Please note that FiO2 is a constant: what decreases in altitude is the athmospheric pressure. The sum of the pressure of alll the gases of air is the athmospheric pressure. So if the athmospheric pressure decreases also the relative pressure of oxygen decreases, BUT FiO2 is always constant (around 20,93%).
To clarify - at high altitude you are breathing in 20.93% of O2 - no matter the altitude rather. So, what is actually decreasing is the pressure of this FiO2?
I was falling asleep while studying about Mountain Sickness (something we all know sometimes happens even with interesting topics) and ended up finding this video in my effort to stay awake.The only thing I do not understand about it, is WHY it doesn't have the hundreds of thousands of likes more I would expect. Don't hesitate I will share your channel to all my colleagues. Greetings from South America!
Interesting. Too little explanation on acclimatization process. As a mountaineer I know it can take up to a month to fully acclimatize. Many hypoxia/EPO response techniques can be used to build the blood to carry from the lungs. Most hikers will travel above 8000-9000ft and stop once reach first AMS symptom then travel down 500ft and rest. Some dive under water to hold the breath. win Goff was known to climb mt Everest in his shorts and his hypoxia breathing techniques obtained a Nobel prize to cause the same response.
This is so interesting as I’ve finally fully dedicated myself to long distance running, elevated training, and hiking along with following the stories of ultramarathoners like Goggins. He had swimming-induced pulmonary edema from SEALS training, HAPE from his 100+ ultramarathons at high elevations, and pitting edema on his leg caused by never properly taking care of himself or properly nurturing his body through the military, ultra runs, & maybe even his insane weight loss journey.
In 16:00 minute there’s a wrong statement in this slide u write in the shifting to the left there’s a decreased y axis and this statement it’s wrong it will be (increasing) in the y axis( not a decrease)
@@MedicosisPerfectionalis At 3:30, you mention that FiO2 (F for fraction) decreases with altitude. I thought the FiO2 remains relatively consistent its just that overall pressure decreases therefore the partial pressure of O2 decreases.
It's magical how I felt from the first time that you are Egyptian 😂💗 you have the typical Egyptian manner of teaching and sense of humor. The only place where I like being told idiot 😂. All the best and thank you so much for offering such priceless lessons to us.
1. FiO2 changes with altitude? Sure? PAO2 does because of barometric pressure. 2. Does gravity explains the barometric pressure? Its true that distance diminish the force. But the taller column of air above a person in sea level its actually why this happens. Higher you go, shorter that column is... so less pressure.
Think about the mechanism of action in edema. Fluid is forced out of blood vessels through interstitial spaces. Increasing hypoxia causes the vessels to vasoconstrict. The squeezing of the blood vessels increases pressure and leads to more fluids squeezing through. EDIT: I left out an important detail. Decreasing oxygen normally results in vasodilation to compensate. But here it cannot occur because there is insufficient oxygen available. Rising CO2 causes acidosis. Acidic environment leads to vasoconstriction. Increased pressure inside the vessels relative to surrounding tissue causes a net flow of fluid into the surrounding tissues such as the intracranial space. Hence HACE occurs. Capillaries are tiny vessels that are deliberately "leaky" to allow capillary filtration of plasma etc. That's important for blood filtration. With that in mind, it is easy to conceptualize how increased pressure from vasoconstriction leads to more fluids being pushed into surrounding tissue. The brain detects the decreased oxygen (specifically the medulla oblongata). It signals the lungs to compensate with hyperventilation. The medulla oblongata also sends out epinephrine and norepinephrine which signals blood vessels to vasoconstrict through adrenergic receptors on the vessel surface smooth muscle. This causes a release of calcium which activate the myosin chains and causes the contraction. Not sure what you meant by shunting. I was curious about the role of RAAS but that doesn't kick in during the initial acute period of AMS? I found some journal articles suggesting individuals can be susceptible to cardiovascular complications arising from incorrect activation of RAAS during acclimitisation.
