HYPOXIA AND ITS TYPES

DR SALEEM ULLAH ABRO

ASSISTANT PROFESSOR OF PHYSIOLOGY
THURSDAY 9 AM TO 10AM
OBJECTIVES
At the end of the session the students should be
able to:
• Define the following terms: Hypoxia, Anoxia,
Anemia, Ischemia.
• Explain the classification of Hypoxia.
• Describe causes of hypoxia.
• Describe stages of hypoxia, its effects on
human body.
DEFINITIONS
HYPOXIA : as lack of oxygen or Oxygen
deficiency at tissue level.
ANOXIA : as complete absence of oxygen in the
tissues or at the tissues level.
ANEMIA: decreased Hb% or RBCs in blood.
ISCHEMIA: decreased blood supply to tissue
cells.
CLASSIFICATION OF CAUSES OF HYPOXIA

• 1. Inadequate oxygenation of blood in lungs

(high altitude).
• 2. Pulmonary disease.
• 3. Venous to arterial shunt (right to left cardiac
shunt.
• 4. Inadequate O2 transport to the tissues by the
blood (Anemia).
• 5. Inadequate tissue capability of using O2 in
cells (Cyanide poisoning).
TYPES OF HYPOXIA
A. Hypoxic hypoxia (PO2 of the arterial blood is
low)
B. Anaemic hypoxia (Amount of Hb% to carry
O2 is Low)
C. Stagnant (ischemic or Circulatory) hypoxia
(Blood flow to the tissue is low)
D. Histotoxic hypoxia (Tissue can’t utilize O2).
 A. HYPOXIC HYPOXIA (ALTITUDE HYPOXIA)
• It is characterized by low arterial pO2 when oxygen
carrying capacity of blood and rate of blood flow to
tissues are normal or elevated
• It is characterized by
i. Low arterial pO2
ii. Low arterial O2 content
iii. Low arterial % O2 saturation of haemoglobin
iv. Low A-V pO2 difference
 HYPOXIC HYPOXIA(CONTD.)
Causes:
A. Low PO2 in the inspired air which include: 1. High Altitude
2. Breathing Gas mixture having Low PO2 3. Breathing in
closed space
B. Decreased Pulmonary Ventilation due to Respiratory
Disorders. 1. Obstructive Lung diseases e.g Asthma 2.
Mechanical or Nervous Disorders (e.g. neuromuscular
disorders) 3. Depression of Respiratory centre 4.
Pneumothorax (air in thorcic cavity).
• Hypoxic hypoxia occurs when not enough oxygen is in the
air or when decreasing atmospheric pressures prevent the
diffusion of O2 from the lungs to the bloodstream.
 B.ANAEMIC HYPOXIA
In anaemic hypoxia arterial pO2 is normal but the
amount of haemoglobin available to carry oxygen
is reduced.
Causes : Reduced O2 carrying capacity due to: 1 .↓
number of RBCs( bleeding) 2. ↓ amount of Hb
(anemia) 3. abnormal hemoglobin (e.g.) Met Hb.
• Characterized by: 1.Normal arterial pO2 , 2. arterial
O2 content moderately reduced, 3.A-V pO2
difference is normal
 C. STAGNANT(ISCHEMIC) HYPOXIA
• Occurs at circulatory level. • A condition that
interferes within the normal circulation of blood
arriving at the cells.
• Blood flow to the tissue is so low that adequate
oxygen is not delivered to them despite normal
arterial pO2 and haemoglobin concentration
Causes : 1. CCF 2. Hemorrhagic Shock Localized
circulatory deficiency (peripheral, cerebral,
coronary vessels) 3. Vasoconstriction (vasospasm) &
4. Thrombo-embolism or blockage.
STAGNANT HYPOXIA (CONTD.)
Characterized by:
i. Normal arterial pO2
ii. Normal arterial O2 content
iii. Normal arterial % O2 saturation of
haemoglobin
iv. A-V difference more than normal
• example: An arm or leg going to sleep
because the blood flow has accidentally
been shut off is one form of stagnant
hypoxia.
 D.HISTOTOXIC HYPOXIA
• Occurs at cell level, Amount of oxygen delivered to
the tissues is adequate but because of the action of
toxic agents(Alcohol and Drugs) the tissues cannot
make use of the oxygen supplied to them.
• Characterized by:
i. Normal pO2
ii. No difference in O2 content of arterial and
venous blood.
iii. A-V pO2 difference is less than normal
 D.HISTOTOXIC HYPOXIA
• Cause : 1.Cyanide poisoning causing damage to
enzyme cytochrome oxidase: refers to a reduction
in ATP production by the mitochondria due to a
defect in the cellular usage of oxygen.
• 2.Sulfide Poisoning
• 3. Vitamin B deficiency (beriberi ) tissue utilization
of oxygen is compromised.
 STAGES OF HYPOXIA
A. INDIFFERENT STAGE • mildest stage of hypoxia. • People are not
generally aware of the effects of hypoxia at this stage. • The primary
is effect on the eye such as loss of night vision or color vision.
B. COMPENSATORY STAGE • The circulatory system, and to a lesser
degree, the respiratory system, provide some defense against hypoxia
in this stage. • C/F: • poor judgement, • drowsiness(sleepy state) •
impaired efficiency. • Pulse rate increases • circulation rate increases
C. DISTURBANCE STAGE • In this stage the physiological compensations
do not provide adequate oxygen for the tissues. • Chance of recovery
greatly diminished. • Symptoms: impaired in flight control,
handwriting, speech, coordination, cyanosis, poor judgments and
difficulty with simple tasks
D. CRITICAL STAGE – • Unconsciousness (e.g: blackout, faint) • In the
critical stage consciousness is lost. Death follows shortly.
ACUTE: ERYTHROCYTOSIS,
FEELING OF THIRST,
LOSS OF CONSCIOUS NESS.
DELAYED: MOUNTAIN SICKNESS (NAUSEA, VOMITING, DEPRESSION, WEAKNESS, FATIGUE.
 EFFECTS OF HYPOXIA
• Death of cells On CNS
• ↓ mental activity
• Coma
• Reduced work capacity of the muscles
TREATMENT OF HYPOXIA

1. Treatment of the underlying cause-

depending upon the type of hypoxia
2. Oxygen therapy-
i. Inhalation of 100% pure oxygen
ii. Hyperbaric or high pressure oxygen therapy
Write 4
effects of
Hypoxia
on the
body
 End
• Thanks