Misplaced Pages

#383616

52-562: When performing the Dix–Hallpike test, patients are lowered quickly to a supine position (lying horizontally with the face and torso facing up) with the neck extended 30 degrees below horizontal by the clinician performing the maneuver. The Dix–Hallpike and the side-lying testing position have yielded similar results. As such, the side-lying position can be used if the Dix–Hallpike cannot be performed easily. Steps: The examiner looks for nystagmus (usually accompanied by vertigo). In BPPV,

104-516: A decline in basic activity level and information usage at 1000 ppm, when compared to 500 ppm. However a review of the literature found that a reliable subset of studies on the phenomenon of carbon dioxide induced cognitive impairment to only show a small effect on high-level decision making (for concentrations below 5000 ppm). Most of the studies were confounded by inadequate study designs, environmental comfort, uncertainties in exposure doses and differing cognitive assessments used. Similarly

156-446: A fixed structure. However, in a Coulomb explosion imaging experiment, an instantaneous image of the molecular structure can be deduced. Such an experiment has been performed for carbon dioxide. The result of this experiment, and the conclusion of theoretical calculations based on an ab initio potential energy surface of the molecule, is that none of the molecules in the gas phase are ever exactly linear. This counter-intuitive result

208-611: A glass state similar to other members of its elemental family, like silicon dioxide (silica glass) and germanium dioxide . Unlike silica and germania glasses, however, carbonia glass is not stable at normal pressures and reverts to gas when pressure is released. At temperatures and pressures above the critical point, carbon dioxide behaves as a supercritical fluid known as supercritical carbon dioxide . Table of thermal and physical properties of saturated liquid carbon dioxide: Table of thermal and physical properties of carbon dioxide (CO 2 ) at atmospheric pressure: Carbon dioxide

260-491: A mature forest will produce as much CO 2 from respiration and decomposition of dead specimens (e.g., fallen branches) as is used in photosynthesis in growing plants. Contrary to the long-standing view that they are carbon neutral, mature forests can continue to accumulate carbon and remain valuable carbon sinks , helping to maintain the carbon balance of Earth's atmosphere. Additionally, and crucially to life on earth, photosynthesis by phytoplankton consumes dissolved CO 2 in

312-428: A much larger denominator and a much smaller value than the true K a1 . The bicarbonate ion is an amphoteric species that can act as an acid or as a base, depending on pH of the solution. At high pH, it dissociates significantly into the carbonate ion ( CO 2− 3 ): In organisms, carbonic acid production is catalysed by the enzyme known as carbonic anhydrase . In addition to altering its acidity,

364-421: A reproduction of vertigo and clinician observation of nystagmus (involuntary eye movement). For some patients, this maneuver may be contraindicated, and a modification may be needed that also targets the posterior semicircular canal . Such patients include those who are too anxious about eliciting the uncomfortable symptoms of vertigo, and those who may not have the range of motion necessary to comfortably be in

416-416: A study on the effects of the concentration of CO 2 in motorcycle helmets has been criticized for having dubious methodology in not noting the self-reports of motorcycle riders and taking measurements using mannequins. Further when normal motorcycle conditions were achieved (such as highway or city speeds) or the visor was raised the concentration of CO 2 declined to safe levels (0.2%). Poor ventilation

468-499: A supine position. The modification involves the patient moving from a seated position to side-lying without their head extending off the examination table, such as with Dix–Hallpike. The head is rotated 45 degrees away from the side being tested, and the eyes are examined for nystagmus . If the test is negative, it makes benign positional vertigo a less likely diagnosis and central nervous system involvement should be considered. Although there are alternative methods to administering

520-467: A typical single C–O bond, and shorter than most other C–O multiply bonded functional groups such as carbonyls . Since it is centrosymmetric, the molecule has no electric dipole moment . As a linear triatomic molecule, CO 2 has four vibrational modes as shown in the diagram. In the symmetric and the antisymmetric stretching modes, the atoms move along the axis of the molecule. There are two bending modes, which are degenerate , meaning that they have

572-485: A waste product. In turn, oxygen is consumed and CO 2 is released as waste by all aerobic organisms when they metabolize organic compounds to produce energy by respiration . CO 2 is released from organic materials when they decay or combust, such as in forest fires. When carbon dioxide dissolves in water, it forms carbonate and mainly bicarbonate ( HCO − 3 ), which causes ocean acidification as atmospheric CO 2 levels increase. Carbon dioxide

