, if you stay sensed by the kidneys  release erythropoietin stimulate
longer and you keep blowing off your carbon dioxide, your stem cells  eventually end up with more RBCs.
bicarbonate production also decreases. This decrease in
bicarbonate is also sensed around the central

PHYSIOLOGY: Human Body and Environment 5

  Tissue and cellular changes:
o Increase in capillarity
Hypoxia is also a trigger for
angiogenesis. You have increased
extraction and utilization of oxygen
from the blood.
And when there is an increase in
hypoxia, you release the HIF (hypoxia
inducible factor) which is a
transcription factor. Eventually you
will produce more VEGF (vascular
epithelial growth factor). The VEGF is
the ligand for the angiogenesis or
new blood vessel formation. And at
normal oxygen levels, that
transcription factor is bound to the
VHL protein so that it is not available
for transcription.
o Increased quantity of mitochondria and
cellular oxidative enzymes
o Increased extraction and utilization of
oxygen from the blood
At certain amount of pO2, the mountain dweller will have a
higher amount of oxygen saturation compared to a sea
dweller. And as you go up (decrease the oxygen), the
mountain dwellers are still able to retain oxygen in their
blood as compared to sea level dwellers. This is
accomplished by all the things that was mentioned in the
process of acclimatization.
Mountain dweller: high amount of oxygen saturation! Also:
 Increase in Cardiac Output (30%)
o Goes back to normal in weeks as
haematocrit rises
PHYSIOLOGY: Human Body and Environment
o In the short term, the haematocrit does
not rise agad, and it is your heart that
compensates for that. It contracts more
forcefully to meet the demands of the
tissues and the organs.
 Increase respiratory rate
 Increase diffusing capacity in lungs
 Increase vascularity of peripheral tissues
 Increase ability to extract oxygen
MOUNTAIN SICKNESS:
Acute:
- Acute cerebral edema from vasodilation of
cerebral arterial blood vessels
 Symptoms: disorientation, coma, death
- Acute pulmonary edema
Chronic Mountain Sickness:
- Increase in red cell mass and this
consequently increases blood viscosity
Pulmonary Artery Vasoconstriction
- Induced by hypoxia also
- An increase in this will result to increased right
ventricular afterload
Both lead to HEART FAILURE. Since ang lapot na ng blood
and ang taas ng pressure na kailangan niya i-overcome
just to pump the blood, mapapagod si heart = FAILURE </3
Treatment:
- Bring to low altitude
- Oxygen therapy
AVIATION AND SPACE PHYSIOLOGY
Concerned about the:
- Effects of acceleratory forces on the body
- Physiologic changes on zero gravity
Accelerations:
 Centrifugal acceleration
This is what happens when an aircraft does an
inner loop. What happens is that the blood (or
your fluids) gets pooled in the lower
extremities.
 Linear acceleration (during blast off)
 Linear deceleration (end of flight of braking)
Like when you suddenly step on the breaks
THE G FORCE
 Measurement of acceleratory forces
 Can be both positive and negative centrifugal force
POSITIVE G
 On ground: +1G
Or 1 x your gravity. You weigh 100 lbs; outside sea
level you also weigh 100 lbs. However, if you do an
inner loop..
Inner loop
You can have as much as +5G (5 times heavier)
6
 If you weigh 100 lbs, when the aircraft does the  Strain on bones, some can have vertebral fractures
inner loop, you suddenly feel that you weigh over (at +20G)
500 lbs heavier.
Effects of Centrifugal Acceleratory Forces on the Body (-G)
NEGATIVE G  Less dramatic but possibly more damaging
Force that holds down the body on descent or when an  Blood is centrifuged to the head
aircraft does an outer loop.  -20G; 300-400 mmHg of cranial blood pressure
This is similar to the force holding you down when going  Sometimes causing blood vessels to rupture
down the roller coaster.
 Pressure is cushioned by CSF
Blast off of spacecraft, force can amount to as much as 9G
 Eyes may develop intense hyperemia (red-out)
F=centrifugal acceleratory force
M=mass
During Lift-Off:
V=velocity
 Linear acceleratory force
R=radium
 Acceleration as high as 9G
Formula: F = mv2/r  To withstand this amount of acceleration, semi-
reclining positions transverse (perpendicular) to
Effects on Centrifugal Acceleratory Forces on the Body the axis of acceleration is employed.
 Blood is centrifuged towards the lower parts of the
During Re-entry
body
 There is linear deceleration
 Venous blood pressure of lower extremities
increases (about 450 mmHg at 5G)  Amount of energy to be dispelled is proportional to
square of velocity
 You will have a decrease in your preload (venous
return); the blood that is going back to the right  Must be accomplished much more slowly from
side of your heart decreases. high velocities
o Decrease in contractility and decrease in
cardiac output.

At +4G - +6G, this may result in a black out (loss of

consciousness). BUT as soon as circulation is restored, it‘s
as if nothing has happened!

Initially, there will be a drop in blood pressure but as long
as processes of body are intact, the blood pressure will go
back to normal.
Aviators have developed G-suits to counter the effects of
great amounts of G force.
Radiation in Space
Most shuttle missions are in the magnetosphere which is
protected from radiation
 1 year on mountains: 200-550 mR
 1 year at sea level: 100 mR
 Typical space shuttle mission: 559 mR
 Skylab mission (87 days): 17,800mR
Effects: skin reddening, nausea/vomiting, retinal flashes
Protections: space suits, protective metals (aluminum belt),
electromagnetic field

How to Counteract +G WEIGHTLESSNESS

 Abdominal tightening  State of near zero G force (microgravity)
 Use of special G suits
 Water suits Physiologic effects:
Motion sickness
Body weight:  First 2-5 days
 +1G  60kg  Unfamiliar motion signals being sensed by
 +2G  120kg equilibrium centers (places inside the ear such as
 +3G  180kg cilia, cochlea, etc.)
 Lacks gravitation signals
Other effects (+G):
 Undue strain on muscles

PHYSIOLOGY: Human Body and Environment 7

Translocation of fluids
 Due to failure of gravity to cause the normal
hydrostatic pressure
o Decrease in:
 blood volume, red blood cell
mass, maximum CO
o Impaired baroreceptor reflexes
o Reduced work capacity
Diminished physical activity
 Causes decrease in muscle strength
 Loss of Calcium and Phosphate in bones
 Ultimate atrophy of cardiac and skeletal muscles

Solutions
 Exercise programs for the astronauts
 Administering artificial gravity inside the space
shuttle

—END OF TRANSCRIPTION—

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PHYSIOLOGY: Human Body and Environment 8