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00:04 | Alright. So, we have a on Tuesday. Hey, you |
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00:10 | it's not your tests are never right? Um And so we got |
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00:15 | lot to cover tomorrow. What to ? Thank you. That means you |
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00:19 | are all doing it. The people aren't here are the ones screwing it |
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00:22 | . All right. Why do I that? It's historical, Right? |
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00:28 | saw that look like he's being mean . Alright. What we're gonna do |
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00:33 | we're gonna first kind of finish up we're talking about compliance and elasticity. |
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00:37 | purpose of surfactant. Then we're jumping the real role of the lung. |
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00:43 | lung is responsible for gas exchange. kind of what I'm looking for is |
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00:48 | exchange. We're gonna look at gas . And then we're just gonna kind |
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00:51 | look at the the system. And have you ever wondered why you cover |
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00:55 | ? I mean, I know we've of pointed out here's why you do |
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00:57 | . Here's what you do Physics. we're really gonna be looking at some |
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01:00 | and chemical laws, not so much them, but basically saying this is |
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01:04 | it happens. And it's because of laws of nature, Right? Things |
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01:09 | gonna move down there. Partial pressure . That's the gist of this lecture |
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01:14 | looking at the partial pressure gradients, ? So, we're gonna start here |
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01:18 | . Um So, we talk about in the last, since I gave |
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01:21 | examples at the very end of And I said no. These two |
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01:24 | and it kind of helps you see . So compliance is the ability for |
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01:28 | lung tissue to do which is up on the board, you can stretch |
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01:33 | then sew last instance its ability to back. Alright. And so anything |
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01:38 | interferes with that is gonna interfere interfere lung function. So for example when |
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01:43 | smoke, what you're doing is you're uh you're cooking the elastic tissue so |
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01:48 | can't be mobile, right? And it becomes harder to actually breathe in |
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01:54 | it becomes harder to breathe out. have to work harder to make that |
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01:58 | . So if you've seen somebody who's from COPD or is from years and |
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02:03 | of lung or sorry, from you see when they breathe because now |
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02:09 | they're doing is they're doing forced breathing get past that problem. Now, |
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02:16 | breathing would be kinda hard if we dealt with the Al Viola, the |
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02:22 | Viola themselves. We we talked a bit about this about blowing up balloons |
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02:26 | parties, right? And when the deflates, you got the liquid inside |
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02:29 | balloon kind of serves as a Well, that's the purpose of |
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02:33 | It basically helps when I actually do . There we go. It deals |
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02:39 | the question of surface tension. So tension. I know this is gonna |
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02:44 | the first thing I have to do . Alright. Surface tension really has |
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02:47 | do just do with what water does is attracted to what more water. |
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02:54 | so what you're doing is with polar are attracted to each other. They |
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02:58 | on each other. So, if ever played with water before, you |
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03:01 | if you take a drop of water put it on a table, what |
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03:03 | that water do? Does it flatten and become a molecule thin? What |
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03:07 | it do form the drop, it up. And so wherever water is |
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03:12 | polar, that polar nature of water gonna do that and that's what it |
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03:16 | in the lung, it will do same thing. And this is what |
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03:19 | this stuff is showing you the physics the chemistry behind all this stuff is |
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03:25 | telling you, look when waters around , it where the more water you |
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03:29 | , the more it's gonna attract itself it's gonna bring with it, those |
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03:33 | too, it's attached. So if on the inside of the lung, |
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03:38 | the the alveoli, what's going to is the water next to water is |
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03:43 | to pull on. It's gonna keep sides until eventually you're pulling the sides |
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03:47 | the alveoli together and you're basically squishing Al Viola so that it's kind of |
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03:53 | the balloon that has deflated. And that water, because of its polar |
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03:57 | is acting kind of like a All right. Who works in labs |
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04:02 | ? Who's done lab work? So gonna land on like six of |
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04:05 | maybe seven of you. Have you had to clean glassware in a |
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04:08 | Like the place for Western blot. , two people are nodding their heads |
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04:14 | , get two panes of glass that perfectly flat, you put water in |
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04:18 | them, you bring them out and stuck together. There's it's impossible to |
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04:23 | what you have to do. You to twist them and then they'll come |
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04:26 | because you've broken all those attractive hydrogen . That doesn't make sense to |
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04:32 | go home, grab yourself a ziploc , filled that ziploc bag with |
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04:37 | empty out the water, push it , seal it come back a couple |
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04:41 | later and try to separate out the sides. The two sides don't want |
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04:45 | separate because the water in there is attracted to itself. And it's holding |
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04:49 | two sides close together. It's a little tiny little experiment that you can |
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04:53 | this. So that's what your lungs doing. So this is a problem |
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04:57 | you're dependent upon that surface area. every time you collapse in Al |
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05:01 | it's no longer involved in the process gas exchange. So, so surfactant |
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05:07 | the chemical that breaks that up. really what surfactant is is a bunch |
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05:11 | lifting a bunch of protein. And little picture down here kind of shows |
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05:15 | like you can see here the water are all attracted to each other. |
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05:18 | what surfactant does is it basically breaks the water so it can't come close |
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05:25 | . And so when the water can't close together, it can't have those |
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05:30 | attractions, you can keep the alveoli collapsing on itself. Now, there's |
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05:37 | relationship here that's really kind of And this is what this little equation |
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05:41 | . Up here, it says the pressure of a spherical structure which the |
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05:46 | are spherical or spheroid, right, equal to twice attention divided by its |
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05:52 | . And really what this says is the smaller the radius, the greater |
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05:57 | tension. All right, So what want you to do is I want |
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06:00 | picture. I wanna make sure I this. Yeah, it's the same |
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06:02 | . So here we have your breathing and you have Alvin ally of different |
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06:07 | . Okay, so the first thing surfactant does it prevents them from collapsing |
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06:12 | themselves. But the second thing that does it allows for alveoli of different |
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06:17 | to distribute air equally to counter that pressure. All right now, let |
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06:23 | just kind of see if I can if that makes that makes this makes |
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06:26 | . Here, you see, I a small Alvin ellis and here I |
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06:29 | a big Al Viola. Now, it's not an algae elicits picture. |
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06:32 | to demonstrate that alright, if air in into both those paces as air |
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06:38 | those up, where does the pressure ? More based on that little |
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06:42 | I just told you which one you're it come on, which one is |
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06:47 | gonna be the big one? Or small one? The small one. |
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06:50 | , so if I have more pressure the small one than in the big |
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06:53 | , what do you know about pressures too high? Too low? So |
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06:57 | small one now is now pushing air of itself and pushing it into the |
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07:02 | one because until equilibrium is met. so what you're doing is the little |
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07:07 | are basically withdrawing or pulling themselves out the surface area. Right? In |
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07:12 | words, because they get greater they can't maintain their shape the same |
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07:20 | that the lb all I do, larger ones do. So the air |
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07:23 | into the larger ones, the little kind of collapse on themselves. Not |
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07:27 | . That reduces your surface area. your fact? It does, is |
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07:31 | reduces this effect. It basically quill so that those two sides basically maintain |
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07:39 | same partial pressures within them or the pressures. So you don't get the |
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07:44 | amount of titian attention. And so get equal equal aberration and when you |