SECTION 10

#1732858648384

624-469: Is Emiliania huxleyi whose calcite scales have formed the basis of many sedimentary rocks such as limestone , where what was previously atmospheric carbon can remain fixed for geological timescales. Plants can grow as much as 50% faster in concentrations of 1,000 ppm CO 2 when compared with ambient conditions, though this assumes no change in climate and no limitation on other nutrients. Elevated CO 2 levels cause increased growth reflected in

676-419: Is 304.128(15) K (30.978(15) °C) at 7.3773(30) MPa (72.808(30) atm). Another form of solid carbon dioxide observed at high pressure is an amorphous glass-like solid. This form of glass, called carbonia , is produced by supercooling heated CO 2 at extreme pressures (40–48  GPa , or about 400,000 atmospheres) in a diamond anvil . This discovery confirmed the theory that carbon dioxide could exist in

728-566: Is 53% more dense than dry air, but is long lived and thoroughly mixes in the atmosphere. About half of excess CO 2 emissions to the atmosphere are absorbed by land and ocean carbon sinks . These sinks can become saturated and are volatile, as decay and wildfires result in the CO 2 being released back into the atmosphere. CO 2 is eventually sequestered (stored for the long term) in rocks and organic deposits like coal , petroleum and natural gas . Nearly all CO2 produced by humans goes into

780-475: Is 79%, along with an estimated specificity of 75%. The test may need to be performed more than once, as it is not always easy to demonstrate observable nystagmus that is typical of BPPV. Also, the test results can be affected by the speed with which the maneuver is conducted and the plane of the occiput. There are several disadvantages proposed by Cohen for the classic maneuver. Patients may be too tense, for fear of producing vertigo symptoms, which can prevent

832-415: Is an end product of cellular respiration in organisms that obtain energy by breaking down sugars, fats and amino acids with oxygen as part of their metabolism . This includes all plants, algae and animals and aerobic fungi and bacteria. In vertebrates , the carbon dioxide travels in the blood from the body's tissues to the skin (e.g., amphibians ) or the gills (e.g., fish ), from where it dissolves in

884-402: Is commercially used in its solid form, commonly known as " dry ice ". The solid-to-gas phase transition occurs at 194.7 Kelvin and is called sublimation . The symmetry of a carbon dioxide molecule is linear and centrosymmetric at its equilibrium geometry. The length of the carbon–oxygen bond in carbon dioxide is 116.3  pm , noticeably shorter than the roughly 140 pm length of

936-632: Is one of the main causes of excessive CO 2 concentrations in closed spaces, leading to poor indoor air quality . Carbon dioxide differential above outdoor concentrations at steady state conditions (when the occupancy and ventilation system operation are sufficiently long that CO 2 concentration has stabilized) are sometimes used to estimate ventilation rates per person. Higher CO 2 concentrations are associated with occupant health, comfort and performance degradation. ASHRAE Standard 62.1–2007 ventilation rates may result in indoor concentrations up to 2,100 ppm above ambient outdoor conditions. Thus if

988-410: Is ordinarily a difficult and slow reaction: The redox potential for this reaction near pH 7 is about −0.53 V versus the standard hydrogen electrode . The nickel-containing enzyme carbon monoxide dehydrogenase catalyses this process. Photoautotrophs (i.e. plants and cyanobacteria ) use the energy contained in sunlight to photosynthesize simple sugars from CO 2 absorbed from

1040-405: Is produced as a by-product. Ribulose-1,5-bisphosphate carboxylase oxygenase , commonly abbreviated to RuBisCO, is the enzyme involved in the first major step of carbon fixation, the production of two molecules of 3-phosphoglycerate from CO 2 and ribulose bisphosphate , as shown in the diagram at left. RuBisCO is thought to be the single most abundant protein on Earth. Phototrophs use

1092-472: Is the true first acid dissociation constant, defined as where the denominator includes only covalently bound H 2 CO 3 and does not include hydrated CO 2 (aq). The much smaller and often-quoted value near 4.16 × 10 (or pK a1 = 6.38) is an apparent value calculated on the (incorrect) assumption that all dissolved CO 2 is present as carbonic acid, so that Since most of the dissolved CO 2 remains as CO 2 molecules, K a1 (apparent) has

