Cyanosis

Bluish discoloration of skin or mucus membrane due to the presence of at least 5gm reduced hemoglobin per 100 ml of blood in capillaries. A person with anemia almost never becomes cyanotic because there is not enough hemoglobin for 5 grams to be deoxygenated in 100 milliliters of arterial blood. Conversely, in a person with excess red blood cells, as occurs in polycythemia vera, the great excess of available hemoglobin that can become deoxygenated leads frequently to cyanosis, even under otherwise normal conditions.

Sites
Mucus membrane Lips Ear lobes Nail beds Tongue Tip of nose

Types
1) Peripheral Peripheral cyanosis is seen in the hands and feet, local cause like Stagnant hypoxia Exposure to severe cold

2) Central Central cyanosis is seen in the tongue and lips, cause in rs or cvs

Note - Cyanosis Never occur in anemia and

histotoxic hypoxia

PERIPHERAL CYANOSIS
Causes are -

Cold exposure
Redistribution of blood flow from extremities

Arterial obstruction
Venous obstruction (thromb.)

CAUSES OF Central CYANOSIS

(A )In lung diseases:
- Obstructive emphysema

- Pulm. Emboli - Cor pulm. Chr. - Pulmonary edema - Hypoxic hypoxia - CO poisoning - polycythemia (B) In Cardiac diseases: Right to left shunts

CAUSES OF Central CYANOSIS:

C. Reduced O2-satur. of arteries 1. On high altitude - decreased atm pressure 2. Impaired lung-functions A. Alveolar hypoventillation B. Hypoventillated and hypoperfused alveoli C. Reduced diffusion of O2 3. Anatomical abnormal pathways: shunts A. Congenital heart diseases (not all of them) (RL shunt) B. Pulmon. AV-fistulas C. Multiple small intrapulmonary shunts 4. Dysfunction of oxygen-binding at the haemoglobin

CAUSES OF Central CYANOSIS:

D. Abnormal haemoglobins

1. Methaemoglobinaemia 2. Sulfhaemoglobinemia

Hypercapnia
Hypercapnia means excess CO2 in the body fluids. When the alveolar Pco2 rises above about 60 to 75 mm Hg, an otherwise normal person by then is breathing about as rapidly and deeply as he or she can, and "air hunger," also called dyspnea, becomes severe. If the Pco2 rises to 80 to 100 mm Hg, the person becomes lethargic and sometimes even semicomatose. Anesthesia and death can result when the Pco2 rises to 120 to 150 mm Hg. At these higher levels of Pco2, the excess carbon dioxide now begins to depress respiration rather than stimulate it, thus causing a vicious circle: more CO2> further decrease in respiration > then more CO2, and so forth-culminating rapidly in a respiratory death.

Dyspnea - Air hunger

Def.- Dyspnea means mental anguish associated with inability to ventilate enough to satisfy the demand for air. Three factors for development of the sensation of dyspnea. (1) Abnormality of respiratory gases in the body fluids, especially hypercapnia and, to a much less extent, hypoxia; (2) The amount of work that must be performed by the respiratory muscles to provide adequate ventilation; (3) State of mind or Neurogenic dyspnea or Emotional dyspnea. This feeling is greatly enhanced in people who have a psychological fear of not being able to receive a sufficient quantity of air, such as on entering small or crowded rooms.

Pneumonia
The term pneumonia includes any inflammatory condition of the lung in which some or all of the alveoli are filled with fluid and blood cells. A common type of pneumonia is bacterial pneumonia, caused most frequently by pneumococci. Two major pulmonary abnormalities: (1) Reduction in the total available surface area of the respiratory membrane and (2) Decreased ventilation-perfusion ratio. Both these effects cause hypoxemia (low blood oxygen) and hypercapnia (high blood carbon dioxide).

Thanks
THE END