The availbility of oxygen plays a vital and
central role in this group of conditions. Anoxia refers to a total lack of
oxygen, while hypoxia refers to a partial lack or deficit. The causes of anoxia
and hypoxia (please note not necessarily asphyxia) can be classified as
follows:
In this group the oxygen tension in the inhaled
air is too low to oxygenate the red blood cells sufficiently. This may be the
result of low barometric pressure, as found at high altitude. It may also be
the result of lung pathology, where the gas exchange capacity of the lungs is
decreased, as seen in emphysema. (Emphysema is a swelling due to presence of
air, applied especially to a morbid condition of the lungs.)
In this condition the oxygen-carrying capacity
of the blood is decreased. This may be the result of a low haemoglobin (the
molecule which binds the oxygen in the blood) level, also known as anaemia.
Blood loss leads to acute anaemia. In some cases the haemoglobin content may be
normal but the molecules cannot bind with oxygen, as another substance, such as
carbon monoxide, has already bonded with the haemoglobin molecule
(carbon-monoxide poison-ing).
This condition arises when the circulation
cannot circulate the blood sufficiently. The most common cause is heart
failure, where the heart is not contracting adequately. This may be the result
of a myocardial infarct (the heart muscle degenerates because of, for example,
a blood clot in a coronary artery which stops the flow of blood), high blood
pressure or other cardiac disease.
In this condition the oxygen delivery to the
tissues is adequate, but the tissues and the cells cannot use the oxygen. This
may be due to a blockage of the enzyme systems in the cell, so that oxygen
cannot be used for cell metabolism. Examples include cyanide poisoning.
Carbon-monoxide poisoning causes anaemic anoxic/hypoxia, as well as an element
of cytotoxic hypoxia due to the inhibition of the enzyme systems in the cells.
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