SECTION 20

#1732858648384

1144-545: Is the main cause of these increased CO 2 concentrations, which are the primary cause of climate change . Its concentration in Earth's pre-industrial atmosphere since late in the Precambrian was regulated by organisms and geological features. Plants , algae and cyanobacteria use energy from sunlight to synthesize carbohydrates from carbon dioxide and water in a process called photosynthesis , which produces oxygen as

1196-419: Is trivially due to the fact that the nuclear motion volume element vanishes for linear geometries. This is so for all molecules except diatomic molecules . Carbon dioxide is soluble in water, in which it reversibly forms H 2 CO 3 (carbonic acid), which is a weak acid , because its ionization in water is incomplete. The hydration equilibrium constant of carbonic acid is, at 25 °C: Hence,

1248-465: Is used in CO 2 scrubbers and has been suggested as a possible starting point for carbon capture and storage by amine gas treating . Only very strong nucleophiles, like the carbanions provided by Grignard reagents and organolithium compounds react with CO 2 to give carboxylates : In metal carbon dioxide complexes , CO 2 serves as a ligand , which can facilitate the conversion of CO 2 to other chemicals. The reduction of CO 2 to CO

1300-535: The carbon cycle , atmospheric CO 2 is the primary carbon source for life on Earth. In the air, carbon dioxide is transparent to visible light but absorbs infrared radiation , acting as a greenhouse gas . Carbon dioxide is soluble in water and is found in groundwater , lakes , ice caps , and seawater . It is a trace gas in Earth's atmosphere at 421  parts per million (ppm) , or about 0.042% (as of May 2022) having risen from pre-industrial levels of 280 ppm or about 0.028%. Burning fossil fuels

1352-439: The air and water: Carbon dioxide is colorless. At low concentrations, the gas is odorless; however, at sufficiently high concentrations, it has a sharp, acidic odor. At standard temperature and pressure , the density of carbon dioxide is around 1.98 kg/m , about 1.53 times that of air . Carbon dioxide has no liquid state at pressures below 0.51795(10) MPa (5.11177(99) atm ). At a pressure of 1 atm (0.101325 MPa),

1404-430: The atmosphere. Less than 1% of CO2 produced annually is put to commercial use, mostly in the fertilizer industry and in the oil and gas industry for enhanced oil recovery . Other commercial applications include food and beverage production, metal fabrication, cooling, fire suppression and stimulating plant growth in greenhouses. Carbon dioxide cannot be liquefied at atmospheric pressure. Low-temperature carbon dioxide

1456-862: The condition. There are few studies of the health effects of long-term continuous CO 2 exposure on humans and animals at levels below 1%. Occupational CO 2 exposure limits have been set in the United States at 0.5% (5000 ppm) for an eight-hour period. At this CO 2 concentration, International Space Station crew experienced headaches, lethargy, mental slowness, emotional irritation, and sleep disruption. Studies in animals at 0.5% CO 2 have demonstrated kidney calcification and bone loss after eight weeks of exposure. A study of humans exposed in 2.5 hour sessions demonstrated significant negative effects on cognitive abilities at concentrations as low as 0.1% (1000   ppm) CO 2 likely due to CO 2 induced increases in cerebral blood flow. Another study observed

1508-510: The degenerate pair of bending modes at 667 cm (wavelength 15.0 μm). The symmetric stretching mode does not create an electric dipole so is not observed in IR spectroscopy, but it is detected in Raman spectroscopy at 1388 cm (wavelength 7.20 μm), with a Fermi resonance doublet at 1285 cm . In the gas phase, carbon dioxide molecules undergo significant vibrational motions and do not keep

1560-566: The dispersing effects of wind, it can collect in sheltered/pocketed locations below average ground level, causing animals located therein to be suffocated. Carrion feeders attracted to the carcasses are then also killed. Children have been killed in the same way near the city of Goma by CO 2 emissions from the nearby volcano Mount Nyiragongo . The Swahili term for this phenomenon is mazuku . Adaptation to increased concentrations of CO 2 occurs in humans, including modified breathing and kidney bicarbonate production, in order to balance

1612-541: The effects of blood acidification ( acidosis ). Several studies suggested that 2.0 percent inspired concentrations could be used for closed air spaces (e.g. a submarine ) since the adaptation is physiological and reversible, as deterioration in performance or in normal physical activity does not happen at this level of exposure for five days. Yet, other studies show a decrease in cognitive function even at much lower levels. Also, with ongoing respiratory acidosis , adaptation or compensatory mechanisms will be unable to reverse