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07:48 | that collaboration small ones can fill up roughly the same rate as the big |
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07:53 | do because the service allows that the tension doesn't pull on the sides equally |
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08:00 | as much. And so the next is the same slide. It just |
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08:04 | of shows us that says here, can see we have lots of surfactants |
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08:08 | there. And what that does is makes this one expand roughly at the |
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08:12 | rate as that one does, it have to fight so hard. And |
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08:16 | they basically can both play a role gas exchange. So surf action has |
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08:22 | roles. It ensures that unequal that would normally be unequal distribution of air |
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08:28 | occur. But it also ensures that alveoli collapse, they actually don't ever |
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08:33 | really is what it says. They can, but you don't get the |
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08:36 | sort of pressure. That kind of sense between those two things. one |
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08:42 | nodding. Yeah, yeah, because this inward pressure. Right? So |
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08:48 | it's saying is is that um you're talking about when there's water because |
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08:53 | attractive, so here's the water on surface of the of the wall of |
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08:58 | alveoli. So it's gonna be attracted the water next to it. But |
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09:03 | also attracted to the surface. So it's doing is it's pulls the two |
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09:08 | close together. So if you get water in there basically serves as glue |
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09:12 | of the polar attraction between the hydrogen that are naturally in the water in |
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09:16 | tissue and on the other tissue on other side it's so again, go |
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09:23 | to a go picture of balloon because , you see that So if you |
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09:26 | water in that balloon, it doesn't to open up, right, you |
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09:28 | put an air in it. But it deflates, right? So, |
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09:31 | will naturally inflate. But once the leaves, instead of staying partially |
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09:36 | the water causes the attraction between the sides. So sandwiches together. And |
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09:41 | it takes more work to separate them . You gotta break those hydrogen |
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09:45 | Very, very hard to do. , they do. But how do |
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09:51 | inflate and deflate as you're breathing? ? So, remember you don't think |
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09:56 | the lung as a big giant Think of it as thousands and thousands |
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10:00 | thousands of little tiny balloons, microscopic , right? So that's where all |
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10:06 | exchanges taking place. So, when expanding your lungs, what you're doing |
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10:09 | you're pulling air in to fill up space, that little tiny space. |
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10:18 | , we come back to where we when we first started talking about |
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10:22 | And I can show you this picture the next picture. But really what |
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10:25 | talking about when we're talking about respiration not the stuff that's going on in |
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10:29 | , because this is middleman, The circulation serves as the middleman to |
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10:34 | the oxygen down to the tissues that need and the carbon dioxide from the |
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10:39 | back out of the body. All ? But in order to go from |
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10:42 | to there, we have to now this middleman and what it's doing, |
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10:46 | ? So, the middleman is Your lungs is just the surface through |
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10:52 | that air is going to go so it can get to these cells. |
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10:57 | what's the furthest part of your body from your lungs toes. Okay, |
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11:02 | gonna go to's would you have toes, feet and toes? So |
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11:06 | order for those little tiny cells in toes to stay alive, they need |
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11:10 | as well as the glucose. So do you get them there? How |
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11:14 | get oxygen to your toes? Your ? Great. So what we're looking |
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11:20 | here is basically that diffusion of oxygen carbon dioxide oxygen, partial pressure of |
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11:27 | in the Al Viola i is greater the partial pressure of the oxygen in |
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11:31 | cells. So it naturally wants to from there to there, partial pressure |
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11:34 | carbon dioxide is greater than the partial of carbon dioxide in the Al |
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11:38 | So the carbon dioxide wants to go the cells to the alveoli. But |
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11:42 | so far apart that they need that . And in order to get the |
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11:47 | into the blood. The partial pressure oxygen in the blood needs to be |
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11:51 | than the partial pressure of the Al . Does that make sense? In |
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11:56 | words, it's a step I have have a step down in order for |
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12:00 | to happen. So the blood coming from your tissues has the same partial |
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12:06 | that surround the tissues. The partial of the gas is coming from the |
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12:12 | is gonna be matched all the way through the blood until it gets down |
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12:15 | the tissues. And that's what this trying to show you is. So |
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12:19 | ignoring all this. But look, partial pressure of the oxygen here is |
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12:24 | to the partial pressure down there. ? Well, pick your poison chicken |
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12:29 | egg, right, Which one ever . But you can imagine here the |
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12:32 | has high partial pressure because the partial difference here auction flows out into the |
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12:38 | until equilibrium is met. What would be 40? So as the blood |
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12:45 | , it has that same partial pressure back up into the lungs. |
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12:49 | look much, much lower. Auction flowing in from the al viola into |
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12:54 | blood until it reaches equilibrium, equilibrium be 100. And so it goes |
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13:00 | down. So this is where that is taking place. We're moving oxygen |
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13:07 | the blood until equilibrium is met so we can then deliver to the |
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13:10 | Because there's such a huge difference. moves into the tissues until equilibrium is |
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13:15 | . That blood returns back to the , repeats the process over and over |
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13:19 | over again. Okay, same thing true for carbon dioxide, carbon dioxide |
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13:24 | are higher than out here. So dioxide is going to flow into the |
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13:29 | because the carbon dioxide partial pressure is in the blood. So we reach |
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13:35 | when that blood leaves, it has equilibrium, traveling through circuit Elation when |
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13:39 | gets into the cap layers of the . Now we can do that |
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13:43 | So, carbon dioxide is going to until it reaches the partial pressure in |
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13:48 | in the Alveoli. So the blood it leaves contain still carbon dioxide, |
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13:54 | it's less. And then that's why still get this exchange going on. |
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13:58 | , if you can envision this, now understand everything we're going to talk |
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14:01 | for the next 40 minutes. do we all understand this this |
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14:05 | Because the harder part is how? ? How does it do this? |
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14:10 | , we know the rule. But do we get all those gasses to |
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14:14 | they need to go? So oxygen transported in two different ways. What |
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14:22 | just been describing, we talked about pressures is literally dissolving the gasses in |
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14:26 | blood in the plasma. Alright, we say the partial pressure of oxygen |
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14:31 | of mercury. That means we have oxygen molecules sitting around inside the fluid |
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14:35 | your blood. Just kind of sitting going, OK, I'm just gonna |
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14:38 | around with the fluid, all But unfortunately, that's not enough to |
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14:42 | us alive. Alright, It's not much oxygen. In fact, I |
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14:47 | the next slide now, it's over shows about three mils of oxygen per |
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14:52 | of blood, and it's not very . Alright, So, this would |
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14:56 | happening if all you had were your vessels and you're moving oxygen from the |
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15:02 | into the blood itself. You reach fairly quickly and wouldn't do you much |
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15:10 | the way that we're more efficient in of moving oxygen is having that |
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15:16 | Alright, hemoglobin is not circulating in blood. It's found in the original |
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15:22 | . If it's in the blood, means your sites are bursting and bad |
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15:26 | are happening. All right. you gotta remember what we're doing is |
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15:29 | sequestering away oxygen into the red blood . All right. So this is |
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15:35 | formula, you know, deok CMA in plus oxygen is gonna favor oxygen |
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15:41 | on and releasing a proton. And if there's disequilibrium, we can move |
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15:46 | . So what we're gonna do is gonna shift between these two states, |
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15:49 | ? We're gonna either load up the with oxygen or once the oxygen is |
