Diving Physiology and Body Systems
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Questions and Answers

The skeletal system provides structure and support for ______ to attach to help move the body, as well as protecting the organs.

muscles

What are the three types of muscles?

  • Smooth (correct)
  • Tough
  • Skeletal (correct)
  • Cardiac (correct)

    • The brain uses 20% of the oxygen in the blood to generate adenosine triphosphate (ATP).

    True

    If there is a lack of oxygen, the brain cells begin to die within 2-4 minutes.

    <p>False</p> Signup and view all the answers

    What is the name of the air spaces that can be compressed during diving in the digestive system?

    <p>Air spaces in the stomach and intestines</p> Signup and view all the answers

    Certain diseases that cause excessive gas in the stomach and intestines may be contraindications to diving due to the danger of expansion and possible rupture on ascent.

    <p>True</p> Signup and view all the answers

    Respiration is the process of taking in and exhaling ______.

    <p>gas</p> Signup and view all the answers

    Respiration refers to the movement of oxygen out of the cells and the transport of carbon dioxide into the cells.

    <p>False</p> Signup and view all the answers

    Upon inhalation, air comes into the system down the trachea, then branches into two ______ at the top of each lung.

    <p>bronchi</p> Signup and view all the answers

    What are the small, air-filled pouches within the bronchioles called?

    <p>Alveoli</p> Signup and view all the answers

    What is a major factor that contributes to the efficiency of gas exchange?

    <p>Extensive surface area</p> Signup and view all the answers

    Oxygen is primarily carried in the blood by the protein ______.

    <p>hemoglobin</p> Signup and view all the answers

    During activity, the gas exchange systems of the body do not adjust to meet the higher demands of exercise.

    <p>False</p> Signup and view all the answers

    What is the chemical energy produced during cellular respiration called?

    <p>ATP (Adenosine triphosphate)</p> Signup and view all the answers

    The brain sends the signal to initiate breathing when decreased levels of CO2 are detected.

    <p>False</p> Signup and view all the answers

    Concentrations of CO2 in the blood over ______ mmHg tell the diaphragm muscle and some of the rib cage muscles to contract.

    <p>40</p> Signup and view all the answers

    During inhalation, the intercostal and diaphragm muscles relax, pulling on pleura surrounding the lungs.

    <p>False</p> Signup and view all the answers

    When those muscles relax, air is pulled out.

    <p>False</p> Signup and view all the answers

    This results in the exhalation of air that contains ______% Oxygen.

    <p>15-16</p> Signup and view all the answers

    What is the largest blood transport channel?

    <p>Arteries</p> Signup and view all the answers

    The configuration of arteries allows for decreased surface area, which limits the efficiency of oxygen transport to cells and tissues of the body.

    <p>False</p> Signup and view all the answers

    Deoxygenated blood enters the left side of the heart via a large vein called the vena cava.

    <p>False</p> Signup and view all the answers

    After gas exchange occurs in the lungs, the oxygenated blood moves back into the left atrium of the heart via the ______ vein.

    <p>pulmonary</p> Signup and view all the answers

    Oxygen is transported in the blood via the protein myoglobin.

    <p>False</p> Signup and view all the answers

    There is a cooperative binding process, which means that each oxygen molecule that binds, makes another bind more ______, increasing hemoglobin's affinity for oxygen.

    <p>tightly</p> Signup and view all the answers

    What are the two types of oxygen toxicity?

    <p>Pulmonary and Central Nervous System (CNS)</p> Signup and view all the answers

    Pulmonary toxicity involves irritation of the lungs and is common in diving with standard air.

    <p>False</p> Signup and view all the answers

    CNS oxygen toxicity can cause confusion, lethargy, vertigo, nausea, tingling, irritability, dizziness, twitching of the lips, tunnel vision, flashing lights, auditory phenomenon, and convulsions.

    <p>True</p> Signup and view all the answers

    A convulsion at depth can easily be fatal for a diver.

