NATIONAL UNIVERSITY OF PHARMACY

DEPARTMENT OF PATHOLOGICAL PHYSIOLOGY

HYPOXIA
PLAN OF LECTURE

1. Definition, classification of hypoxia.

2. The concept of hypoxic hypoxia.
3. Types of endogenous hypoxia.
4.Urgent and long-term mechanisms of
compensation of hypoxia.
 * Questions of Independent
work

1. Iso- and hyperbaric oxygenation.

2. Toxic effect of oxygen. Hyperoxia and
free radical reactions.
Suggested Reading
 Basic
1. General and clinical pathophysioilogy/ Editer by Anatoliy V. Kubyshkin.
– Vinnytsa : Nova Knyha Publishers, 2016. – 656 p.
2. Lecture notebook pathological physiology. Manual for working in lectures
/ N.M.
3. Kononenko, S.I. Kryzhna, V.A. Volkovoy at al.; Kh.: NPhаU, 2013. – 99
p.
Pathological Physiology: The textbook for the students of higher pharmaceutical
educational institutions and pharmaceutical faculties og higher medical
educational institutions III-IV levels of accreditation / S/I/ Kryzhna, N.M.
Kononenko, I.Yu. Tishenko et al.: under edition of the professor A.I.
Bereznyakova. – Kharkiv: NphaU, 2006. – 416 p.
Auxiliary


1. Professional guide to Pathophysiology / M.H. Birney, C. L. Brady,

K.T. Bruchak et al. – Lippincott Williams and Wilkins. – 2002. – 696
p.
2. Crowley L.V. An introduction to human disease: pathology and
pathophysiology correlations / L.V. Crowley . – London : Lones and
Bartlett Publishers International Bard House. 2001. – 790 p.
 1 4
O2 of the the enveroment
O2 in the vessels

2
O2 in the lung
5
O2 in the tissue

3
RBC carry O2
 Hypoxia is a typical pathologic process, developing as a result
of insufficient tissue supply by oxygen or its disturbed use.
Classification by time of appearance
and duration of hypoxia features
1. Fulminant (immedate) – developing during several
seconds (histotoxic hypoxia during cyanide poisoning)
2. Acute – developing during several minutes (shock, cardiac
accidents, bronchospasm)
3. Subacute – continues for several hours or day
(extreme conditions and pathological states)
4. Chronic – continues for months and years (chronic
heart or
respiratory failure)
 Classification by etiology and
pathogenesis
2 Respiratory hypoxia
1 Hypoxic or exogenous occurs as a result of disturbed
external breathing:
hypoxia develops in the decreased
partial pressure of oxygen. The most disturbance of lung ventilation,
the
typical example of it – is a lung blood supply or oxygen
mountain disease. diffusion.

4 Circulatory hypoxia
in different
developsdisturbances of 3 Haemic hypoxia develops in
blood disturbances and in
blood
circulation. There are ischemic and
particular the decrease its
congestive forms.
of
oxygen capacity.

Tissue hypoxia is a disturbance in

combined forms oxygen utilization. Tissue supply by
of hypoxia. 6 oxygen is sufficient, but its
5
biologi calis disturbed.
oxidation
 PATHOGENESIS OF HYPOXIA

During hypoxia occur metabolism disorders.

Violation of carbohydrate metabolism leads to
the accumulation of unoxidized products (for
example lactic acid). The normal environment
of organism pH=7.4 and during hypoxia occurs
acidosis (6.8; 6.6; 6.4). Acidic environment or
acidosis destroys the cells in the body.
 Etiology and pathogenesis
Type of Etiology Pathogenesis

hypoxia
Hypoxic Getting to high altitudes, rapid Decreased partial pressure
depressurization of the closed aircrafts, of oxygen in inspired air
quick ascent to high altitude, flying in
open planes, when persons are situated
in small room with bad ventilation long
time, in divers with the problems of
aqualung function.