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15:54 | away and you have freedom to move of it. That's what you're going |
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15:57 | do. So, what we typically is we talk about this in terms |
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16:00 | saturation. So, we're not looking each individual hemoglobin molecule. We're making |
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16:04 | general observation but to think about a molecule, we've already talked about |
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16:09 | How many binding sites for oxygen are for? Right, So each hemoglobin |
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16:14 | a team. Each team combining So that means you combine four oxygen's |
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16:19 | real easy numbers are 100% saturated. means I have all four. Right |
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16:24 | the next one would be 75% and 25%. 0%. So, they're |
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16:31 | easy numbers to work with. But you've ever had an oxygen monitor, |
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16:35 | gone to the doctor to put the ox reader on your finger. You've |
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16:39 | that. What does the number usually out to 96 98? If it |
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16:44 | under 90 everyone gets really, really . Right. So, obviously not |
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16:49 | hemoglobin in your body is 100% saturated the time. Right? There is |
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16:54 | an exchange that's taking place during normal . You're not gonna be 100%. |
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16:59 | we're gonna work with the easy numbers the numbers make things easy, |
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17:05 | Only in the hard math classes do make you work with really scary |
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17:09 | Right. Whereas, my kids would right now, because they're working with |
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17:12 | that's not a fraction. I don't how to do that, you |
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17:16 | All right. So very, very . The partial pressure of oxygen is |
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17:22 | to contribute to the percentage of hemoglobin . Now, where's the partial pressure |
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17:27 | oxygen in the plasma blood? That's what we're looking for. |
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17:35 | if I raise the partial pressure of in the plasma oxygen wants to go |
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17:40 | well, where can it go? can go into the red blood |
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17:43 | There's actually float in the red blood . That also has a partial pressure |
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17:46 | oxygen. And then what that's gonna is as that increases the oxygen. |
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17:50 | to try to find the next place fill up. Think of it as |
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17:52 | bunch of empty cups, right? I fill up one and now I |
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17:56 | spill over, I can fill in the next cup and then the next |
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17:59 | in the next cup and the bottom is gonna be a red blood |
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18:02 | And inside the red blood cells is hemoglobin. So the more oxygen you |
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18:06 | into your body, it's gonna try fill up the hemoglobin. So the |
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18:10 | the partial pressure of oxygen. Where the greatest partial pressure of oxygen in |
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18:13 | body? In your lungs? So what am I doing is I |
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18:18 | oxygen in my blood, it's gonna to go and bind to the hemoglobin |
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18:22 | the red blood cells. And we're load up the hemoglobin. And so |
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18:25 | we're talking about that partial pressure or that percent saturation, it's going to |
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18:29 | dependent upon adding in more oxygen. all we're saying. So I just |
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18:34 | a lot of words to make something simple. The more oxygen you |
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18:37 | the more partial pressure, the more pressure, the greater hemoglobin saturation. |
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18:44 | should make sense. Right? So way you can think about hemoglobin in |
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18:50 | blood or in the red blood cells that they are serving as an oxygen |
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18:55 | , You are carrying more oxygen in blood than you need right now, |
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18:59 | ? If we took out your you wouldn't have enough to stay |
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19:02 | But the hemoglobin in your blood right contains more oxygen than you need. |
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19:07 | this a good thing for you? . Alright. Let's say we invite |
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19:12 | to come into the classroom, not guy in the costume, talking the |
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19:18 | lion that we have over at the . Right? We say Shasta, |
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19:22 | play now, how many of you gonna want to play with Shasta? |
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19:26 | one, Everyone's gonna be like, out of here. Don't run away |
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19:28 | a mountain lion that just says come me. All right, But what's |
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19:32 | happen is you want all that So you actually have these reserves already |
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19:37 | circulation to meet your your immediate And then as you start depleting it |
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19:42 | what do you do breathe harder and all those sympathetic responses to ensure that |
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19:49 | get the auction in. Alright, auction is serving as a depot. |
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19:53 | , I throw this up here to of show you what we're talking |
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19:56 | We have to think about. There multiple layers in this, right? |
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20:01 | your Al Viola. You have to through the water layer. There's a |
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20:03 | water layer. You have to go the wall of the cell, |
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20:06 | So there's a type one cell. have to keep going through all these |
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20:10 | layers. We don't ever talk about because it's just a lot of |
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20:14 | But you can imagine at each The oxygen partial pressures are lower and |
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20:18 | and lower. So over here inside red blood cell, that's where the |
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20:22 | level is. So oxygen is gonna flow into the red blood cells. |
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20:25 | it's, oh by the way, can load it up in the hemoglobin |
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20:28 | keep this low so I can keep oxygen in. That kind of makes |
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20:39 | . I'm trying to think of a example that you might know, but |
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20:44 | like as more oxygen loaded, So think about it like this um |
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20:56 | have a series, I mean this not gonna be easy to do |
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21:00 | You have a series of things that want to fill up. This is |
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21:03 | one that you ultimately want to fill , but you can't fill up directly |
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21:06 | . Right plates full of Oreos. say every plate can come up 200 |
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21:12 | . Right? So if I put cookie on this plate, that's |
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21:16 | I can keep loading in cookies on plate. But each cookie wants to |
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21:19 | over the next plate until it gets the very end. So what you're |
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21:21 | is you just keep adding to the . So hemoglobin is the final |
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21:25 | And what it's doing is by your you're filling this up. It's drawing |
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21:28 | oxygen this direction because the thing in of it is not full. The |
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21:32 | in front of that isn't full. thing of that in front of the |
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21:35 | thing that's full of the Al Viola , so oxygen is always gonna be |
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21:39 | in that direction until everything fills up . But by the time the blood |
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21:43 | you've now reached equilibrium and you've loaded your hemoglobin up to 100%. That |
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21:49 | of makes sense. That makes Yeah, go ahead, start. |
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21:55 | right, you just keep putting it there until you can't put anymore and |
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22:00 | that's when Right, well the the is always, the red blood cells |
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22:05 | always in motion, right? So why can we load everything up? |
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22:09 | did we say about capillaries in the of of blood, through the capillary |
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22:15 | or slow, slow. So basically taking its sweet time through the tissue |
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22:20 | be able to receive all that so it reaches equilibrium before it |
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22:25 | it doesn't leave because it's reached Alright. Yeah, well, so |
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22:40 | now we're not even using the we're just caring. Alright, maybe |
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22:44 | might be helpful. Been to a where someone's passing out cake, |
|
|
22:49 | And they give you the cake and like, I'm ready to eat the |
|
|
22:51 | . But it's like no, you gotta pass it down, So |
|
|
22:54 | what's going on here, keep passing down till hemoglobin is full, keep |
|
|
22:58 | it down, hemoglobin is sitting there okay, keep giving me the |
|
|
23:01 | okay now we've got enough cake. we can fill up the next thing |
|
|
23:05 | now we can fill up the next and so on and so forth. |
|
|
23:07 | the idea is hemoglobin is the last because it's not 100% full. So |
|
|
23:13 | it spills, No, not we still haven't left the lungs. |
|
|
23:19 | is all just in the lung. so think about this once hemoglobin fills |
|
|
23:23 | , what's the next thing that fills ? The red blood cell itself, |
|
|
23:27 | up partial pressure becomes collaborated what's becoming with the air in the alveoli. |
|
|
23:35 | fills up. Now this one's gonna up the the oxygen in the plasma |
|
|
23:41 | and then this stuff we just kind ignore. So we're here. So |
|
|
23:46 | this is a 100 of mercury and , when you come in, I'm |
|
|
23:52 | gonna make up a number of The red blood cells. The |
|
|
23:56 | the red blood cells will fill up 100%. Then the fluid inside the |
|
|
24:01 | blood cell is gonna reach a partial of oxygen, 200 millimeters of |
|
|
24:06 | then the surrounding blood is going to 200 millimeters of mercury. Now we're |
|
|
24:09 | equilibrium, there is no gas exchange place. But by that time I |
|
|
24:14 | you, I'm now off moving off the tissues. Right. Uh |
|
|
24:22 | Now this is trying to demonstrate Okay, and it's not a great |
|
|
24:27 | because it's not intended to describe but this shows you what happens when |
|
|
24:31 | don't have red blood cells, I can reach equilibrium, but I |
