The tauma of major surgery Flashcards

1
Q

What are systemic responses to injury?

A
  1. increased cardiac output
  2. increased minute ventilation
  3. febrile
  4. increased metabolic rate
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2
Q

What happens to supply the increased energy demand of wounds?

A
  1. accelerated lipolysis
  2. accelerated proteolysis
  3. amino acids–wound healing, acute phase proteins)
  4. glucose–vital organs, wound healing
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3
Q

What role does pain play in trauma?

A
  1. increased metabolic rate
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4
Q

What are factors that play a role in the energy and nitrogen balance?

A
  1. endocrine system
  2. nervous system
  3. tissue factors
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5
Q

why is skeletal muscle lost before adipose tissue?

A

gluconeogenesis is easier from protein than lipid

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6
Q

What happens the the fluid compartments in response to major trauma?

A
  1. expansion of ECF–Vd of drugs!!! aminoglycosides
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7
Q

What changes occur in response to injury?

A
  1. volume loss
  2. underperfusion
  3. starvation
  4. tissue damage
  5. infection
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8
Q

What does endotoxin cause release of?

A

TNF
cyclooxgenase (prostaglandins)
constrition and dilation in different orgnans

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9
Q

increased metabolic rate, endocrine response, decreased nutritional state lead to what?

A

weight loss

immune suppression

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10
Q

What are contronllable factors with major trauma?

A
  1. volume loss
  2. underperfusion
  3. starvation
  4. tissue damage
  5. infection
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11
Q

What are the factors of the pain management?

A
  1. preemptive
  2. systemic analgesia
  3. local pain control–epidurals, intraarticular analgesia
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