    <p>True</p> Signup and view all the answers

    What is the most common cause of carbon monoxide contamination in a SCUBA cylinder?

    <p>Combustion fumes at the intake of a dive compressor system</p> Signup and view all the answers

    Carbon monoxide binds more tightly to hemoglobin than oxygen.

    <p>True</p> Signup and view all the answers

    What are some of the symptoms of carbon monoxide poisoning?

    <p>Dull headache, weakness, dizziness, nausea, shortness of breath, confusion, blurred vision, and loss of consciousness</p> Signup and view all the answers

    Smoking is a habit that is compatible with diving.

    <p>False</p> Signup and view all the answers

    The effects of drugs, both medical and recreational, can be magnified at depth due to the increased pressure.

    <p>True</p> Signup and view all the answers

    Taking decongestants before diving can put a diver at risk for reverse block.

    <p>True</p> Signup and view all the answers

    Pulmonary barotrauma, or lung overexpansion, occurs when the volume of gas in the lungs exceeds the elastic capacity of the lungs.

    <p>True</p> Signup and view all the answers

    What can cause lung overexpansion?

    <p>Holding one's breath during ascent or gas pockets trapped in the lungs due to respiratory disease</p> Signup and view all the answers

    Gas from a lung rupture can leak into the bloodstream, causing the Arterial Gas Embolism (AGE).

    <p>True</p> Signup and view all the answers

    Gas from a lung rupture can leak into the space between the chest wall and lungs, causing pneumothorax.

    <p>True</p> Signup and view all the answers

    Gas from a lung rupture can leak into the area surrounding the heart, causing mediastinal emphysema.

    <p>True</p> Signup and view all the answers

    Gas from a lung rupture can leak into the subsurface of the upper back/chest/neck, causing subcutaneous emphysema.

    <p>True</p> Signup and view all the answers

    What are some ways to avoid pulmonary barotrauma?

    <p>Never hold your breath while diving, ascend slowly, and avoid diving if you have a compromised respiratory system</p> Signup and view all the answers

    As a diver ascends, air in the lungs ______.

    <p>expands</p> Signup and view all the answers

    If a diver fails to exhale sufficiently during ascent, the expanding air may rupture lung tissue and release gas bubbles into the blood.

    <p>True</p> Signup and view all the answers

    What are some symptoms of AGE?

    <p>Loss of consciousness, confusion, convulsions, bloody froth from the mouth or nose, weakness, paralysis, and stroke-like symptoms</p> Signup and view all the answers

    AGE does not require immediate medical treatment.

    <p>False</p> Signup and view all the answers

    Pneumothorax is a partially or fully collapsed ______.

    <p>lung</p> Signup and view all the answers

    A tension pneumothorax is a less dangerous type of pneumothorax.

    <p>False</p> Signup and view all the answers

    Pneumothorax in divers with decompression illness may require recompression.

    <p>False</p> Signup and view all the answers

    Mediastinal emphysema is a type of emphysema that affects the lungs.

    <p>False</p> Signup and view all the answers

    Subcutaneous emphysema occurs most often in the skin covering the chest wall or neck, but can also occur in other parts of the body.

    <p>True</p> Signup and view all the answers

    People with lung conditions that may increase the risk of pulmonary barotrauma should avoid scuba diving.

    <p>True</p> Signup and view all the answers

    Rapid ascents generally decrease the risk of pulmonary barotrauma.

    <p>False</p> Signup and view all the answers

    Oxygen is often used as a treatment for emphysemas because it helps the body to absorb the subcutaneous air more quickly.

    <p>True</p> Signup and view all the answers

    Decompression sickness (DCS) is caused by the formation of nitrogen bubbles in the body after descending from a dive.

    <p>False</p> Signup and view all the answers

    Hypothermia is the reduction of core temperature below 95°F.

    <p>True</p> Signup and view all the answers

    Hyperthermia is more common in colder climates.

    <p>False</p> Signup and view all the answers

    Signs of hyperthermia include exhaustion, flushed or red skin, muscle cramps, headache, lightheadedness, and nausea.