|
|
24:36 | have enough blood or enough oxygen in blood to keep me alive here. |
|
|
24:41 | is trying to show you that, there is a point where this will |
|
|
24:46 | moving in. So the red blood serve as a bank in which I |
|
|
24:50 | store up that oxygen. And then I'm moving, let's say I move |
|
|
24:55 | one here to saturate. So now hemoglobin 100% saturated, not an |
|
|
24:58 | So the auction here will come here I reach equilibrium. That kind of |
|
|
25:03 | sense. And this you can ignore one. But this is saying even |
|
|
25:08 | you didn't have enough oxygen in the , the red blood cells still are |
|
|
25:12 | to hold more oxygen than the blood itself. So this is why you're |
|
|
25:16 | to stay alive in pain when there's oxygen. Like in colorado, you're |
|
|
25:22 | always in pain in colorado, I'm making that up. Okay, useless |
|
|
25:28 | . But it kind of shows the thing. See what's the red blood |
|
|
25:31 | coming as? Is it 100% No, but when you get in |
|
|
25:35 | lungs, oxygen is moving into the the blood and look, oh now |
|
|
25:39 | gonna start loading up hemoglobin with So by the time I leave I'm |
|
|
25:45 | as saturated. Yeah, Fill So why would it start? We'll |
|
|
25:54 | to that. All right, it's good question. Right. So, |
|
|
25:58 | kind of doing kind of blanket Right. Each molecule is going to |
|
|
26:03 | to the oxygen is bound to And so if you're decreasing infinity or |
|
|
26:07 | infinity, that will cause oxygen to or or enter on. But let's |
|
|
26:12 | an oxygen molecule falls off. that's another one which has less will |
|
|
26:15 | want to bind it. Alright, , what we're looking at here is |
|
|
26:19 | curve, this oxygen hemoglobin saturation It's the sigmoid curve. Alright, |
|
|
26:24 | what this does It demonstrates this cooperative that you kind of just were kind |
|
|
26:29 | alluding to. So, down here the bottom are little graph has a |
|
|
26:32 | pressure of oxygen. Over here, is percent saturation. Again, keeping |
|
|
26:36 | simple, 175. 50 25 is really easy way to look at |
|
|
26:41 | Alright, if you're looking at a molecule, you can kind of think |
|
|
26:44 | those lines. But again, we're really closer to about that 98 |
|
|
26:51 | this is showing you is you can Alright, if one molecule of oxygen |
|
|
26:54 | fall off, right, where would occur? Right, So, over |
|
|
26:59 | here, I am I'm 100% saturated my 100% saturated, Where my partial |
|
|
27:05 | is a 100 of mercury. Why it 100 of mercury? Because that's |
|
|
27:09 | air in the lungs. Right. look, I'm now traveling through the |
|
|
27:15 | , I'm still holding on even as partial pressure of oxygen drops and drops |
|
|
27:19 | drops, I'm still holding on until about there. Right? So there's |
|
|
27:25 | natural affinity to hold on to oxygen you reach a certain partial pressure. |
|
|
27:33 | then once I've released that one the next one will be released somewhere |
|
|
27:39 | . I'm just gonna say right about . So that's about 25 millimeters of |
|
|
27:43 | . Right? So we're saying is there's this natural like, oh, |
|
|
27:48 | there is a need for oxygen, gonna happen is, and how do |
|
|
27:52 | know there's a need for oxygen? pressure is dropping, I'm gonna be |
|
|
27:56 | prone to start releasing oxygen faster. to get from my to get rid |
|
|
28:00 | my first oxygen to release my first , I go from 100 millimeters to |
|
|
28:04 | millimeters. That's a 60 millimeter difference pressure, Right? But to drop |
|
|
28:10 | next one, it's only 15 millimeters pressure. And then the next one |
|
|
28:14 | be about 25. So what we're about there. So let's just call |
|
|
28:17 | 18, Right? The next difference only about seven of mercury. So |
|
|
28:22 | see what it's trying to tell you is that as the body needs more |
|
|
28:27 | hemoglobin is more likely to release that . So affinity is dependent upon the |
|
|
28:34 | of oxygen, you can look at one or two ways, right? |
|
|
28:38 | there's lots of oxygen available. The auction that binds creates an affinity to |
|
|
28:42 | the next one to bind to cause next one to bind. And then |
|
|
28:46 | , oh well it's really high. then we can add the next |
|
|
28:49 | right? So there's this quick, rate at which I'm gonna bind up |
|
|
28:54 | . And that last one it takes little bit of effort. The same |
|
|
28:57 | true. The other direction I quickly oxygen as it's needed. So I |
|
|
29:01 | start off with a lot of option , right? And then it's gonna |
|
|
29:04 | a long time before I release that one. And then boom boom boom |
|
|
29:09 | quickly it occurs. So there's a between the saturation and the amount of |
|
|
29:14 | in the surrounding environment. So partial of oxygen has a direct effect on |
|
|
29:20 | affinity of hemoglobin to oxygen. So the lower the partial pressure, |
|
|
29:27 | lower the affinity. In other the more and more likely to |
|
|
29:30 | Alright, the more partial pressure there , the greater the affinity of me |
|
|
29:35 | to put it onto the hemoglobin. right, So this serves as an |
|
|
29:42 | reserve. Right? So right while you're sitting here, your body |
|
|
29:46 | start releasing that first auction about 40 . Your tissues are not doing a |
|
|
29:51 | of work right now and so you need a lot of oxygen. So |
|
|
29:55 | releasing one oxygen is enough to provide oxygen to keep yourselves going. But |
|
|
30:00 | , if you start running, you're be burning through oxygen much, much |
|
|
30:04 | . So, you need to have source of oxygen. You can't breathe |
|
|
30:08 | enough oxygen to make that happen. we can do is we can add |
|
|
30:13 | that off that hemoglobin and deliver more at any given time. And then |
|
|
30:17 | that that hemoglobin comes back to I can reload all the oxygen that |
|
|
30:23 | just lost and then move it back those tissues. All right, That |
|
|
30:32 | of makes sense, Y'all? Yes no. See a couple of people |
|
|
30:36 | couple of blank faces to its Let's if this makes more sense. |
|
|
30:48 | So, again, it depends on the need of the tissue is. |
|
|
30:52 | that's what these next slides are. , remember. So, here this |
|
|
30:55 | what you are at rest, So, what are you releasing? |
|
|
30:58 | releasing just one let's say you're really exercising, right? You |
|
|
31:03 | So, you can imagine I'm So, what are my tissues using |
|
|
31:07 | oxygen? So, the partial pressure expect to drop, right? Because |
|
|
31:12 | I'm consuming all available oxygen. how do I replace all the available |
|
|
31:17 | ? Well, let me take it the hemoglobin. So, that's what |
|
|
31:20 | doing here is So, down here when I'm burning through oxygen faster than |
|
|
31:25 | . So, my partial pressures Remember, partial pressure just represents the |
|
|
31:30 | of auction that's sitting around available, ? It's like I'm hungry. I |
|
|
31:35 | to go to Taco Bell. What you do? You start picking through |
|
|
31:38 | cushions for free change? Right. what that's that's free available money. |
|
|
31:44 | what that's what your cells are It's like it's already there. I |
|
|
31:47 | need to go to the bank or anything. But let's say you really |
|
|
31:51 | to eat a meal. What do have to do? Pull out that |
|
|
31:54 | . A. T. M. . Right. I have to go |
|
|
31:56 | the bank. I have to actually some real money so I can have |
|
|
31:59 | tacos instead of just one. Or whatever. I don't know what |
|
|
32:02 | guys eating. Yes. Mhm. about All right. All right. |
|
|
32:32 | , So I'm what I'm what I'm you're describing here. And I'm just |
|
|
32:35 | see if I can repeat the So, when I hold my breath |
|
|
32:38 | having no respiration. I'm not bringing fresh air. I'm not removing old |
|
|
32:44 | . Right? So, what's happening all the only type of exchange between |
|
|
32:48 | Al Viola air and the blood is available in the alveoli. So, |
|
|
32:54 | if I'm holding my breath for a of seconds, Nothing's happening because the |
|
|
32:58 | of exchange is just a is a . But let's say I'm now holding |
|
|
33:03 | breath for 20 seconds a minute, minutes. Anyone here done the three |
|
|
33:08 | breath holding now. All right. know? So now what am I |
|
|
33:13 | ? I am now limited to whatever was there. That exchange has been |
|
|
33:16 | on for that same period of So now my body is starting to |
|
|
33:20 | desperate, right? It's it's looking tissues themselves are now looking for |
|
|
33:24 | They're burning through the oxygen that's being on the hemoglobin. The partial pressure |
|
|
33:29 | oxygen are now coming becoming steady The levels of carbon dioxide from your |
|
|
33:35 | of oxygen are rising. And that's sending a signal which we're gonna get |
|
|
33:38 | . We're gonna talk about all this a little bit. It's in the |
|
|
33:40 | to the brain that says we are are a starving of oxygen. We |
|
|
33:48 | this stuff and that's when your heart beating faster. Like well maybe we |
|
|
33:51 | pump it there quicker because it's not Oh yeah, we're holding our |
|
|
33:56 | It's making assumptions that you have access the oxygen hand up. Yeah, |
|
|
34:04 | like when you're submerged underwater, that . No, that's just it's just |
|
|
34:09 | function. When you're underwater, you're a little bit harder to write. |
|
|
34:12 | mean, unless you literally just kind push yourself underwater and hold your breath |
|
|
34:15 | a little bit, you know. , I had a friend who was |
|
|
34:18 | swimmer for stanford and one of the he had was to see how many |
|
|
34:22 | he could swing back and forth across pool. I don't know what his |
|
|
34:25 | was, but he said he actually out and just from muscle men where |
|
|
34:29 | was going, you know? So , they had to pull him out |
|
|
34:34 | the pool and he was like hitting wall at that point, you |
|
|
34:39 | He's a physicist now at Los Just that makes you feel any |
|
|
34:47 | Just picturing him tall goofy guy. . So what are the factors that |
|
|
34:54 | to promote this? Alright, so I when I was in your |
|
|
34:57 | I took a micro economics class. right. You know, here take |
|
|
35:02 | economics, did they do the guns guns and butter demonstration the guns and |
|
|
35:07 | curve? No, they didn't. Well, guns and butter was where |
|
|
35:12 | I spend my where do I spend money and my effort? Right. |
|
|
35:15 | like do I spend it on guns do I spend it on food? |
|
|
35:19 | , it might have been macroeconomic. can't remember. It's been a long |
|
|
35:22 | . Alright. But one of the I remember the professor saying is when |
|
|
35:26 | curve shifts or when you do the curve shifts shifts to the right |
|
|
35:30 | . I'm looking at our resident mathematician ever shift on their own? Do |
|
|
35:35 | ever shift on their own? just on their own. Do |
|
|
35:39 | just move left and right and do know what in order to make a |
|
|
35:43 | change? What you have to Change of variable? Right? So |
|
|
35:49 | reason I'm asking right is what we're at here is this red line that |
|
|
35:54 | looking at that is our normal saturation and you can see there's a green |
|
|
35:58 | blue and I hated every single time the professor would say the curve |
|
|
36:02 | the curve does not shift. What doing is we're changing the curve. |
|
|
36:05 | presenting a new curve to you that based on the original curve. |
|
|
36:10 | But I'm gonna use the word shift it's just easy problem. Was that |
|
|
36:15 | professor who was teaching just like no, it shifts and it was |
|
|
36:18 | he couldn't connect those two things. , So, there are a couple |
|
|
36:21 | things that make this shift. what we're saying when we're saying |
|
|
36:24 | is that a new thing happens at sea same point. Right. |
|
|
36:29 | for example, over here we're looking a hemoglobin saturation P. 02. |
|
|
36:33 | what we're talking about is temperature and the effect of temperature is on that |
|
|
36:37 | down here again, same sort of up. But we're looking at here |
|
|
36:41 | um this acidity Yeah, effective ph right. And so what this is |
|
|
36:47 | is, alright, when when did unload? What was the normal partial |
|
|
36:51 | of oxygen to unload the first? was what, 75%. But what |
|
|
36:58 | the carbon? It was 40. . So, you can see over |
|
|
37:02 | , right, if I go here 40, there's 75. It's a |
|
|
37:05 | easy thing. But look what happens I lower the temperature? Where does |
|
|
37:10 | 75 occur? It's right over it's at a lower partial pressure. |
|
|
37:16 | , temperature with the temperature lowers, hold on to oxygen a lot |
|
|
37:22 | But when I heat up temperature, here we can see, but there's |
|
|
37:27 | 75, I'm releasing it at a higher partial pressure. Oh, so |
|
|
37:34 | I increase temperature, I release oxygen readily. If I lower the |
|
|
37:39 | I don't release oxygen. Now, would this be? Why? |
|
|
37:44 | I mean, this is an effect the hemoglobin. But why, why |
|
|
37:47 | this kind of an important thing? is activity? What does activity result |
|
|
37:53 | what's that? Heat kinetic energy results heat? Right, So, when |
|
|
37:57 | produce heat, that is an indicator metabolic activity. So, hemoglobin has |
|
|
38:03 | to recognize the presence of heat, recognizes the need for oxygen. |
|
|