Loved this! I'll be taking pathophysiology classes next year in my nursing studies. You make learning fun and easy to remember with your upbeat style! Keep it up :)
Thank you very much brother I has recently discovered your channel , yes i mean it , it is a discovery ! This video is not the only video I watched in your channel , it is obvious that you are a high IQ man ما شاء الله . There are many things you were astonishing in the way you introdeuced them , among which i was very amzed in etymology , actually i used etymology late in the med school ... but i think it is very important . Excuse me ,,, The first thing changed in high altitude is not the FIO2 , what decreases is the PIO2 . The FIO2 which is the fraction of air comprised by O2 is not changed in high altitudes , it remains constant , i.e approximately 21 % . However PIO2 , which is given by the folowing equation , decreases : PIO2 = FIO2 x (Pb - 47 mmHg), where FIO2 is the fraction of oxygen in inspired air, Pb is the barometric pressure, and 47 mmHg is the vapor pressure of H2O at 37°C. The PIO2 is directly affected by the barometric pressure ( which i think is the hallmark change in high altitude , because of decreased weight of air above the measuring unit ) .
Thanks for the question, I want you to clarify some info: 1) Since you commented on a video about mountain sickness...Is there a difference in altitude between where you lived in Western WA and eastern WA? 2) When you say less inflammation, do you mean less chronic inflammation, less acute flares, less pain, less stiffness, or what? 3) Were you diagnosed with RA by a doctor? Is it confirmed? What serum antibodies are you positive for? If you want some privacy...You can send me a message on my Facebook page. Disclaimer: I am not a licensed physician so I cannot give any medical advice...Please talk to your doctor.
Because vasodilation within the brain from the hypoxia ant the relative waste concentrations will cause vasodilation, which increases flow to the organs, in this case the brain
Sujith it's for an another reason. It's because when the ↑pH in the brain the the cerebral vessels constrict. Vice versa when the ↓pH in the brain the cerebral vessels dilate to get rid of the H+
@@mariothrowsfireballsuntitl1841 u basically said the same thing as I did. Accumuli of co2 causes acidosis and also a direct effect of hypoxia is lactic acidosis (i just put them all as waste products)
@@Carbon12r In every artery there is vasodilatation because of hypoxia and waste products. But the cerebral vessels are especially sensitive to acidosis
I used to live at elevation greater than 2500 m. When I descended to sea level I felt that the air is dense and somewhat uncomfortable but I acclimatized to it after 14 weeks. Why did this happen? I am supposed to feel more comfortable at sea level because there is more oxygen but what happened to me during those 14 weeks was the opposite.
First big error - there is no less oxygen on higher altitudes!! The amount of oxygen in atmosphere remains the same no matter how high it is, it's always 21% of air
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Should we Take acetazolamide when we have corona?
Please note that FiO2 is a constant: what decreases in altitude is the athmospheric pressure. The sum of the pressure of alll the gases of air is the athmospheric pressure. So if the athmospheric pressure decreases also the relative pressure of oxygen decreases, BUT FiO2 is always constant (around 20,93%).
The comment I was looking for…😹
Yep true
To clarify - at high altitude you are breathing in 20.93% of O2 - no matter the altitude rather. So, what is actually decreasing is the pressure of this FiO2?
I was falling asleep while studying about Mountain Sickness (something we all know sometimes happens even with interesting topics) and ended up finding this video in my effort to stay awake.The only thing I do not understand about it, is WHY it doesn't have the hundreds of thousands of likes more I would expect. Don't hesitate I will share your channel to all my colleagues. Greetings from South America!
Thank you so much 😊
Cuz he is lame as “flip” and his annoying comments ruin his videos
I swear this channel is underrated.