Respiratory Diseases of respiratory system: Disturbed external

pneumonia (inflammation of lungs), breathing: the disturbance
inflammation of bronchus, bronchial of the lung ventilation, the
asthma,asphyxia, overdose of narcotic lung blood supply or oxygen
(depressing of respiratory center), diffusion
tumor of bronchi, pneumosclerosis,
bronchial asthma.
Etiology and pathogenesis
Type of Etiology Pathogenesis
hypoxia
Haemic 1)Anemia after hemorrhage Decreases of oxygen
(bleeding), as a result of deficiency capacity as a result of
of vitamins and minerals decreases of a quantity
2) Inactivated forms of of erythrocytes (RBC)
hemoglobin: and hemoglobin)
 poisoning of carbon monoxide –

carboxyhemoglobin
poisoning of nitrites, by nitrates,

dyes - methemoglobin
Circulatory Diseases of the heart (heart Disorders of blood
insufficiency, the defects of heart, circulation
myocardial infarction) and blood
vessels (shock, collapse and
disturbed of peripheral blood
circulation – ischemia, venous
hyperemia )
Etiology and pathogenesis
Type of Etiology Pathogenesis
hypoxia
Tissue poisoning of cyanides, alcohol, Disturbance of the
(Histotoxic) barbiturates – inactivation of utilization of oxygen be
respiratory enzymes; tissue
protein starvation, avitaminosis of
B1, B2, PP – disturbance of the
synthesis of respiratory enzymes
lipid peroxidation products, toxic
metabolites in uremia – damage to
mitochondrial membranes

Mixed Anaphylactic, traumatic, cardiac Several types of hypoxia

shock
Hypoxia of Intensive physical work deficiency of oxygen
load
 MOUNTAIN SICKNESS
develops after getting to high altitudes in mountains.
Example, hikers, skiers and adventurers hike up a mountain
or go skiing.
In this moment you body may not have enough time
to adaptation for low partial pressure of oxygen in inhaled
air.
 ALTITUDE SICKNESS
It develops after rapid depressurization of the closed aircrafts,
quick ascent to high altitude, flying in open planes. It is
characterized loss of consciousness, gas embolism, explosive
decompression.
 Disturbances in the nervous Metabolic disturbances in the
first euphoria occurs (characterized by the
system: tissue : toxic products of incomplete
emotional & motion excitation, the oxidation are accumulated, accumulated
of
feeling
one's own power or, on the contrary, the lactic acid leads to acidosis. The
loss of interest to the surroundings, appearance of products of lipids
inadequate behavior). Then reflex activity
peroxide oxidation is an important
is disturbed, loss of consciousness and
convulsions development factor of hypoxic injury of the cell.

Signs of hypoxia

Disturbance of the respiratory Disturbance of cardiovascular

system: breathing becomes frequent system: tachycardia, reduced or
and superficial, with symptoms of preserved systolic blood pressure,
hypoventilation may occur periodic pulse pressure does not change or
Chein-Stock’s breathing increased
 Compensatory-adaptation reactions develop in the system
of transport and utilization of oxygen.

2. Blood is redistributed to
1. The increase of lung supply the most important organs
ventilation due to excitation – lungs, heart, and brain at
of the respiratory centre by the decreased blood
accumulation of CO2. circulation in the skin,
spleen, muscles, and
intestines.
3. The increase of erythrocytes and
hemoglobin extends oxygen 4. The changes of
capacity of blood due to ejection oxyhemoglobin
of blood from depots. dissociation curve
 The mechanisms of long-term adaptation to
hypoxia: hypertrophy and hyperplasia

The changes in oxygen utilization :

The weight of the respiratory muscles,
-tissue enzymes utilize oxygen
lung alveoli, myocardium, and
better, support a high level of oxidizing
respiratory neurons is increased.
processes and realize normal synthesis
These organs become better supplied
of ATP;
with blood at the expense of the
- the most effective use of energy.
increased number of capillaries and
their hypertrophy.

The other mechanism of adaptation

is an increase of the respiratory
enzymes and mitochondria.
Thanks for attention!