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- Hypoxia = inadequate oxygenation of tissue (same definition of a shock). Need O2 for oxidation phosphorylation pathway – where you get ATP from inner Mito membrane (electron transport system, called oxidative phosphorylation). The last rxn is O2 to receive the electrons. Protons are being kicked off, go back into the membrane, and form ATP, and ATP informed in the mitochondria
- Terms:
- Oxygen content = Hb x O2 satn + partial pressure of arterial oxygen (these are the 3 main things that carry O2 in our blood)
In Hb, the O2 attaches to heme group (O2 sat’n) Partial pressure of arterial O2 is O2 dissolved in plasma In RBC, four heme groups (Fe must be +2; if Fe+ is +3, it cannot carry O2) Therefore, when all four heme groups have an O2 on it, the O2 sat’n is 100%.
- O2 sat’n is the O2 IN the RBC is attached TO the heme group = (measured by a pulse oximeter)
- Partial pressure of O2 is O2 dissolved in PLASMA
O2 flow: from alveoli through the interphase, then dissolves in plasma, and increases the partial pressure of O2, diffuses through the RBC membrane and attaches to the heme groups on the RBC on the Hb, which is the O2 sat’n
Therefore – if the partial pressure of O2 is decreased, O2 sat’n HAS to be decreased (B/c O2 came from the amount that was dissolved in plasma)
- Causes of tissue hypoxia:
- Ischemia (decrease in ARTERIAL blood flow ……NOT venous)
MCC Ischemia is thrombus in the muscular artery (b/c this is the mcc death in USA = MI, therefore MI is a good example of ischemia b/c thrombus is blocking arterial blood flow, producing tissue hypoxia)
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Other causes of tissue ischemia: decrease in Cardiac Output (leads to hypovolemia and cardiogenic shock) b/c there is a decrease in arterial blood flow.
- 2 nd MCC of tissue hypoxia = hypoxemia
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Hypoxia = ‘big’ term
Hypoxemia = cause of hypoxia (they are not the same); deals with the partial pressure of arterial O2 (O2 dissolved in arterial plasma, therefore, when the particle pressure of O2 is decreased, this is called hypoxemia). Here are 4 causes of hypoxemia:
- Resp acidosis (in terms of hypoxemia) – in terms of Dalton’s law, the sum of the partial pressure of gas must = 760 at atmospheric pressure (have O2, CO2, and nitrogen; nitrogen remains constant – therefore, when you retain CO2, this is resp acidosis; when CO2 goes up, pO2 HAS to go down b/c must have to equal 760; Therefore, every time you have resp acidosis, from ANY cause, you have hypoxemia b/c low arterial pO2; increase CO2= decrease pO2, and vice versa in resp alkalosis).
- Ventilation defects – best example is resp distress syndrome (aka hyaline membrane dz in children). In adults, this is called Adult RDS, and has a ventilation defect. Lost ventilation to the alveoli, but still have perfusion; therefore have created an intrapulmonary shunt. Exam question: pt with hypoxemia, given 100% of O2 for 20 minutes, and pO2 did not increase, therefore indicates a SHUNT, massive ventilation defect.
- Perfusion defects – knock off blood flow
MCC perfusion defect = pulmonary embolus, especially in prolonged flights, with sitting down and not getting up.
Stasis in veins of the deep veins leads to propagation of a clot and 3-5 days later an embolus develops and embolizes.
In this case, you have ventilation, but no perfusion; therefore there is an increase in dead space. If you give 100% O2 for a perfusion defect, pO2 will go UP (way to distinguish vent from perfusion defect), b/c not every single vessel in the lung is not perfused.
Therefore, perfusion defects because of an increase in dead space, while ventilation defects cause intrapulmonary shunts.
To tell the difference, give 100% O2 and see whether the pO2 stays the same, i.e does not go up (shunt) or increases (increase in dead space).