38:09 | temperature affects how hemoglobin responds, thus me more oxygen when I need it |
|
|
38:16 | . Alright, Same thing with partial or not partial pressure. Same thing |
|
|
38:20 | ph ph is an indicator as ph . In other words, more protons |
|
|
38:25 | a vet available. The acidity That's an indicator of metabolic activity. |
|
|
38:30 | , protons buying hemoglobin says your attraction not so much anymore. So, |
|
|
38:36 | release oxygen as ph goes down if want to make that easy as acidity |
|
|
38:42 | an increase in acidity or a drop ph is an indicator of metabolic |
|
|
38:52 | Carbon dioxide. The more carbon dioxide . What's that an indicator of what |
|
|
39:01 | metabolic activities? Right. It's the thing you can go through. Yeah |
|
|
39:06 | can go through the whole pathway And the very end I end up with |
|
|
39:09 | carbon dioxide. So it's an indicator increased metabolic activity. So you mean |
|
|
39:14 | I increase the temperature of the tissue if I provide more protons which is |
|
|
39:19 | function of metabolic activity or if I more carbon dioxide all those things are |
|
|
39:23 | tell hemoglobin to let go of oxygen I need it. Yes. And |
|
|
39:28 | we have another agent D. G. This is in red blood |
|
|
39:32 | basically it is a product of an like allergic pathway that we haven't bothered |
|
|
39:37 | about. And what it does is cells tell the red blood cells hey |
|
|
39:43 | starving of oxygen. It activates or the D. P. G. |
|
|
39:47 | . And D. P. Basically tells hemoglobin um time to release |
|
|
39:51 | oxygen. So when do we release when we need it? Right. |
|
|
39:58 | the cells themselves are sending the signal non specific means in other words by |
|
|
40:05 | simply doing what they do best. is go through their metabolic activity. |
|
|
40:09 | you here is where I say that to the right shift to the left |
|
|
40:13 | causing a shift to the right life the right. In other words when |
|
|
40:17 | when you're looking this direction, we're releasing more oxygen or we're releasing |
|
|
40:23 | earlier than we normally would is really of what we're saying, it's releasing |
|
|
40:28 | at a higher partial pressure. And are all indicators of, oh, |
|
|
40:33 | stuff must be going on, This activity must be going on. But |
|
|
40:37 | go ahead and keep adding an oxygen they're gonna burn through it. |
|
|
40:40 | factors that cause the curve to shift the left. In other words, |
|
|
40:44 | hold onto the oxygen beyond what I would, So at a lower partial |
|
|
40:49 | is when I'm gonna release that that is what's going on. |
|
|
40:56 | does that kind of makes sense? the easy way to think about in |
|
|
40:59 | mind is just think in terms of activity. If I can know what |
|
|
41:03 | activity results in is telling me when need to have more carbon or more |
|
|
41:11 | . That was one of the gas now the other gas, We don't |
|
|
41:14 | about nitrogen, care about carbon Alright, carbon dioxide is a little |
|
|
41:19 | more difficult. It has three ways this is kind of weird. First |
|
|
41:24 | is easy, right? We dissolve in the gas just like we are |
|
|
41:28 | in the plasma, just like we the oxygen. So when we do |
|
|
41:32 | , that's partial pressure of carbon That one's easy. Okay, others |
|
|
41:41 | can bind it up to hemoglobin. a lot like oxygen, right? |
|
|
41:44 | we bind it up to uh what we get we get uh carb |
|
|
41:49 | hemoglobin. Not carb oxy hemoglobin. wrong. Carb amino hemoglobin. |
|
|
41:54 | so this is kind of how we it. So you can see in |
|
|
41:57 | of percentage is what we're looking About 6% of the carbon dioxide is |
|
|
42:01 | as a gas in the blood, 21% bind up to hemoglobin. So |
|
|
42:04 | rest is carried through the third mechanism is a little bit more complex. |
|
|
42:09 | in the form of bicarbonate. you've all seen this equation before any |
|
|
42:14 | your classes, right? So, you're not familiar, this right here |
|
|
42:17 | by carbonate. Carbon dioxide plus water naturally combined for carbonic acid. It |
|
|
42:23 | . So a lot easier when you carbonic and hydrates nearby. But this |
|
|
42:27 | this is a natural occurrence. carbonic and our carbonic acid likes to |
|
|
42:35 | into a proton and into bicarbonate, being the base in this situation. |
|
|
42:41 | right now, the reason we moved of our carbon dioxide in this way |
|
|
42:46 | because bicarbonate is much much more soluble the blood than carbon dioxide is which |
|
|
42:52 | you can carry more of it. is what you see by percentage. |
|
|
42:56 | so we're going to convert carbon actively using carbonic and hydrates inside the |
|
|
43:03 | blood cells or as I say here , the blood meaning it will naturally |
|
|
43:07 | So if you if it sticks around enough and the ratios favor the movement |
|
|
43:12 | the equation to the right. This why you have to take Chemistry. |
|
|
43:17 | just one question. No, I'm a lot more than this right |
|
|
43:23 | As you can imagine here, I've carbon dioxide inside the red blood |
|
|
43:26 | Following the same rules we just right, I have carbon dioxide in |
|
|
43:29 | tissues from the tissue, from the gets pushed down in the interstitial fluid |
|
|
43:33 | the interstitial fluid, it gets pushed to the blood from the blood. |
|
|
43:36 | says, oh, there's less carbon in the red blood cells. So |
|
|
43:38 | goes inside the red blood cell and the red blood cell it combined up |
|
|
43:42 | the uh hemoglobin. Or it can combined with water through the carbonic anhydrous |
|
|
43:49 | . Make carbon carbonic asset when it you get the bicarbonate. And as |
|
|
43:56 | can imagine inside the red blood cell would start accumulating and get bigger and |
|
|
43:59 | and bigger. And so, if increase the amount here, what happens |
|
|
44:02 | the rate of reaction in this It slows down, right? There's |
|
|
44:08 | be a point where you reach equilibrium then you basically everything would stop. |
|
|
44:13 | ? That's rates of reaction fun stuff back from chemistry one. Chemistry |
|
|
44:19 | I can't remember. All right. we want this to stop? |
|
|
44:23 | we want to get rid of the dioxide. So what we're gonna do |
|
|
44:26 | we have in the membrane, a bicarbonate exchanger. And this is what |
|
|
44:32 | the chloride shift. So what we is we take chlorine from out in |
|
|
44:37 | blood, right? And what we is we say, hey, we'll |
|
|
44:41 | . You. Look, there's something attracted to. And here we have |
|
|
44:43 | proton. I know you're really attracted that proton. So why don't you |
|
|
44:46 | on in? So the chlorine comes and we change it for that by |
|
|
44:49 | . Now by carbon it's out in blood. And now you can keep |
|
|
44:53 | more bicarbonate. Alright, So you have to worry about that proton not |
|
|
44:59 | matched because you're always reading chlorine So chlorine is moving down this electrical |
|
|
45:06 | . It's attracted to the proton. able to move more um bicarbonate and |
|
|
45:11 | can move more carbon dioxide in because equation doesn't aquila berate. So this |
|
|
45:18 | kind of a map showing you So up here you can see I'm |
|
|
45:21 | in the blood. There's a carbon comes out of the tissue dissolved in |
|
|
45:24 | blood. I can actually convert it bicarbonate there. But that's a very |
|
|
45:28 | slow reaction. So we just kind ignore it for a little bit. |
|
|
45:31 | can bring it into the cell some it stays dissolved. Just like you |
|
|
45:34 | there some of it can be bound to hemoglobin, Right? So that's |
|
|
45:39 | this is trying to show you. most of it is going to be |
|
|
45:42 | to bicarbonate, which is then shifted . And so 70% of your carbon |
|
|
45:47 | is traveling in your body in the of bicarbonate. Okay, so, |
|
|
45:52 | happens when I get to the Do I, do I breathe out |
|
|
45:57 | ? What's that? Red in the blood cell? Yes. This isn't |
|
|
46:02 | only place that made your body. is the reaction you're going to see |
|
|
46:05 | couple more times in the near kidney digestive system. All right |
|
|
46:11 | do you breathe out? Bicarbonate? , bicarbonate is a uh, something |
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46:17 | gonna actually uh kind of float out solution. So, if I want |
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46:21 | get rid of the carbon dioxide, I have to do, I gotta |
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46:25 | refer to back. So, if have bicarbonate out here and I'm now |
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46:29 | my lungs, where do I have carbon dioxide? Where's where's my lowest |
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46:33 | carbon dioxide out over here in the . Right. So, I'm gonna |
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46:39 | moving carbon dioxide this way, and need to replace my carbon dioxide that |
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46:42 | move out. So I'm gonna take dioxide inside the cell. Put it |
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46:45 | . But if I have less carbon here, and I got by carbon |
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46:48 | there, I'm gonna shift by carbon the cell and I just do the |
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46:51 | reaction. I just lost everybody. I? No, just, just |
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46:57 | of it this way, right, I've got an equation that is |
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47:01 | liberated one direction, and now I'm an environment that shifts in the other |
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47:05 | . I just have a bunch of tissues. I have to run through |
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47:08 | make that happen. And my tissues are the al villas, right inside |
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47:14 | alveoli, the interstitial fluids, the and the red blood cell. |
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|
47:20 | So, where that reaction takes place here. But what's driving it is |
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47:24 | presence of the carbon dioxide and the of the bicarbonate. Remember go back |
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47:29 | the reaction carbon dioxide and bicarbonate are things you're shifting one way or the |
|
|
47:33 | . So, in areas where I lots of carbon dioxide, which way |
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47:36 | I shift? I'm gonna be the . Here's my Here's the equation. |
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47:42 | way does the equation shift? Lots carbon dioxide. There you go. |
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|
47:47 | , which tissue would I be in that's happening just everywhere that you that |
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47:54 | using oxygen, making carbon dioxide. , now, I'm in the |
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47:59 | I traveled to the lungs. I a lot less carbon dioxide. Which |
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48:03 | am I gonna shift? Right? , I'm shifting between these two |
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|
48:11 | But where is the reaction occurring in red blood cells in the blood? |
|
|
48:19 | , that's the key thing here. right. So, we're using bicarbonate |
|
|
48:25 | the default way to carry carbon dioxide the blood. It's the easiest way |
|
|
48:31 | do so, but to get it of our bodies, we have to |
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48:33 | it back into the gas and then can exhale it out. So, |
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|
48:46 | an effect called the haldane effect. haldane effect basically is kind of what |
|
|
48:51 | looking at when we looked at temperature we looked at um ph and we |
|
|
48:56 | at um the presence of carbon it describes two of those steps and |
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49:02 | says, look at any partial total carbon dioxide content of the blood |
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|
49:07 | rise as the partial pressure of oxygen . Okay, so it's not dependent |
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49:14 | the partial pressure of carbon dioxide, dependent upon the partial pressure of |
|
|
49:19 | Now, this should kind of make as partial pressure of oxygen falls. |
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49:24 | I'm doing is I'm converting oxygen into dioxide. And so I'm making more |
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49:30 | dioxide available as that cell is undergoing . It's making protons right now. |
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49:38 | it? Making protons directly, nowhere making protons from there you go. |
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49:47 | . Carbon dioxide doesn't want to stick . It wants to be made in |
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49:49 | bicarbonate. So, as I make and more carbon dioxide, I'm making |
|
|
49:54 | bicarbonate and protons. So, the that's happening is when I make more |
|
|