    <p>True</p> Signup and view all the answers

    Temperatures above 100°F are considered safe and do not pose a danger at a cellular level.

    <p>False</p> Signup and view all the answers

    Maintainig good physical fitness levels and sufficient aerobic capacity will decrease your ability to respond to the rigorous physical demands of general scientific diving and the even higher demands of a rescue situation.

    <p>False</p> Signup and view all the answers

    It is important to get enough sleep before dive days, as a well-rested body and mind perform more efficiently.

    <p>True</p> Signup and view all the answers

    It is important to avoid smoking and the use of substances that can negatively affect decision making while diving.

    <p>True</p> Signup and view all the answers

    It is important to move mindfully during dive activities to avoid mechanical injury from lifting heavy equipment.

    <p>True</p> Signup and view all the answers

    Study Notes

    Diving Physiology - Learning Objectives

    • Basics of circulatory and respiratory systems, relating to diving
    • Types of respiratory injuries in diving, prevention, and treatment
    • Temperature-related injuries in diving
    • Pressure effects on the body (direct and indirect), and resulting injuries
    • Fitness to dive criteria, common areas of injury, and injury prevention

    The Musculoskeletal System

    • Skeletal system provides structure and support for muscles, and protects organs
    • Muscles help move the body and food through the digestive system
    • Three muscle types: smooth, cardiac, and skeletal
    • Some muscles are controlled consciously, others autonomically
    • Common scuba injuries include torn muscles or injured joints, from heavy gear, strenuous in-water activities, and slips/falls

    The Nervous System

    • Consists of neurons (nerve cells) and glial cells (nerve support)
    • The brain, as the central hub, uses 20% of blood oxygen to generate ATP, controlling neuron electrical pulses.
    • Nerve cells lose their electrical charge and die within 4-6 minutes without oxygen
    • Decompression sickness can impede nervous system functions, due to inert gas bubbles pressing on neurons
    • Oxygen at high partial pressures can also affect the nervous system (discussed later)

    The Nervous System and Dive Injuries

    • In decompression sickness, nervous system functions may be impeded by inert gas bubbles pressing on neurons
    • High partial pressures of oxygen can affect the nervous system

    Symptoms of Oxygen Toxicity

    • Eyes: Visual field loss, near-sightedness, cataract formation, bleeding, fibrosis
    • Central: Seizures
    • Respiratory: Jerky breathing, irritation, coughing, pain, shortness of breath, tracheobronchitis, acute respiratory distress syndrome
    • Muscular: Twitching

    The Digestive System

    • Consists of: mouth, stomach, small intestine, large intestine, pancreas, liver, and gall bladder
    • Function: mechanically and chemically breaks down food into usable forms for cells
    • Soluble food forms pass into the blood; insoluble forms use specialized proteins for transport across cell membranes
    • Air spaces in the digestive system can compress during diving
    • Depth-related diseases can cause gastric and intestinal gas-trapping, leading to expansion and rupture risks during ascent

    The Respiratory System

    • Consists of nose, mouth, pharynx (throat), larynx (voice box), trachea (windpipe), airways, and lungs
    • Respiration is the process of inhaling and exhaling gases (oxygen and carbon dioxide)
    • Crucial process for cellular level survival
    • Air inhalation enters down the trachea, branching into two bronchi; leading to smaller bronchopulmonary branches
    • These branches continue to divide into bronchioles forming the five lobes of the lungs (three on the right, two on the left) containing alveoli
    • Alveoli are small air sacs surrounded by capillaries allowing for easy gas exchange with bloodstream

    Lung Anatomy

    • Inhalation brings air down the trachea, branching into two bronchi, then smaller bronchopulmonary branches that create the five lobes in the lungs
    • Three lobes in the right lung, and two in the left lung; the heart takes up some space on the left.
    • Bronchioles divide further into bronchioles, with structural organization to allow greater surface area
    • Alveoli and capillaries have a single cell thickness to make gas exchange with bloodstream easy