Thank you so much 😊
your humor is what gets me the hardest... makes the knowledge fuse to my brain
Thank you 🙏
How do you keep being so funny and making everything understandable? Thank you so much for the great effort
Thank you ☺️
The Fio2 is 21% at any altitude
Interesting. Too little explanation on acclimatization process. As a mountaineer I know it can take up to a month to fully acclimatize. Many hypoxia/EPO response techniques can be used to build the blood to carry from the lungs. Most hikers will travel above 8000-9000ft and stop once reach first AMS symptom then travel down 500ft and rest. Some dive under water to hold the breath. win Goff was known to climb mt Everest in his shorts and his hypoxia breathing techniques obtained a Nobel prize to cause the same response.
This is so interesting as I’ve finally fully dedicated myself to long distance running, elevated training, and hiking along with following the stories of ultramarathoners like Goggins. He had swimming-induced pulmonary edema from SEALS training, HAPE from his 100+ ultramarathons at high elevations, and pitting edema on his leg caused by never properly taking care of himself or properly nurturing his body through the military, ultra runs, & maybe even his insane weight loss journey.
Best explanation!
Someday I might die but this glorious slide will remain forever hopefully..
It will remain forever.
Thank you so much, bro!
Can you please help me by sharing?
Wow, man, your explanation is so incredible! A million thanks!
Thanks a million for your encouraging words:)
Can you please help me by sharing?
Why does hypoxia cause cerebral edema? Does hypoxia also cause vasoconstriction of the cerebral blood vessels?
Are you seeing this Doctor Who is comparing CoVid to this?
Dr.Cameron kyle...I'm here because of him.
we are ahead of the people, government has it wrong,.
Covid 19 = AMS!
Excellent job explaining this. Thank you! Can you also do one on Hypothyroidism?
That’s a great idea 💡
Sir, you are a genius, i dont have enough words to thank you!
I appreciate you!
I didn't know you're Egyptian! All the respect, bro♥🔥
Thanks 🙏
الدم المصري عظمة يدكتور ❤️
Thank you!
Egyptians = noble mindness
Love you ❤️
12:18 was really impressive 😢, i took a screen shot
In 16:00 minute there’s a wrong statement in this slide u write in the shifting to the left there’s a decreased y axis and this statement it’s wrong it will be (increasing) in the y axis( not a decrease)
I love the way you speak and explain.🔥😅
Thanks 🙏
I’m not sure if amount of oxygen changes with height or the lower partial pressure of oxygen is the case 🧐
Great content! Cheers from Poland!
Partial pressure
@@MedicosisPerfectionalis At 3:30, you mention that FiO2 (F for fraction) decreases with altitude. I thought the FiO2 remains relatively consistent its just that overall pressure decreases therefore the partial pressure of O2 decreases.
great explanation, may god bless you
Nice video! I am doing a presentation and I am looking for scientific articles about this. What sources did you base this video on? :)
Thank you so much for this amazing lecture
You’re most welcome!
Would you please help me by sharing?
It's magical how I felt from the first time that you are Egyptian 😂💗 you have the typical Egyptian manner of teaching and sense of humor. The only place where I like being told idiot 😂. All the best and thank you so much for offering such priceless lessons to us.
Thank you so much 😊
I have already study a case by lecturio that said "The FiO (fraction of inspired oxygen) at any altitude level on earth is 21%."
3.28
1. FiO2 changes with altitude? Sure? PAO2 does because of barometric pressure. 2. Does gravity explains the barometric pressure? Its true that distance diminish the force. But the taller column of air above a person in sea level its actually why this happens. Higher you go, shorter that column is... so less pressure.
FiO2 does NOT change with altitude.
I made a mistake.
Such honest open answer, makes me trully admire you. Thanks. Will follow.
I enjoyed every bit of it,thank you❤️
Can you do a teaching video on carbon monoxide poisoning?
I already did...Watch it here: ruclips.net/video/6iyAHeH7nHg/видео.html/
F=mg as well so mg counts for weight where a=gravitational acceleration. :)))))
What's the cause for Cerebral Edema???
Thanks for the informative video
My pleasure 😇
Love your sense of humor!!! 😍😍😍
Thank you so much 😊
That was beautiful!!😍😍
Thank you so much 😊
Cool presentation. Interesting to follow. Learned some new things.