49:58 | , that's gonna lower the affinity of , the oxygen. So that means |
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|
50:03 | gonna kick off more oxygen. in essence, I'm driving the reaction |
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|
50:09 | by a function of doing metabolic This is also true for the carbon |
|
|
50:15 | as carbon dioxide rises. That's an , You need to release the |
|
|
50:20 | So I'm gonna lower the the attraction hemoglobin, the oxygen. So they'll |
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|
50:27 | they bind directly to the hemoglobin. carb amino hemoglobin and the D Oxy |
|
|
50:33 | are the two different types that we're at here. That's the oxy that |
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|
50:37 | be carb amino. This picture just of shows the same thing. It's |
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|
50:41 | the opposite direction. Right, what I doing? I'm pushing carbon dioxide |
|
|
50:47 | and then I'm making the exchange. not a very good picture. |
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|
50:50 | I don't wanna waste time on Now. I told you something on |
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50:54 | that I want you to take to , even though this picture doesn't show |
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|
50:57 | . All right. You can see the two waves, right? You |
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|
51:02 | the wave of oxygen partial pressure. see the wave of carbon dioxide partial |
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|
51:07 | , right? So, naturally while breathing in and out. When I |
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51:11 | in air, am I putting more into my lungs than was there |
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|
51:15 | Yes. Alright, Alright. As as I'm making the exchange is more |
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51:20 | dioxide building up in my lungs. , but it's not to the point |
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|
51:24 | it's really measurable. I mean, could measure it. It's not like |
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|
51:28 | but it's not like a difference of 100 millimeters or something like that in |
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|
51:32 | , right? It's very very So I said on Tuesday, it |
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|
51:36 | matter if you're breathing in and breathing the mean, or the average stays |
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|
51:41 | or less the same now to answer question coming back over here, if |
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|
51:44 | held my breath for a couple of , are those numbers going to |
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|
51:47 | Yeah. And they'll change drastically to point where my body responds to |
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|
51:52 | right? But what I want you understand is that at any given |
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|
51:58 | you know, whether you're exercising or you're sitting still or holding your breath |
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|
52:03 | breathing in and breathing out. The of gasses is a constant right auction |
|
|
52:09 | always gonna be moving into the tissues the lungs. Carbon dioxide is always |
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|
52:13 | be trying to exit. All And so it's not that all of |
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|
52:17 | sudden I'm holding my breath and everything topsy turvy. That's what I'm trying |
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|
52:21 | instill and use that. It's not weird, nothing weird is happening. |
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|
52:27 | just a constant, This is showing around those two values. That is |
|
|
52:32 | , very small. Alright, so is a So I know so, |
|
|
52:37 | gonna ask that question on the And so the answer is does do |
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|
52:39 | see any real changes? The answer no. Even though the slide says |
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|
52:45 | leads to variations and partial partial gasses it does when I breathe in more |
|
|
52:49 | is coming in, but it's not big difference. And so I want |
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|
52:55 | to make sure you understand that Okay, that makes sense. Kind |
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|
52:59 | sort of. So back to a bit of math, pulmonary ventilation is |
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|
53:10 | volume of air breathe in and out one minute's time. Alright, |
|
|
53:14 | what that means is we can take tidal volume, Right? And we |
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|
53:19 | multiply it by your respiratory rate. what's your title volume? That's just |
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|
53:23 | your normal breathing. It's about 500 per breath. Right? And then |
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|
53:29 | just gotta ask any time do I in a minute and then voila, |
|
|
53:32 | can figure out what my title volume . It's gonna be mils per |
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|
53:35 | breath times minutes. So that you it now. If I want to |
|
|
53:40 | pulmonary ventilation. So, PV ask math people here real quick. If |
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|
53:44 | doubled my title volume, what am doing to my pulmonary ventilation? I'm |
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|
53:49 | it. See, y'all learn your . Real simple. If I double |
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|
53:53 | respiratory rate, what would you expect happen? A double My pulmonary ventilation |
|
|
53:59 | is is actually it's much easier or important to increase title. Uh |
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|
54:06 | wait, let me make sure I this right. Oh, it's the |
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|
54:09 | volume. Not the respiratory rate. becomes important. Alright. And the |
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|
54:14 | for this is because of what we what is called anatomical dead space. |
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|
54:18 | right. Now, when we looked the lungs, the lungs consist of |
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|
54:23 | I and a bunch of bronchial walls then you get down to the very |
|
|
54:28 | and that's when you get down to alveoli. Right? So gas exchange |
|
|
54:32 | takes place in those terminal bronchial, very, very small portion in all |
|
|
54:37 | alveoli. So everything above that is space and it's not vacuum, there's |
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|
54:43 | in there. So when you breathe , you're not only filling up the |
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|
54:46 | viola in the terminal bronc kills you're filling up all the other bronc kills |
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|
54:50 | the way up through the bronc. and there's air in there that's not |
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|
54:53 | through exchange. So, the first that leaves is the air that's in |
|
|
54:57 | bronchi and the bronchial walls and then air down in the terminal bronchi and |
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|
55:03 | alveoli leave. But remember, we leave make all the air leave, |
|
|
55:07 | always have air stuck in and so portion stay stuck inside. So we |
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|
55:12 | in again, we get some fresh that's gonna mix in with all that |
|
|
55:15 | air, but we still end up dead space. So, the better |
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|
55:21 | to do to increase pulmonary ventilation is to breathe faster, but to adjust |
|
|
55:28 | much we're breathing in per breath. right. So, what we're really |
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|
55:35 | interested in is al veel or ventilation much air is getting in the july |
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|
55:40 | to make sure that you understand that of which is more important. |
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|
55:44 | Is it better athletes? I know , but I'm talking athletes in |
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|
55:50 | your coaches when they told you when running or whatever, What do they |
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|
55:55 | you? Deep breaths run deep, slower breath or breathe as fast as |
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|
56:01 | can. As short as you Deep slow breaths, right? Rather |
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|
56:10 | right now, can you picture I mean picture of air moving in |
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56:14 | time I'm doing that that a It's very, very shallow. So |
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|
56:18 | can imagine I'm just moving area. still getting all the air exchange going |
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|
56:24 | the alveoli, but that air is leaving my body. If you hyperventilate |
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|
56:29 | extend periods of time, what do do? Pass out. Alright, |
|
|
56:33 | , demonstrated the differences between my your generation. We used to go |
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|
56:36 | parties. We put people on chair say, all right, I want |
|
|
56:39 | to lean over and I want you do hyperventilate and then I want you |
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|
56:43 | stand up. Did you do that ? Yeah. Okay, good. |
|
|
56:47 | . You're the first person in one my classes ever admitted that you did |
|
|
56:51 | ? It is over 16 years, ? You do it to a |
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|
56:54 | You're watching they stand up and then do they do then everyone laughed at |
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56:58 | draw penises on their faces. All . Oh, you don't go to |
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57:04 | kind of parties, man. You are missing out. All right. |
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|
57:09 | obviously what I'm doing is I'm only the air that's found in the dead |
|
|
57:13 | . Alright, so the volume. that's that's air volume. That's not |
|
|
57:18 | for gas. So what we gotta is when we're looking at Al Viola |
|
|
57:22 | , this is the value we want look at, we just got to |
|
|
57:25 | that title volume and subtract away from . That anatomical dead space. So |
|
|
57:29 | so, you know, you we're breathing in 500 mils. |
|
|
57:33 | And so anatomical dead space makes up 100 and 50 mils. So really |
|
|
57:37 | a normal breath, you're only getting mils of fresh gas. Fresh air |
|
|
57:43 | you breathe in and out on on normal breath, Right? So if |
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|
57:48 | are breathing and I hate this I don't know why I keep this |
|
|
57:51 | here. I should make my own what they're trying to they're trying to |
|
|
57:55 | pulmonary ventilation the same. But I you to think about this. If |
|
|
57:58 | breathing in deeper. So instead of in 500 mils, I'm breathing in |
|
|
58:03 | mills. Then the amount of fresh that I'm bringing in is going to |
|
|
58:09 | . But if I do shallow so, if I'm breathing in 100 |
|
|
58:11 | 50 mils, right, I'm only air in that dead space. And |
|
|
58:17 | I'm not getting any real exchange. so this is just trying to show |
|
|
58:21 | like, look what happens if I the title volumes at this and this |
|
|
58:25 | what I'm taking out. So you see the big difference is trying to |
|
|
58:29 | a constant but we know that's not , right? If you're exercising, |
|
|
58:34 | you breathe faster? Does your respiratory go up? Yeah, it |
|
|
58:39 | So what they should do is let's what happens if we keep this constant |
|
|
58:42 | we change our title volume and you actually see much much bigger values, |
|
|
58:47 | ? Changes question crap. You would a lot lower. That's why it'd |
|
|
58:56 | crap. Right? So, think about it. If I'm |
|
|
58:59 | that would be an example of lower volume. Right? It would be |
|
|
59:04 | rapid, Right? But the title is going down and that that would |
|
|
59:09 | the problems because I'm not doing gas . I'm just moving air in and |
|
|
59:13 | of the bronchitis and bronchial. That do me any good. Alright, |
|
|
59:19 | want those deep breaths want to get air in. I don't want to |
|
|
59:24 | all that stale air out. So or dead space also exists. |
|
|
59:32 | So remember you said Al Viola can now for all you guys, you're |
|
|
59:35 | healthy. You don't have a lot alcohol or dead space. Alright. |
|
|
59:39 | the older you get you can get dead space. And really what little |
|
|
59:43 | space we have. We have systems counter it. All right, So |