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Goljan Pathology Lecture Notes PDF Free Download Section
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Some of the lecture notes were prepared in LaTeX by Alan Dunn, a former MIT student. He used Prof. Zahn's handwritten notes to produce them.
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H/M = Haus, Hermann A., and James R. Melcher. Electromagnetic Fields and Energy. Englewood Cliffs, NJ: Prentice-Hall, 1989. ISBN: 9780132490207.
SES # | TOPICS | LECTURE NOTES |
---|---|---|
I. Maxwell's equations | ||
L1 | Coulomb-Lorentz force law; Maxwell's equations in integral form; simple electric and magnetic field solutions using Gauss' and Ampere's laws for point, line, and surface charges and currents; superposition; simple cylindrical and spherical source problems Demos: H/M 10.2.1 - Edgerton's Boomer | (PDF) |
L2 | Derive boundary conditions; apply boundary conditions to surface charge and surface current problems | (PDF) |
L3 | Divergence and Stokes' theorems; Maxwell's equations in differential form; electroquasistatics and magnetoquasistatics (MQS); potential and the gradient operator Demo: H/M 10.0.1 nonuniqueness of voltage in an MQS system | (PDF) |
L4 | The electric field, electric scalar potential, and the gradient; Poisson's and Laplace's equations; potential of point charge; Coulomb superposition integral | (PDF) |
L5 | Method of images | (PDF) |
L6-L7 | Lecture 6Media: dielectric, conducting, and magnetic constitutive laws; charge relaxation Demos: H/M 6.6.1 artificial dielectric; 9.4.1 measurement of B-H characteristic (magnetic hysteresis loop) Lecture 7Conservation of charge boundary condition; Maxwell capacitor; magnetic dipoles and circuits; reluctance | (PDF - 1.2 MB) |
II. Plane waves | ||
L8 | Wave equation; Poynting's theorem | (PDF) |
L9 | Oblique incidence on a perfect conductor; transverse magnetic (TM) waves with oblique incidence on lossless media described by ε and µ; reflection and transmission; transverse electric (TE) waves with oblique incidence on lossless media | (PDF) |
III. Transmission lines and waveguides | ||
L10 | Parallel plate transmission lines; wave equation; sinusoidal steady state Demo: H/M 13.1.1 visualization of standing waves | (PDF) |
L11 | Gamma plane; Smith chart; voltage standing wave ratio (VSWR); λ/4 transformer Demo: V(z,t), I(z,t) movies | (PDF - 2.6 MB) |
L12-L13 | Lecture 12Wave equations (lossless); transient waves on transmission lines Demo: H/M 14.4.1 transmission line matching, reflection, and quasistatic charging Lecture 13Reflections from ends; driven and initial value problems | (PDF - 2.5 MB) |
L14 | Rectangular waveguides; TM and TE modes; cut-off | (PDF) |
IV. Fields and forces | ||
L15 | Dielectric waveguides Demo: evanescent waves | (PDF) |
L16-L17 | Lecture 16Energy in electric and magnetic fields; principle of virtual work to find electric and magnetic forces; magnetic circuit problems Demo: H/M 11.6.2 force on a dielectric material (video) Lecture 17Synchronous rotating machines Film: Synchronous Machines | (PDF) |
L18 | Self-excited electric and magnetic machines Demo: H/M 7.7.1 van de Graaff and Kelvin generators (video); self-excited commutator machines | (PDF - 1.3 MB) |
V. Antennas and radiation | ||
L19 | Radiation by charges and currents; setting the gauge; Lorentz gauge; superposition integral solutions for scalar and vector potentials; radiation from a point electric dipole; receiving antenna properties | (PDF) |
L20 | 2 element array; broad side and end-fire arrays Demo: radiation patterns | (PDF - 1.1 MB) |
L21 | Transmitting and receiving antennas; wireless and optical communications | (PDF - 1.5 MB) |
VI. Acoustics | ||
L22 | Acoustic waves | (PDF - 2.5 MB) |
L23 | Course review | (PDF - 1.2 MB) |
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