Dix–Hallpike test - Misplaced Pages Continue

1664-551: The electrical conductivity of fully deionized water without CO 2 saturation is comparably low in relation to these data. CO 2 is a potent electrophile having an electrophilic reactivity that is comparable to benzaldehyde or strongly electrophilic α,β-unsaturated carbonyl compounds . However, unlike electrophiles of similar reactivity, the reactions of nucleophiles with CO 2 are thermodynamically less favored and are often found to be highly reversible. The reversible reaction of carbon dioxide with amines to make carbamates

1716-469: The gas deposits directly to a solid at temperatures below 194.6855(30) K (−78.4645(30) °C) and the solid sublimes directly to a gas above this temperature. In its solid state, carbon dioxide is commonly called dry ice . Liquid carbon dioxide forms only at pressures above 0.51795(10) MPa (5.11177(99) atm); the triple point of carbon dioxide is 216.592(3) K (−56.558(3) °C) at 0.51795(10) MPa (5.11177(99) atm) (see phase diagram). The critical point

1768-597: The harvestable yield of crops, with wheat, rice and soybean all showing increases in yield of 12–14% under elevated CO 2 in FACE experiments. Increased atmospheric CO 2 concentrations result in fewer stomata developing on plants which leads to reduced water usage and increased water-use efficiency . Studies using FACE have shown that CO 2 enrichment leads to decreased concentrations of micronutrients in crop plants. This may have knock-on effects on other parts of ecosystems as herbivores will need to eat more food to gain

1820-417: The head of their bed up in a 30- or 45-degree angle. Carbon dioxide Carbon dioxide is a chemical compound with the chemical formula CO 2 . It is made up of molecules that each have one carbon atom covalently double bonded to two oxygen atoms. It is found in the gas state at room temperature and at normally-encountered concentrations it is odorless. As the source of carbon in

1872-413: The head, neck and extremities. Using anatomical terms of location , the dorsal side is down, and the ventral side is up, when supine. In scientific literature "semi-supine" commonly refers to positions where the upper body is tilted (at 45° or variations) and not completely horizontal. The decline in death due to sudden infant death syndrome (SIDS) is said to be attributable to having babies sleep in

1924-426: The immature state of their central chemoreceptors , infants do not respond to the subsequent respiratory acidosis that develops. Typical non-infants realize autonomic responses of increased rate and depth of respiration ( hyperventilation , yawning). Obstructive sleep apnea (OSA) is a form of sleep apnea that occurs more frequently when throat muscles relax and is most severe when individuals are sleeping in

1976-444: The majority of the carbon dioxide is not converted into carbonic acid, but remains as CO 2 molecules, not affecting the pH. The relative concentrations of CO 2 , H 2 CO 3 , and the deprotonated forms HCO − 3 ( bicarbonate ) and CO 2− 3 ( carbonate ) depend on the pH . As shown in a Bjerrum plot , in neutral or slightly alkaline water (pH > 6.5), the bicarbonate form predominates (>50%) becoming

2028-443: The most prevalent (>95%) at the pH of seawater. In very alkaline water (pH > 10.4), the predominant (>50%) form is carbonate. The oceans, being mildly alkaline with typical pH = 8.2–8.5, contain about 120 mg of bicarbonate per liter. Being diprotic , carbonic acid has two acid dissociation constants , the first one for the dissociation into the bicarbonate (also called hydrogen carbonate) ion ( HCO − 3 ): This

2080-458: The necessary brisk passive movements for the test. A subject must have adequate cervical spine range of motion to allow neck extension, as well as trunk and hip range of motion to lie supine. From the previous point, the use of this maneuver can be limited by musculoskeletal and obesity issues in a subject. In rare cases a patient may be unable or unwilling to participate in the Dix–Hallpike test due to physical limitations. In these circumstances

2132-408: The nystagmus typically occurs in A or B only, and is torsional—the fast phase beating toward the lower ear. Its onset is usually delayed a few seconds, and it lasts 10–20 seconds. As the patient is returned to the upright position, transient nystagmus may occur in the opposite direction. Both nystagmus and vertigo typically decrease on repeat testing. A positive test is indicated by patient report of