|
|
59:48 | what we're gonna do is what we're try to do is we're gonna try |
|
|
59:51 | match perfusion to ventilation. You guys what the definition of perfusion is? |
|
|
59:57 | blood flow, right? And ventilation airflow, right? How much? |
|
|
60:01 | ? so what we're gonna do is going to try to make sure those |
|
|
60:05 | things match each other. Not so in terms of volume, but to |
|
|
60:09 | that when I have dead space, other words, areas where I have |
|
|
60:13 | , not taking place, I don't blood going through that because that means |
|
|
60:17 | not getting any exchange. But where have taken breath and I do have |
|
|
60:21 | . I want to open up my vessels so that blood can come through |
|
|
60:24 | do gas exchange. That's what this is really trying to describe. All |
|
|
60:29 | now, there's a lot of words and this can be kind of confusing |
|
|
60:32 | you look at this. Alright. what I want you to think about |
|
|
60:34 | is when your bronc kills dilate, they're doing is they're basically opening up |
|
|
60:40 | that I can have an exchange between lungs and the external environment. |
|
|
60:44 | So my bronchial remember we are going want to trap oxygen but when my |
|
|
60:49 | dioxide levels rise up, I want open up my bronchial so that gasses |
|
|
60:53 | be released. That kind of makes . Might be better if I draw |
|
|
60:57 | and I'm watching my time because I I'm getting down here to the |
|
|
61:01 | Let's see if I can make this . That would go into my Poppins |
|
|
61:09 | . Here we go. All So trying to get a flat surface |
|
|
61:21 | ? Alright, So, when I in, it would help if I |
|
|
61:27 | keep this white screen. There we . Alright, so here I |
|
|
61:35 | Right, what I would expect, expect to have lots of oxygen and |
|
|
61:38 | little carbon dioxide. Right? And you imagine a blood vessel should be |
|
|
61:43 | than that. So, I'm just make it wider. So, what |
|
|
61:46 | imagine is blood our blood coming in have very little or have big |
|
|
61:50 | 02 and very little oxygen. And so by the time what's gonna |
|
|
61:54 | is oxygen is gonna leave carbon dioxide gonna go. So, what you'll |
|
|
61:57 | up with is hopefully oxygen coming out then very little carbon dioxide. |
|
|
62:04 | now, when that happens, the dioxide here, I'm just gonna draw |
|
|
62:10 | over here. Alright, you're gonna up with lots of carbon dioxide and |
|
|
62:13 | little oxygen inside. So, what wanna do is you want to take |
|
|
62:18 | bronchial here and you want to dilate . Does that look like dilation relative |
|
|
62:23 | the first one? Okay, what you can do now is you |
|
|
62:26 | move that carbon dioxide out and move oxygen in. But at the same |
|
|
62:30 | , you don't want the blood coming at the same rate as it was |
|
|
62:34 | then, you know, carbon dioxide then go back into the blood. |
|
|
62:38 | what you wanna do is you want vaso constrict the blood vessel. |
|
|
62:45 | So now blood isn't really kind of through there. So you don't get |
|
|
62:50 | ? So you get your exchange? , so, I'm just gonna draw |
|
|
62:53 | picture again. So here I I am dilated and so I breathe |
|
|
62:58 | and I got lots of oxygen and little carbon dioxide. Now, what |
|
|
63:01 | I want to do? Well, want to constrict here and I want |
|
|
63:05 | take that blood vessel and I want dilate it. Right? So what's |
|
|
63:09 | end up happening is I end up my oxygen and I don't have a |
|
|
63:14 | of C. 02 and then I up my blood vessel. So now |
|
|
63:19 | I'm getting good perfusion. So my c. 0. 2, my |
|
|
63:25 | oxygen, you get the exchange And so you end up doing |
|
|
63:30 | And so this coupling this process counters Viola dead space. This right here |
|
|
63:38 | what Al Viola dead space looks like you don't get exchange. Right? |
|
|
63:43 | the idea is that you have thousands thousands and thousands of alveoli locally regulating |
|
|
63:53 | exchange of oxygen and carbon dioxide while normally breathing in and out. That |
|
|
64:01 | makes sense. So the picture that book shows this one is what that |
|
|
64:06 | supposed to represent. And I don't if it does a good job or |
|
|
64:10 | I did a good job. But the explanation kind of helped you out |
|
|
64:16 | . Does that make sense to y'all , is that like weird? It |
|
|
64:24 | sense. All right, we're gonna down to our last little bit. |
|
|
64:30 | there questions about this? So, can see that, you know when |
|
|
64:35 | talked about breathing, you know that not just a function of Oh, |
|
|
64:40 | I gotta do is inflate my lungs then push the air out again. |
|
|
64:43 | levels and levels and levels of exchange are going on at each, even |
|
|
64:48 | the level of the al viola. ? And I'm making small, tiny |
|
|
64:52 | along the way to ensure that I all the oxygen that my body can |
|
|
64:57 | at that given time. Now we respiration through a series of different |
|
|
65:06 | Alright, So, first we want make sure that we're generating a pattern |
|
|
65:10 | inspiration expiration. I mean, you don't regularly sit there and go, |
|
|
65:13 | , time to breathe in. Time read that, right? Something is |
|
|
65:17 | that for you. So that your is naturally going through this. |
|
|
65:21 | do we have voluntary control over our ? Yeah, I mean, you've |
|
|
65:26 | me makes right? I can do , right? But that skeletal muscle |
|
|
65:32 | under a control mechanism that also allows to generate this without thought without voluntary |
|
|
65:39 | . Second thing we're gonna do is gonna try to make sure that magnitude |
|
|
65:43 | the body's needs. So that always up, right? What everybody |
|
|
65:47 | Your body's gonna get that's the right? And if you can't do |
|
|
65:50 | , then you're not allowed to do it is you're trying to do, |
|
|
65:52 | ? And the third thing is there's other needs that our body does to |
|
|
65:57 | and to change how we breathe. ensure that, say we don't choke |
|
|
66:02 | our food. Ever tried to breathe eating or drinking. It's not a |
|
|
66:07 | not a good thing, right? when that's when you're doing something really |
|
|
66:11 | , right? Like someone tells you joke, right? So your body |
|
|
66:16 | is telling you when to breathe and not to breathe. So, those |
|
|
66:20 | don't happen. So we are in midbrain or shooting the brain stem. |
|
|
66:26 | it's gonna be the medulla and the . And so, what we're looking |
|
|
66:29 | here, how do we create that ? So, we have some CPG |
|
|
66:33 | there um that are in the medulla are responsible for this. So they're |
|
|
66:38 | always at the subconscious level. There's expository and exploratory neurons here. |
|
|
66:42 | basically things that tell you it's time breathe in, telling you time to |
|
|
66:46 | out. Alright, now, the one is called the dorsal dorsal respiratory |
|
|
66:51 | . It's the medulla. And let just time out here for a second |
|
|
66:54 | you look in the literature, you're actually if you if you ever bothered |
|
|
66:57 | do. So you'll see that much the terminology that we're using in these |
|
|
67:01 | are falling by the wayside because they've this a little bit further. It's |
|
|
67:05 | more complex than what I'm presenting All right. But I think this |
|
|
67:09 | a good springboard on which to kind learn this stuff. Alright, So |
|
|
67:13 | off the dorsal respiratory group, the these are the things that cause |
|
|
67:18 | So what they do is they fire they increase the rate of firing and |
|
|
67:21 | increase rate. But they added more more cells to cause firing. And |
|
|
67:25 | that basically sends a positive signal that the lung to go. And so |
|
|
67:29 | those muscles are are basically contracting and continue to track as long as these |
|
|
67:34 | are firing. So what they do they build up their firing and then |
|
|
67:37 | get this feedback that says okay, to stop and then all those cells |
|
|
67:40 | and when they stop, what do do? You relax? Right. |
|
|
67:44 | inspiration. Remember normal inspiration is a of contraction of the diaphragm and the |
|
|
67:51 | intercostal and breathing out is just telling not to contract. So, those |
|
|
67:57 | things working side by side, that's DRG. Alright, so that's when |
|
|
68:03 | not firing. You get expiration. right now in the ventral respiratory |
|
|
68:08 | Also the medulla. So you have DRG and the V. R. |
|
|
68:11 | . This has both respiratory and So when you need to increase your |
|
|
68:17 | . Right? So one would be example of increasing inspiration. Working out |
|
|
68:22 | about going up seven flights of Right. So it tells you breathe |
|
|
68:29 | more and it tells you now let's using that active expiration. Alright, |
|
|
68:35 | now we're recruiting in the the the , the internal intercostal, the abdominal |
|
|
68:43 | . That's what you're now recruiting in . Exploration. Alright. You also |
|
|
68:49 | the pre boxing complex and this is one I think that they're trying to |
|
|
68:52 | they're kind of reconfiguring a re So this is the group of cells |
|
|
68:57 | in inflammatory in nature they display is activity in the literature. I |
|
|
69:02 | I think previously what they've said is it's the one that initially, on |
|
|
69:05 | DRG to create that conspiratorial activity. the key thing here is this is |
|
|
69:11 | central pattern generator. All right. then lastly, we have the ponds |
|
|
69:18 | the ponds has two regions. And pretty sure these two names have changed |
|
|
69:22 | um Your textbook has been written. fact, I think your textbook uses |
|
|
69:26 | names. But what we have here we have ways to adjust or modify |
|
|
69:32 | expiration. Alright, so the idea is that the app new schtick |
|
|
69:36 | it's responsible for lengthening your inspiration. it creates these long breaths. So |
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69:44 | kind of acts as the gas The attacks on the other hand, |
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69:48 | it. Alright. Shortens inspiration. it's acting as a break. So |
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69:54 | are basically signaling to the DRG to prg what you need to be |
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70:01 | It's a control on the controls. that's the first one. So we |
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70:08 | these portions in the brain stem that responding. So when are we? |
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70:14 | do we know we need to breathe ? When do we know we need |
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70:17 | ? Now the easy answer is say I don't have auction around my partial |
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70:21 | drops, but we actually measure oxygen dioxide levels and protons and we do |
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70:27 | in two different places. First we it in the peripheral nervous system and |
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70:31 | do it in the central nervous Which one do you think is more |
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70:35 | ? Central? Because who needs the ? Your brain? Okay. So |
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70:41 | we're gonna first like a peripheral then say yeah but central is more |
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70:45 | All right now we have um these that are located in the crowded and |
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70:52 | the aortic arteries. Why do we to measure oxygen levels in those two |
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71:01 | ? That's where the blood is. the first place that's leaving the heart |
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71:05 | systemic. So in theory you should saturated your blood in the pulmonary |
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71:11 | that blood has been returned back to left side of the heart and now |
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71:15 | leaving to the rest of your So if that blood doesn't have |
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71:20 | something has gone horribly wrong. All now we're monitoring the changes ph partial |
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71:27 | of oxygen, partial pressure of carbon . But it's the carbon dioxide that |
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71:32 | the most because that's an indicator of consumption of oxygen, right? |
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71:39 | if we're seeing that there's more carbon than we expect something is being metabolically |
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71:47 | . We need to breathe in and in more oxygen. Alright. If |
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71:51 | partial if the if the ph is , right, that's an indicator of |
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71:56 | activity. So, with regard to peripheral nervous system, we're gonna look |
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72:00 | looking at these things. The partial of oxygen is measured. But the |
