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Questions and Answers
Which reactive species is NOT typically considered a reactive oxygen species (ROS)?
Which reactive species is NOT typically considered a reactive oxygen species (ROS)?
What condition is defined as the injury caused by reintroducing blood flow after ischaemia?
What condition is defined as the injury caused by reintroducing blood flow after ischaemia?
How much of the total body water is made up of intracellular fluid (ICF)?
How much of the total body water is made up of intracellular fluid (ICF)?
Which statement is true regarding the production of ROS?
Which statement is true regarding the production of ROS?
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What can excess ROS lead to following reperfusion after ischaemia?
What can excess ROS lead to following reperfusion after ischaemia?
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Which type of fluid makes up the extracellular fluid (ECF)?
Which type of fluid makes up the extracellular fluid (ECF)?
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What is a potential complication following cardiac reperfusion in patients with myocardial ischaemia?
What is a potential complication following cardiac reperfusion in patients with myocardial ischaemia?
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Why is hydration considered vital for the body's functions?
Why is hydration considered vital for the body's functions?
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What does the phrase 'time is tissue' emphasize in the context of ischemic events?
What does the phrase 'time is tissue' emphasize in the context of ischemic events?
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Which of the following can cause ischemia?
Which of the following can cause ischemia?
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What is the relationship between hypoxia and cell death?
What is the relationship between hypoxia and cell death?
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Why is early recognition of ischemic tissue critical?
Why is early recognition of ischemic tissue critical?
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What is a common misconception about hypoxia?
What is a common misconception about hypoxia?
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What clinical action can help reduce hypoxic cell injury?
What clinical action can help reduce hypoxic cell injury?
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When is ischemia considered a time-critical condition?
When is ischemia considered a time-critical condition?
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What does the reduced availability of oxygen in the atmosphere indicate?
What does the reduced availability of oxygen in the atmosphere indicate?
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What is the primary process through which water moves in and out of cells?
What is the primary process through which water moves in and out of cells?
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Which process predominantly contributes to the loss of water under normal conditions?
Which process predominantly contributes to the loss of water under normal conditions?
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What role do aquaporins play in cells?
What role do aquaporins play in cells?
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Where is hydrostatic pressure the highest in the circulatory system?
Where is hydrostatic pressure the highest in the circulatory system?
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What is the primary function of oncotic pressure?
What is the primary function of oncotic pressure?
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What happens to any fluid that is not drawn back into the bloodstream by oncotic pressure?
What happens to any fluid that is not drawn back into the bloodstream by oncotic pressure?
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Which statement about hydrostatic and oncotic pressure is true?
Which statement about hydrostatic and oncotic pressure is true?
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Which process is primarily responsible for fluid movement in the presence of higher solute concentration inside the vessel?
Which process is primarily responsible for fluid movement in the presence of higher solute concentration inside the vessel?
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What condition is characterized by the accumulation of fluid in the interstitial space?
What condition is characterized by the accumulation of fluid in the interstitial space?
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What primarily drives the osmotic movement of fluid back into a blood vessel?
What primarily drives the osmotic movement of fluid back into a blood vessel?
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Which of the following is a common complication of fluid therapy?
Which of the following is a common complication of fluid therapy?
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In the capillaries, which factor contributes to fluid reabsorption?
In the capillaries, which factor contributes to fluid reabsorption?
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What effect does increased hydrostatic pressure have on fluid movement?
What effect does increased hydrostatic pressure have on fluid movement?
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Which of the following statements about edema is true?
Which of the following statements about edema is true?
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Which vessels primarily have the highest hydrostatic pressure?
Which vessels primarily have the highest hydrostatic pressure?
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What is the primary factor that can lead to increased hydrostatic pressure?
What is the primary factor that can lead to increased hydrostatic pressure?
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What symptoms did Phyllis exhibit that led to paramedics being called?
What symptoms did Phyllis exhibit that led to paramedics being called?
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How does sodium influence water movement in the body?
How does sodium influence water movement in the body?
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What is the normal concentration range for sodium in the extracellular fluid?
What is the normal concentration range for sodium in the extracellular fluid?
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Which of the following best describes the relationship between sodium and chloride?
Which of the following best describes the relationship between sodium and chloride?
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What could be a potential cause for Phyllis' leg swelling and reluctance to walk?
What could be a potential cause for Phyllis' leg swelling and reluctance to walk?
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What roles do the kidneys play regarding sodium levels in the body?