Dix–Hallpike test - Misplaced Pages Continue

2184-495: The presence of carbon dioxide in water also affects its electrical properties. When carbon dioxide dissolves in desalinated water, the electrical conductivity increases significantly from below 1 μS/cm to nearly 30 μS/cm. When heated, the water begins to gradually lose the conductivity induced by the presence of C O 2 {\displaystyle \mathrm {CO_{2}} } , especially noticeable as temperatures exceed 30 °C. The temperature dependence of

2236-499: The presence of sufficient oxygen, manifesting as dizziness, headache, visual and hearing dysfunction, and unconsciousness within a few minutes to an hour. Concentrations of more than 10% may cause convulsions, coma, and death. CO 2 levels of more than 30% act rapidly leading to loss of consciousness in seconds. Because it is heavier than air, in locations where the gas seeps from the ground (due to sub-surface volcanic or geothermal activity) in relatively high concentrations, without

2288-496: The products of their photosynthesis as internal food sources and as raw material for the biosynthesis of more complex organic molecules, such as polysaccharides , nucleic acids , and proteins. These are used for their own growth, and also as the basis of the food chains and webs that feed other organisms, including animals such as ourselves. Some important phototrophs, the coccolithophores synthesise hard calcium carbonate scales. A globally significant species of coccolithophore

2340-420: The same amount of protein. The concentration of secondary metabolites such as phenylpropanoids and flavonoids can also be altered in plants exposed to high concentrations of CO 2 . Plants also emit CO 2 during respiration, and so the majority of plants and algae, which use C3 photosynthesis , are only net absorbers during the day. Though a growing forest will absorb many tons of CO 2 each year,

2392-411: The same frequency and same energy, because of the symmetry of the molecule. When a molecule touches a surface or touches another molecule, the two bending modes can differ in frequency because the interaction is different for the two modes. Some of the vibrational modes are observed in the infrared (IR) spectrum : the antisymmetric stretching mode at wavenumber 2349 cm (wavelength 4.25 μm) and

2444-427: The side-lying test or other alternative tests may be used. Precautions Absolute contraindications Supine position The supine position ( / ˈ s uː p aɪ n / ) means lying horizontally with the face and torso facing up, as opposed to the prone position , which is face down. When used in surgical procedures, it grants access to the peritoneal , thoracic and pericardial regions; as well as

2496-532: The supine position. The realization that infants sleeping face down, or in a prone position, had an increased mortality rate re-emerged into medical awareness at the end of the 1980s when two researchers, Susan Beal in Australia and Gus De Jonge in the Netherlands, independently noted the association. It is believed that in the prone position babies are more at risk to re-breathe their own carbon dioxide . Because of

2548-421: The supine position. Studies and evidence show that OSA related to sleeping in the supine position is related to the airway positioning , reduced lung volume , and the inability of airway muscles to dilate enough to compensate as the airway collapses. With individuals who have OSA, many health care providers encourage their patients to avoid the supine position while asleep and sleep laterally or sleep with

2600-442: The test, Cohen proposes advantages to the classic maneuver. The test can be easily administered by a single examiner, which prevents the need for external aid. Due to the position of the subject and the examiner, nystagmus , if present, can be observed directly by the examiner. The negative predictive value of this test is not 100%. Some patients with a history of BPPV will not have a positive test result. The estimated sensitivity

2652-535: The upper ocean and thereby promotes the absorption of CO 2 from the atmosphere. Carbon dioxide content in fresh air (averaged between sea-level and 10 kPa level, i.e., about 30 km (19 mi) altitude) varies between 0.036% (360 ppm) and 0.041% (412 ppm), depending on the location. In humans, exposure to CO 2 at concentrations greater than 5% causes the development of hypercapnia and respiratory acidosis . Concentrations of 7% to 10% (70,000 to 100,000 ppm) may cause suffocation, even in

SECTION 50

#1732858648384

2704-546: The water, or to the lungs from where it is exhaled. During active photosynthesis, plants can absorb more carbon dioxide from the atmosphere than they release in respiration. Carbon fixation is a biochemical process by which atmospheric carbon dioxide is incorporated by plants, algae and cyanobacteria into energy-rich organic molecules such as glucose , thus creating their own food by photosynthesis. Photosynthesis uses carbon dioxide and water to produce sugars from which other organic compounds can be constructed, and oxygen

#383616