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72:07 | of measuring doesn't really start kicking in you fall underneath 60 millimeters of |
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72:13 | So, remember we started releasing oxygen of hemoglobin at 40 millimeters of |
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72:18 | Right? We're normally at 100 millimeters . So, we're getting really close |
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72:21 | what normal resting temperature tissue is as leave the heart. That's a big |
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72:30 | , right? It's saying you're almost normal resting temperature or a tissue that's |
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72:34 | through your oxygen at a normal You're not you're not bringing in oxygen |
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72:39 | all. Um This is gonna be real weird one. Did your parents |
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72:45 | tell you not to play in No. I mean, it's it |
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72:52 | incredibly foreign, right to you guys I was a kid. That was |
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72:55 | of the things don't play in a . I was like, why? |
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72:58 | , well, back in the day , we were environmentally conscious, people |
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73:02 | just throw trash away wherever there was vacant lot. Alright. So, |
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73:06 | number one and number two refrigerators used have not just doors with the rubber |
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73:11 | . What they had is they had , right? If you've been in |
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73:14 | of the uh science buildings, you'll cold rooms and they have the big |
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73:18 | freezer doors. And you have to that handle, right? And you |
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73:22 | in. You can go inside and on the other side, you can |
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73:24 | push a button and unlatch is the and you can go out, refrigerators |
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73:29 | have that latch on the inside. so, you can imagine a bunch |
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73:32 | kids in a vacant lot playing hide go seek. You have this abandoned |
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73:36 | . That's a great place to You go inside there. You |
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73:40 | No one finds you. And what now are is you are sealed in |
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73:45 | box, right? And as you imagine, you can start breathing, |
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73:52 | start using up the oxygen inside that box. Brain says, hmm, |
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73:58 | not getting the oxygen I need. , my oxygen levels are dropping, |
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74:01 | carbon dioxide levels are rising. What I need to do? Burning through |
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74:09 | oxygen producing more carbon dioxide suffocate the . That's why you're not supposed to |
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74:17 | in refrigerators. All right. But see here, this is the type |
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74:21 | thing is your body responds to a of oxygen. As in, |
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74:26 | I need increased respiratory rate. Only it becomes life threatening. And in |
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74:31 | situation I just described. Not only it life threatening, but it causes |
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74:36 | . Yeah. Now these are just . I don't want you to know |
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74:40 | mechanisms. I threw these up I used to talk about them and |
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74:43 | just I think it's unnecessary but ultimately that each of them so hypoxia, |
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74:49 | ? We're talking over this this next . This is gonna be high per |
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74:53 | . It's the the rising levels of dioxide and also acidosis are all signaling |
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74:59 | the same mechanisms to cause your body do this in the central nervous |
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75:04 | We have receptors as well, but they're geared primarily towards ph and carbon |
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75:09 | because the same thing is going on carbon dioxide levels rise. Right, |
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75:13 | do we do? We're going to it into bicarbonate and that free |
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75:17 | So I'm watching ph like a hawk I'm watching the carbon dioxide level. |
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75:21 | an indicator of an increased activity. ? So these these central chemo receptors |
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75:29 | near the V. R. Right? And what is the |
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75:32 | R. G. Responsible for? , let's get more oxygen and |
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75:38 | So, there is a um this describes the mechanism as that increases that's |
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75:43 | to result in a drop in the . Alright, and just just go |
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75:47 | to that original equation, which way I moving? So the big picture |
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75:51 | is when you are trying to figure what is most important what causes me |
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75:56 | breathe in faster or harder. It's central ph ph drops in the central |
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76:03 | system, That's an indicator that I to breathe in. Have you ever |
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76:07 | this? That that random sigh out nowhere? Right? Why do you |
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76:14 | you do that? What do you it actually has to do with ph |
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76:23 | brain? Basically what you're doing is oh ph levels are going are |
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76:29 | So it's acidosis. So what your says is let me breathe out carbon |
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76:33 | , let me exhale. So what doing is you're creating a disequilibrium that |
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76:38 | the reaction to remove protons out of blood. Alright. Which is that's |
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76:47 | yawns are too. Apparently, but anyway, so this just kind |
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76:51 | look, central nervous system is more than peripheral. If you stick with |
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76:55 | little thing right here, you're good go, ph is always the most |
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76:58 | . Doesn't matter which system it But central ph is greater than anything |
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77:02 | the peripheral. When you're dealing with carbon dioxide is more important than the |
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77:06 | pressure of oxygen. That should always the way you think about it. |
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77:11 | . Carbon dioxide oxygen. Central greater peripheral. Someone asked on Tuesday. |
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77:20 | how does your lung know when to and it's because of this reflex right |
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77:25 | . They're stretch receptors in the lungs basically say what would be damaging to |
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77:29 | tissue. So the herring herring breuer , what it does as you expand |
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77:34 | or when you hit certain um That's when it's like no, |
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77:38 | no. Stop. And so it inhibits the excitatory neurons. That way |
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77:42 | don't hurt yourself. Alright. Acts the medulla. You didn't think I |
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77:50 | gonna get through them all, did ? Yeah. All right. This |
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77:55 | the last one. This is the slide. And again, it's like |
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77:58 | are other things that we control right? So you can go through |
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78:02 | pictures, right? So the hypothalamus looking at high temperatures and so that's |
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78:06 | affect breathing rate. So this is trying to you know when you're |
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78:09 | what do you do breathe more? your limbic system when you're laughing? |
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78:15 | notice that you stop breathing? Right. So there's that so limit |
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78:22 | opt or how about how about when crying ever had that Good ladies, |
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78:26 | you have ever had that good You know what I'm talking about? |
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78:29 | good cry Guys don't do good We just push it down, push |
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78:34 | . But the good cry, you're , right, You got the snot |
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78:38 | tears and you know, Ben and the good cry. So you can |
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78:43 | picture the good cry, right? breathing, you know? And then |
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78:48 | the crying and then Right, also love this one. I don't know |
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78:54 | I found this picture. It's just . Does he just look like? |
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78:57 | this is this is what it's all for him. right? I don't |
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79:00 | what he's singing, but it's like you sing, you you change your |
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79:05 | patterns to match, or even when talking, you know, to allow |
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79:09 | to bring it in the air and you use that air to kind of |
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79:13 | whatever the activity is singing the so and so forth. So that's |
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79:17 | real cortex matching your need in order get whatever that is accomplished. Um |
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79:23 | another one drinking water, right? to that earlier. It's like you |
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79:29 | you don't breathe in while you're That would just be tragic. Did |
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79:35 | talk about the tricky in here? right. We're the only species that |
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79:41 | right? I mean, that can through the written word or through the |
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79:46 | word, and I know we're getting of here are trachea. As the |
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79:50 | actually is much further down than all other primates. If you look at |
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79:54 | chimps and anything else, the trachea much longer. They can actually chew |
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79:59 | and breathe at the same time because when they swallow and stuff, their |
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80:03 | sits up higher, right? So can breathe. We can't do |
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80:09 | but we're also the only primate that actually use our voices to, So |
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80:13 | one of the, one of the . Um Anyway, then the last |
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80:17 | is just remember uh your cortex uh be overcome? And so the involuntary |
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80:25 | be overridden by voluntary control, Yeah. So when your need for |
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80:32 | , right, breathe in and |
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