physiology Flashcards
(72 cards)
how do hypoxia, hypercapnia, and acidosis effect pulmonary vasculature
pulm vasocontriction
urine to plasma osmolar ratio > 1.5 indicates what
oliguria 2/2 prerenal hypovolemia
how does sodium bicarb administration effect LV contractility, preload, intracranial, lactate
- bicarb increases calcium so increases LV contractility
- its hypertonic so increases preload due to increase intravascular volume
- increases lactate
- can cause intracranai hemmorhage (due to number 2 )
what properties of gas determine flow rate through annular space at low fresh gas flow vs high
at low –> viscosity
high –> density
think low cost
high demand
what type of cells are have the most insulin dependent transporter for glucose uptake
cardiac myocytes
think u have to give insulin with hyper K to stabilize that shit or whatever
when is pulmonary vascular resistance at its lowest
at FRC
how does uremia interefere w platlet activation and aggregation (4 places)
- vWF
- gp IIb-IIIa
- increases prostacylcin
- increased NO
how does hetastarch inhibit platelet aggregation
will cause decreases in gp IIa-bIII
how do u interpret increased platuea pressure vs increased peak pressure
increased platuea pressure = decreased pulm compliance (TRALI, pulm edema etc.)
increased peak pressure = increased airway resistance (kinked tube, asthma, bronchospasm etc)
define lithotripsy and. how the pressure volume loop would change for increased lithotripsy
increased compliance
will have a rightward downward shift of end diastolic pressure volume curve to show more volume at decreased LV pressure
large volumes of licorice will create more of what hormone
aldosterone so you will have HTN, metabolic alk, hypo K, hypernatremia
how can u diagnose abdominal compartment sydrome w bladder and what effect does it have on ICP
the pressure will be greater > 20 ish
increased ICP
patients with 3 or more risk factors for CAD are recommended to take what medication perioperatively?
what is the risk factors
beta blocker
risk factors: hx of ischemic heart dz, stroke, DM, CHF, CKD
which nerve carries afferent signals from carotid bodies
CN 9 or glossopharyngeal nerve
3 ways in which volatile anesthetics potentiate NMBA
- decreasing sensitivity of the post junctional membrane to depolarization
- increasing skeletal muscle blood flow which augments NMBA
- depression of upper motor neurons
when minute ventilation exceeds fresh gas flow how will that affect fio2
fio2 will be lower because u are rebreathing exhaled gases and therefore less O2
normal umbilical artery blood gas sample?
pH 7.2-7.3
pco2. 50s
pao2 20s
bicarb 22 ish
how do you trouble shoot o2 pipeline failure
disconnect o2 pipeline from wall
open emergency oxygen cylinder
ventilate by hand
what would u see etco2 do with co2 embolism
etco2 will usually decrease with CV collapse but may increase as well
if you decrease paco2 by 1 how much does that decreased CBF
decreases 1-2 cc
what 2 lab tests are low in DIC
factor 8
fibrinogen
d dimer is high af
whats the benefit of stopping smoking the day before surgery
shifts hemeglobin O2 dissociation curve to the right
whats the primary cause of low serum bicarb in patients w high AG metabolic acidosis
low bicarb is bc they are used to buffer H+ ions
if you have paraplegic patient how will the TOF differ between hand and foot nerve stims (if the foot is paralyzed)
the foot will have a increased TOF ratio due to ach receptor build up in the muscle of the paralyzed limb