    Gas Diffusion

    • A large difference in partial pressure of gases across thin cell walls increases gas diffusion efficiency, including oxygen and carbon dioxide

    Gas Exchange in the Lungs

    • The body needs oxygen for cellular respiration
    • Oxygen is primarily carried in the blood by hemoglobin
    • Gas exchange occurs at the cellular level through diffusion
    • Carbon dioxide, a byproduct of cellular respiration, is carried back to the lungs via the bloodstream and exhaled

    Controls of Respiration

    • The brain initiates breathing based on increased carbon dioxide levels in the blood, which must be over 40 mmHg
    • Other triggers for increased carbon dioxide levels include exercise

    The Mechanical Process of Respiration

    • Intercostal and diaphragm muscles contract during inhalation, pulling on the pleura surrounding the lungs
    • This increases lung volume
    • Air, with 21% oxygen, is inhaled
    • Relaxed muscles force air out during exhalation
    • Exhaled air contains 15-16% oxygen

    Circulation

    • Arteries are major blood transport channels branching into arterioles and finally into capillaries.
    • This configuration increases surface area for efficient oxygen transport to the body's cells and tissues

    Circulatory Route

    • Deoxygenated blood enters the right side of the heart through the vena cava
    • Blood moves through the heart chambers (right atrium, right ventricle) and is sent to the lungs via the pulmonary artery
    • Oxygenated blood returns to the left side of the heart through the pulmonary vein
    • Blood then moves through the heart chambers (left atrium, left ventricle) to the aorta, reaching the rest of the body's tissues

    Transport and Exchange of Gases

    • Oxygen, carried in the blood via hemoglobin, exhibits a cooperative binding process where each oxygen molecule makes another bind more tightly (increasing hemoglobin affinity)
    • During activity, the body adjusts gas exchange systems by increasing heart rate and breathing rate (deeper breaths) to meet the body's oxygen demand

    Respiratory Fatigue

    • Lung, heart, and blood vessel capacity to deliver oxygen is related to an individual's aerobic fitness level
    • Higher aerobic fitness leads to a greater ability to perform tasks without respiratory fatigue
    • This is especially true for divers in challenging environments or during underwater work

    Insufficient Oxygen

    • Brain cells require a constant oxygen supply
    • Lack of oxygen can lead to irreversible brain/nerve cell damage in as little as 4-6 minutes
    • Absence of oxygen to body tissues: hypoxia/anoxia

    Hypoxia and Anoxia

    • Hypoxia/anoxia can be caused by issues like being out of breathing gas underwater
    • Hyperventilation can cause hypoxia by decreasing carbon dioxide levels, which reduces breathing signals

    Pressure Direct Effects - Descents

    • Any gas in the body will compress on descent, affecting air spaces and surrounding tissues
    • Equalizing air spaces early and often is important to prevent negative pressure effects
    • Pressure-related injuries are termed barotraumas or squeezes.

    Air Spaces and Pressure Changes

    • Masks are airspaces and their volume decreases with descent (Boyle's Law). Exhaling occasionally into the mask compensates this.
    • Failure to equalize can injure/rupture capillaries in the face and eyes.
    • Sinuses are also airspaces; they often equalize naturally. Congestion can impede equalization.
    • Teeth and gums can experience discomfort due to airspaces, but modern dentistry rarely causes an issue.
    • Equalization needs to occur during descent/ascent.

    The Ear Canal

    • Divers may experience pressure or discomfort during ascent/descent, which can lead to serious pain and/or injury.
    • Equalizing is necessary for the ear canal; a technique or procedure must be utilized to prevent ear canal injuries.

    Equalization Techniques

    • Valsalva Maneuver: close nose, exhale to open Eustachian tubes.
    • Frenzel Maneuver: close nostrils, sound 'K' to encourage Eustachian tubes to open.
    • Toynbee Maneuver: Pinch nostrils close, then swallow.