Thank you 🙏
still didnt understand why high altitude causes cerebral edema. Hypoxia in the lung causes shunting, in the brain too?
Think about the mechanism of action in edema. Fluid is forced out of blood vessels through interstitial spaces. Increasing hypoxia causes the vessels to vasoconstrict. The squeezing of the blood vessels increases pressure and leads to more fluids squeezing through.
EDIT: I left out an important detail. Decreasing oxygen normally results in vasodilation to compensate. But here it cannot occur because there is insufficient oxygen available. Rising CO2 causes acidosis. Acidic environment leads to vasoconstriction. Increased pressure inside the vessels relative to surrounding tissue causes a net flow of fluid into the surrounding tissues such as the intracranial space. Hence HACE occurs.
Capillaries are tiny vessels that are deliberately "leaky" to allow capillary filtration of plasma etc. That's important for blood filtration.
With that in mind, it is easy to conceptualize how increased pressure from vasoconstriction leads to more fluids being pushed into surrounding tissue.
The brain detects the decreased oxygen (specifically the medulla oblongata). It signals the lungs to compensate with hyperventilation.
The medulla oblongata also sends out epinephrine and norepinephrine which signals blood vessels to vasoconstrict through adrenergic receptors on the vessel surface smooth muscle. This causes a release of calcium which activate the myosin chains and causes the contraction.
Not sure what you meant by shunting.
I was curious about the role of RAAS but that doesn't kick in during the initial acute period of AMS? I found some journal articles suggesting individuals can be susceptible to cardiovascular complications arising from incorrect activation of RAAS during acclimitisation.
Have gained alot, love ur way of teaching, LOVE from Pakistan❤
❤️❤️
Loved this! I'll be taking pathophysiology classes next year in my nursing studies. You make learning fun and easy to remember with your upbeat style! Keep it up :)
Thank u so much for the very useful video :)
Thank you very much brother
I has recently discovered your channel , yes i mean it , it is a discovery !
This video is not the only video I watched in your channel , it is obvious that you are a high IQ man ما شاء الله .
There are many things you were astonishing in the way you introdeuced them , among which i was very amzed in etymology , actually i used etymology late in the med school ... but i think it is very important .
Excuse me ,,,
The first thing changed in high altitude is not the FIO2 , what decreases is the PIO2 .
The FIO2 which is the fraction of air comprised by O2 is not changed in high altitudes , it remains constant , i.e approximately 21 % .
However PIO2 , which is given by the folowing equation , decreases :
PIO2 = FIO2 x (Pb - 47 mmHg), where FIO2 is the fraction of oxygen in inspired air, Pb is the barometric pressure, and 47 mmHg is the vapor pressure of H2O at 37°C.
The PIO2 is directly affected by the barometric pressure ( which i think is the hallmark change in high altitude , because of decreased weight of air above the measuring unit ) .
What is the mechanism that makes pulmonary arteries react paradoxical to all other arteries in hypoxia?
Redirecting bloodflow to Alveoli that has more oxygen from ambient.
Man this was so helpful
Awesome 👏
Thanks 🙏
Nicely explained baby 😊 thanks 🙏
Thank you so much 😊
Hey, if Cerebral Blood vessels dilate during hypoxia, how does it cause Cerebral edema?
Dilation of blood vessel increases flow of blood which raises hydrostatic pressure in capillaries. This increases the risk of edema.
wow. highly impressed
Thank you so much!
Oh wow now I get it why I’m sick yesterday after a climb .
Stay safe!
Talk to your doctor if you have any medical questions!
Love your spirit bob
Thank you 🙏
This really is a fun way of learning hahhaahah thank you!
My pleasure 😇
I wonder what is your specialty 🙄 and,thanks alot❤
where is the cyanosis?
The way he kept saying baabbbyyy
Haha 😆
I have RA. I live in western WA. I went on a trip to Spokane in eastern WA. I had much less inflammation in Spokane. Why would that be?
