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Flashcards in Pulmonary Effects: PaO2 Deck (26)
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1

Which agent impairs the hypoxic ventilatory response the LEAST?

Study on!!!!

2

The ---- receptors in the carotid bodies monitor for hypoxemia and are important in the hypoxic ventilatory response

Peripheral chemo-receptors

3

The peripheral chemoreceptors in the carotid bodies monitor for hypoxemia and are important in the hypoxic ventilatory response. A PaO2 < ---mmHg is a stimulus to increase minute ventilation in an effort to restore arterial oxygenation

< 60 mmHg

4

The carotid bodies relay afferent input to the respiratory center via the ----- nerve (CN #)

Glossopharyngeal nerve (CN IX)

5

The carotid bodies relay afferent input to the respiratory center via the glossopharyngeal nerve (CN IX) and the aortic bodies relay afferent traffic via the ----- nerve (CN #)

Vagus nerve (CN X)

6

The carotid bodies are more sensitive to change in arterial tensions of which gases?

 

 

PaO2, PaCO2

7

The carotid bodies are more sensitive to change in arterial gas tensions (PaO2, PaCO2) and to change in the concentration of which ion?

[H+]

8

While the carotid bodies are more sensitive to change in arterial gas tensions (PaO2, PaCO2) and H+ concentration, the aortic bodies are more sensitive to changes in -----.

Blood pressure

9

It is important to note that volatile agents also depress ventilation by ----- muscle function in the upper airway, diaphragm, and intercostals

" inhibiting"

10

Volatile anesthetics impair the peripheral chemoreceptors for up to ---- hours after anesthesia

Several hours

11

The impaired response to acute hypoxia occurs at --- MAC of Volatile anesthetics

0.1 MAC

12

The impaired response to acute hypoxia occurs at 0.1 MAC. By contrast, 0.1 MAC ----- the response to PaCO2

"does not impair"

13

The ----- cells in the carotid bodies provide the sensory arm of the hypoxic drive

Glomus type I

14

The glomus type I cells in the carotid bodies provide the sensory arm of the hypoxic drive. It is hypothesized the volatile agents create a ----- that impairs the glomus type I cells

Reactive oxygen species

15

The glomus type I cells in the carotid bodies provide the sensory arm of the hypoxic drive. It is hypothesized the volatile agents create a reactive oxygen species that impairs the glomus type I cells. Because anesthetic metabolism is the source of these reactive oxygen species, those agents that undergo the greatest amount of ----- in the body inhibit the hypoxic drive the most

 

Biotransformation

16

Which agent undergoes the greatest amount of biotransformation in the body and, therefore,  inhibits the hypoxic drive the most?

A. Halo

B. Sevo

C. Iso

D. Des

 

Halothane

(Halo> Sevo > lso > Des)

17

--- percent of Halothane undergoes hepatic biotransformation,  so it makes sense that halothane depresses the hypoxic drive the most

40 percent

18

Only --- percent of Desflurane undergoes metabolism, and it impairs the hypoxic drive the least

0.02 percent

 

19

Nitrous oxide also ----- the carotid body response to hypoxemia, but likely for a different reason

"impairs"

20

This physiology is especially important in the patient who relies on the hypoxic drive to -----.

"breathe"

21

This physiology is especially important in the patient who relies on the hypoxic drive to breathe, such as those with ----- or -----.

Emphysema or Sleep apnea

22

This physiology is especially important in the patient who relies on the hypoxic drive to breathe, such as those with emphysema or sleep apnea. ----- is the best agent in this patient

Desflurane

23

Pain and surgical stimulation do not ----- the depression of the hypoxic ventilator drive. This is in contrast to their effects on the ventilator response to CO2,

"reverse"

24

Which agent impairs the hypoxic ventilatory response the LEAST?

Desflurane

25

While all anesthetic agents suppress the hypoxic ventilatory response, ----- affects this response the least

Desflurane

26

References:

 

Hemming s. Pharmacology and Physiology for Anesthesia: Foundations and Clinical Application. 1st ed. 2013. p. 166- 167. Nagelhout. Nurse Anesthesia. 6th ed. 2018. p. 89.

Flood. Stoelting's Pharmacology & Physiology in Anesthetic Practice. 5th ed. 2015. p. 133- 134 & 578-579.