    Middle Ear Barotrauma or Ear Squeeze

    • Pressure imbalance in the middle ear during ascent/descent can cause tissues to swell, leading to fluid or blood leakage and eardrum bulging inward; known as middle ear barotrauma or Barotitis Media, but rarely needs treatment if equalized properly.
    • Symptoms after the dive can include hearing loss or fullness in the ear.
    • Seek medical attention if symptoms don't resolve.

    Inner Ear Barotrauma

    • The inner ear, responsible for balance and hearing, can be affected by pressure imbalances causing tearing of the inner-ear tissues, resulting in symptoms, including, vertigo, vomiting, hearing loss, and ringing in the ears.
    • Equalizing is required.

    Ear Drum Rupture

    • Ear drum rupture can be caused by large impact from the water or prolonged lack of equalization.
    • Under water rupture will usually precede with intense pain; once the pressure is released, pain relief will occur.
    • This may be accompanied by vertigo, and hearing loss.

    Important Take Home Messages

    • Equalization should be performed and monitored; stopping ascent if issues arise, and preventing excessive forceful equalization.
    • Causes of equalization issues may be poor technique, overly fast dive, and congestion from conditions (like allergies or cold.
    • Immediate action should be taken if pain ensues from equalization problems.

    Outer Ear Issues

    • Otitis externa, swimmers ear, is an inflammation of the outer ear canal. Symptoms include itching, outer-ear pain and/or jaw pain, redness of ear.
    • Preventative measures include cleaning/treating the outer ear canal, and taking breaks between dives to allow ear canal drying
    • Ear canal vessel rupture is rare, characterized by minor bleeding. Seek medical assessment before diving again.

    Ascent Issues - Ears/Sinuses

    • Reverse block: increasing gas volume cannot escape during ascent; can put pressure on ear and cause ascent barotrauma. This occurs when decongestant medicine wears off and passageways are blocked once again.
    • Alternorbaric Vertigo: Unequal pressure between ears during ascent can cause strong dizziness.
    • Nitrogen narcosis (a.k.a. rapture of the deep), is a side effect when diving deep from impaired judgment and impaired behaviors, that is influenced by nitrogen in inhaled air.
    • Oxygen Toxicity, is a concern when inhaled oxygen's partial pressure exceeds 1.4 ATM
    • Carbon monoxide poisoning is rare but can occur from combustion fumes from the compressor intake/system.
    • Medical drugs, both recreational and medical, side effects can be magnified under pressure.

    Inert Gas/Nitrogen Narcosis

    • Nitrogen at higher pressure can lead to narcosis, which can manifest as symptoms including, paranoia, euphoria, dizziness, poor judgment, elation, confusion and anxiety.
    • Repeated exposure does exhibit an adaptive effect, reducing the symptoms of nitrogen narcosis.
    • Diving buddies' mental awareness is important to recognize warning signs of impaired judgment.

    Oxygen Toxicity

    • Pulmonary toxicity irritates the lungs; causing coughing, burning, and respiratory discomfort; common in long, very deep dives
    • Central nervous system (CNS) toxicity has greater concern; causing confusion, lethargy, vertigo/nausea, tingling, irritability, dizziness, twitching lips, tunnel vision and flashing lights, auditory phenomenon like ringing ears, and convulsions. Convulsions at depth are potentially fatal.
    • Depth limits should be observed to avoid toxicity of oxygen

    Carbon Monoxide (CO) poisoning

    • CO binds to hemoglobin 200-300 times tighter than oxygen, resulting in hypoxia.
    • Symptoms can include a dull headache, weakness, dizziness, nausea, vomiting, shortness of breath, confusion, blurred vision, and loss of consciousness
    • Smoking can also lead to CO poisoning.