Thanks for the question,
I want you to clarify some info:
1) Since you commented on a video about mountain sickness...Is there a difference in altitude between where you lived in Western WA and eastern WA?
2) When you say less inflammation, do you mean less chronic inflammation, less acute flares, less pain, less stiffness, or what?
3) Were you diagnosed with RA by a doctor? Is it confirmed? What serum antibodies are you positive for?
If you want some privacy...You can send me a message on my Facebook page.
Disclaimer: I am not a licensed physician so I cannot give any medical advice...Please talk to your doctor.
Why edema occur in brain , there is vasodilation in brain right due to hypoxia?
Because vasodilation within the brain from the hypoxia ant the relative waste concentrations will cause vasodilation, which increases flow to the organs, in this case the brain
@@Carbon12r which is not what medicosis perfictionalis said
Sujith it's for an another reason. It's because when the ↑pH in the brain the the cerebral vessels constrict. Vice versa when the ↓pH in the brain the cerebral vessels dilate to get rid of the H+
@@mariothrowsfireballsuntitl1841 u basically said the same thing as I did. Accumuli of co2 causes acidosis and also a direct effect of hypoxia is lactic acidosis (i just put them all as waste products)
@@Carbon12r In every artery there is vasodilatation because of hypoxia and waste products. But the cerebral vessels are especially sensitive to acidosis
Thanks baby
My pleasure 😇
I have so much fun just from listening to you hahahaha
Thank you so much 😊
And thanks for downloading from my website!
Can I mirror this content?
I used to live at elevation greater than 2500 m. When I descended to sea level I felt that the air is dense and somewhat uncomfortable but I acclimatized to it after 14 weeks. Why did this happen? I am supposed to feel more comfortable at sea level because there is more oxygen but what happened to me during those 14 weeks was the opposite.
Adaptation
Love you man😍
Thank you so much 😊
Does hypovolemia effects gait too?
It depends!
If there is serum sodium anomalies, then it’s possible!
Thank you Dr ❤️ i love your channel and vibes🤗
Good video
Thank you 🙏
First big error - there is no less oxygen on higher altitudes!! The amount of oxygen in atmosphere remains the same no matter how high it is, it's always 21% of air
Yes, FiO2 doesn’t change, but PiO2 does.
I keep coming and I keep laughing jajajajaja
Big Fan Sir!!!
Thank you 🙏
👨🏫 Nephrology Playlist: ruclips.net/p/PLYcLrRDaR8_d7bEi4DvucO73N4N_1vvPk
How to increase EPO ?
Why do you want to increase it?
المصريين حواار❤️تسلم يدوك❤️
Thank you 🙏
Sp02?
"and u r that blue idiot on the top" 😂😂🤣🤣
Just joking 🙃
@@MedicosisPerfectionalis i knooow 😄🤓 was funny 😍 what’s your specialty? (im “no pain, no pain” 😎…. having my spec-exam in December 🤯)
Why did I not see this person before???
Nice to meet you 😊😊
@@MedicosisPerfectionalis needed you when I was studying😭. It is okay this will help me study for my licensure exam😊
Sweet!
9:40
Got my physiology final exam tomorrow lol
Good luck 🍀
“Edema Baby!” Yeas my way to “freakin’” learn !
Awesome 👏
Can you please help me by sharing?
U r Gr8
I am humbled
Flatearthers triggered in under two minutes
😁😁
Very nice baby
آخرتها طلعت طعمية 🙂
امزح 😂😂😂😂 مجهود كبير والله ❤❤
Thank you so much 😊
This guy is sweet AF
Yo baby!
Are you gipty bro 🇪🇬?
Its so gud honeyy😘
Thank you so much 😊
HASHTAG PHYSICS BABY
Yup 🤣
Yes, the rich people need to stop trying to climb Mt Everest. Your money won't change your physiology. Also, good job sneaking those jokes in. 😉
Hey Jennie...It's been a while since your last comment...How are you?
NERDDDDDDDDDDDDDDD
😁😁