N E I L A R M S T R O N G 1 9 6 9

A P O L L O M I S S I O N T O M O O N

“One

small step for man; one giant leap for mankind”
-

Neil Armstrong, 1969. -First man on the moon. -First words spoken on the moon.

HIGH ALTITUDE PHYSIOLOGY
By Dr. M. Anthony David MD, Professor of Physiology

RESPIRATION IN UNUSUAL ENVIRONMENTS: I

ALTITUDES & HEIGHTS
 

Normally most people on earth stay at around the Mean Sea Level (MSL) However, groups of people stay at higher than normal attitudes. The Sherpas, a mountain tribe of Himalayas live at around 5500 Meters above MSL, normally. When people living around MSL go up to higher altitudes, changes occur in their physiology, especially in Respiration.

BAROMETRIC PRESSURE CHANGES IN HIGH ALTITUDE

As the altitude increases above the sea level, the corresponding atmospheric pressure decreases. The partial pressure of Oxygen also decreases. The arterial Oxygen saturation levels also decrease with increase in the altitude.

ALTITUDE, PRESSURE & PO2
ALTITUDE (feet) 0 (MSL) 10,000 20,000 30,000 40,000 50,000 BAROMETRIC PRESSSURE mm Hg 760 523 349 226 141 87 PO2 IN AIR mm Hg 159 110 73 47 29 18

EFFECT OF ALTITUDE ON ARTERIAL O2 SATURATION
100 Art. Oxygen Saturation% 90 80 70 60 50 50 23 Altitude(1000s of feet) Breathing Pure Oxygen Breathing Air

OXYGEN CYLINDERS

CO2 & O2 Partial pressures in Alveoli across altitudes
PLACE ALTITUDE Mts. BAROMETRIC PRESSURE mmHg PA CO2 Mm Hg PA O2 Mm Hg

SEA LEVEL COLORADO SPRINGS PIKE’S PEAK EVEREST North Col. EVEREST Summit

0 1800 4300 6400 9100

760 620 460 355 240

40 36 28 19 15

100 79 53 39 24

PARTIAL PRESSURES OF OXYGEN

EFFECTS OF ACUTE EXPOSURE TO HIGH ALTITUDE : breathing air
ALTITUDE (ft) PRESSURE mmHg Alv. PCO2 mmHg Alv. PO2 mmHg Art O2 saturation

0 10,000 20,000 30,000

760 523 349 226

40 (40) 36(23) 24(10) 24(7)

104 (104) 67(77) 40(53) 18(30)

97 (97) 90(92) 73(85) 24(38)

VALUES IN BRACKETS FOR ACCLIMATIZED PEOPLE

EFFECTS OF ACUTE EXPOSURE TO HIGH ALTITUDE: breathing pure Oxygen
Alt(Feet) Pressure Mm Hg Alveolar PCO2 Alveolar PO2 Art O2 satn%

0 10,000 20,000 30,000 40,000 50,000

760 523 349 226 141 87

40 40 40 40 36 24

673 436 262 139 58 16

100 100 100 99 84 15

ACUTE EFFECTS OF HYPOXIA

As the altitude increases, the barometric pressure decreases. This causes a handicap which may be:
• Appreciable • Considerable • Serious • Causing Imminent Collapse

ACCLIMATIZATION
 

“Getting used to…” People remaining at high altitudes for days, weeks or years become more and more acclimatized to low PO2. This causes the hypoxia to cause fewer deleterious effects on their bodies. They can thus work harder at higher altitudes without hypoxic effects.

How does acclimatization occur?

Increased :
• Pulmonary ventilation. • Number of RBCs ( Hypoxia causes excess erythropoiesis). • Diffusing capacity of the lungs. • Vascularity of the peripheral tissues • Ability of the tissue cells to use Oxygen despite low PO2.

NATURAL ACCLIMATIZATION

 

This occurs in people living from their birth at high altitudes. Those living in the Andes & Himalayan mountains, for instance. Acclimatization begins in them in infancy. The chest size is greatly increased. Their hearts are considerably larger than those of lowlanders

ACUTE MOUNTAIN SICKNESS

This is also called as “High Altitude Pulmonary Edema.” This occurs in a small number of lowlanders who ascend rapidly to high altitudes. Begins from a few hours up to 2 days after their ascent. Is serious and results in their death unless they are given Oxygen or taken to a low altitude.

ACUTE MOUNTAIN SICKNESS : SYMPTOMS & SIGNS

Acute Cerebral Edema:
• Hypoxia causes cerebral vasodilatation • Increases capillary pressure • Causes fluid to leak out into the tissues • This leads to cerebral edema causing:
Severe disorientation  Other cerebral dysfunctions

ACUTE MOUNTAIN SICKNESS : SYMPTOMS & SIGNS

Acute Pulmonary Edema:
• Severe hypoxia causes Pulmonary arteriolar constriction. • In some areas it is more and causes edema. • This can extend progressively to other areas of the lungs. • Can be reversed within hours on Oxygen therapy

CHRONIC MOUNTAIN SICKNESS

 

Seen in people who reside for long at high altitudes. Red cell number and mass increases exceptionally. Pulmonary arterial pressure becomes very high. The heart becomes enlarged in the right side. The peripheral arterial pressure begins to fall Congestive Cardiac failure & death follows They need to be taken to low altitudes as soon as possible. They recover in low altitudes within days or weeks.

S P A C E P H Y S I O L O G Y

WEIGHTLESSNESS IN SPACE

Astronauts experience “weightlessness” or “microgravity” during space travel. Physiological problems of weightlessness include:
• • • Motion sickness in the first few days. Translocation of fluids in the body Diminished physical activity as no strength of muscular contraction is required to oppose gravity.

PROLONGED STAY IN SPACE CAN CAUSE

Decrease in :
• Blood volume. • Red cell mass. • Muscle strength. • Work capacity • Maximal Cardiac Output

Loss of
• Calcium & Phosphate from the bones. • Bone mass.

PROLONGED STAY IN SPACE
Most of the problems are prevented by:  Vigorous exercise programs while in the space.  Especially for prolonged stay in space.