What roles do the kidneys play regarding sodium levels in the body?
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Which electrolytes are considered the main positive electrolytes in the body?
Which electrolytes are considered the main positive electrolytes in the body?
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What type of transport does chloride utilize in relation to sodium?
What type of transport does chloride utilize in relation to sodium?
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Study Notes
Time is Tissue
- Prolonged tissue deprivation of oxygenated blood increases the risk of cell death and permanent damage.
- Early intervention is crucial to minimize tissue loss and improve patient outcomes.
Ischaemia
- Reduced oxygen in the atmosphere does not automatically result in ischaemia.
- Ischaemia is caused by obstructed blood flow, reduced blood volume, low oxygen levels, or external pressure on blood vessels.
Hypoxia and Ischaemia
- Hypoxia and ischaemia are the most common causes of cell death.
- Some cells can regenerate, but others are permanently lost upon death.
- Proper assessment and airway management/oxygenation can reduce or avoid hypoxic cell injury/death.
- Ischaemia is time-critical in situations such as strokes and heart attacks.
Reperfusion Injury
- Restoring blood flow to a cell can lead to further injury known as ischaemia-reperfusion injury.
- This occurs because oxygen molecules interact with reactive oxygen species (ROS) during reperfusion, causing ROS to multiply and damage cells.
Paramedic Considerations
- Some paramedic treatments resolve ischaemia, potentially leading to ischaemia-reperfusion injury.
- Reperfusion in myocardial ischaemia may cause temporary cardiac dysrhythmias like ventricular fibrillation or tachycardia.
Total Body Water
- Total body water is divided into intracellular fluid (ICF) and extracellular fluid (ECF).
- ICF comprises two-thirds of total body water.
- ECF comprises the remaining third and is further divided into interstitial fluid and intravascular fluid.
Water Loss
- Under normal conditions, most water loss occurs through urine, breathing, sweat, and faeces.
- The majority of water loss is through urine.
Osmosis
- Osmosis is the movement of water through a semi-permeable membrane from an area of low solute concentration to an area of high solute concentration.
- In cells, water moves across the lipid bilayer through aquaporins, which are protein water channels.
Hydrostatic Pressure
- Hydrostatic pressure is the pressure inside of vessels.
- Fluid under pressure is pushed out of vessels, primarily water.
- Hydrostatic pressure is highest in arteries due to higher pressure in the arterial system.
Oncotic Pressure
- Oncotic pressure, also called osmotic pressure, is the pull of fluid back into vessels due to osmosis.
- This pull is caused by the higher concentration of proteins like albumin inside the vessel.
- Under homeostatic conditions, any fluid not drawn back in by oncotic pressure is collected by the lymphatic system.
- Oncotic pressure is highest in the veins because of lower pressure in the venous system and less hydrostatic pressure.
Fluid Pressure
- Fluid pressure is highest in arteries.
Osmotic Movement
- The osmotic movement of fluid back into a blood vessel is due to oncotic pressure.
Oedema
- Oedema is the accumulation of fluid in the interstitial space.
- The four main causes of oedema are:
- Increased hydrostatic pressure
- Reduced oncotic pressure
- Increased capillary permeability
- Lymphatic obstruction
Case Study - Phyllis
- Phyllis presents with significant pitting oedema in her right foot and leg, swollen up to the thigh.
- This suggests increased hydrostatic pressure in the lower extremity, potentially due to venous insufficiency or heart failure.
Electrolytes
- Electrolytes are molecules with either a positive or negative charge.
- The main positive electrolytes in the body are sodium, potassium, calcium, and magnesium.
- The main negative electrolytes are chloride, bicarbonate, phosphate, and sulfate.
Sodium
- Sodium (Na+) is the main extracellular cation, responsible for regulating water balance and extracellular volume.
- Its concentration is maintained by the kidneys, neural, and hormonal processes.
Chloride
- Chloride (Cl-) is the main extracellular anion and balances the charge of sodium.
- Its transport is passive and is proportionately related to sodium movement.
Sodium Concentration
- The normal sodium concentration is 135-145 mEq/L.
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Description
Explore the critical concepts of ischaemia and hypoxia and their effects on tissue health. Understand the factors causing tissue deprivation and the importance of timely intervention in medical emergencies such as heart attacks and strokes. This quiz will help deepen your understanding of how these conditions lead to cell death and the significance of reperfusion injury.