    Drugs and Diving

    • Effects of drugs and/or other medications can increase under pressure, and/or affect divers during diving activity.
    • Medication, whether recreational or medical, should be considered and reported to diving professionals beforehand with any changes

    Ascent Injuries - Lung Overexpansion

    • Pulmonary barotrauma or lung overexpansion is caused by a gas volume exceeding the lung's elastic capacity; commonly from holding one's breath during ascent/reduced pressure causing ruptures.
    • Symptoms include several forms of emphysema: mediastinal, subcutaneous
    • Treatment should include rapid equalization, and/or medical treatment(s).

    Air Embolism

    • As a diver ascends, air in the lungs expands.
    • Insufficient exhaling can cause expanding air to rupture lung tissue and release gas bubbles into the arteries or other areas of the body
    • Restricted blood flow can occur, damaging the brain and other body tissues

    AGE Recognition and Treatment

    • Arterial Gas Embolism (AGE): Serious medical emergency; occurs within 15 minutes of surfacing
    • Symptoms: Loss of consciousness, confusion, convulsions, bloody froth from mouth/nose, weakness paralysis, stroke-like symptoms, requires immediate medical treatment
    • Emergency oxygen must be given immediately.

    Pneumothorax

    • Pneumothorax: collapsed lung due to air leaking into the intra-pleural space, which interrupts the negative pressure holding the pleural layers together
    • Rapid breathing, blue-tinged skin/fingernails/lips, chest pain are possible symptoms of tension pneumothorax-in which, air is pressing on heart/other important structures - this type is especially dangerous.
    • Treatment may need immediate medical attention

    Emphysemas

    • Emphysema: a collection of air in body tissue; can result in damage to alveoli
    • Two common forms: mediastinal and subcutaneous

    Mediastinal Emphysemas

    • Mediastinal emphysema is characterized by a substernal ache/chest tightness
    • Pain in shoulder, back, neck are possible side effects
    • Other Symptoms: voice change

    Subcutaneous Emphysemas

    • Subcutaneous emphysema arises from damaged tissue, manifested as a skin bulge, and a crackling sensation when the gas is pushed through the tissue
    • Possible Symptoms: sore throat, pain in neck/chest, and/or difficulty breathing

    More on Pulmonary Barotraumas

    • People with lung illnesses should avoid/be cautious in diving.
    • Risk for pulmonary barotrauma is high with rapid ascents
    • Highly concentrated oxygen treatment is recommended/used for certain pulmonary illnesses to hasten subcutaneous absorption of air more quickly
    • Medical evaluations are needed after a pulmonary barotrauma experience before further diving activity.

    Decompression Sickness (DCS)

    • DCS is caused by nitrogen bubbles forming in the body after an ascent from a dive
    • Understanding tissue compartments, M values, and modern decompression methods are important for minimizing decompression risks.

    Temperature Effects on Divers

    • Body maintains ideal core temperature for biological and cellular equilibrium; controlled by central nervous system and endocrine systems.
    • Exposure to cold/warm environments beyond the body's temperature adaptive processes can cause negative outcomes; such as, hypothermia or hyperthermia

    Hypothermia

    • Hypothermia: core temperature below 95°F; causes shivering, reduced dexterity, and short-term memory problems/inability to think clearly.
    • Negative impacts: manipulating/coordinating movements; particularly with heavy diving equipment.

    Hyperthermia

    • Hyperthermia: over heating, common in warmer environments.
    • Symptoms include exhaustion, flushed skin, muscle cramps, headaches/light-headedness, and nausea
    • Temperatures above 100°F can become dangerous at a cellular level.

    Fitness to Dive

    • Required physical exams, screening for underlying health conditions
    • Maintenance and improvement of physical fitness for efficient and responsive diving action
    • Adequate Sleep, Hydration, and nutrition are important for appropriate dive decision making
    • Avoiding smoking/drugs are important

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    Diving Physiology PDF

    Description

    This quiz focuses on the physiological aspects of diving, covering the circulatory, respiratory, musculoskeletal, and nervous systems. It includes discussions on injuries related to diving activities, prevention strategies, and the body's response to various diving conditions. Test your knowledge on how different body systems interact during diving.

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