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Flashcards in The tauma of major surgery Deck (11):
1

What are systemic responses to injury?

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

2

What happens to supply the increased energy demand of wounds?

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

3

What role does pain play in trauma?

1. increased metabolic rate

4

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

1. endocrine system
2. nervous system
3. tissue factors

5

why is skeletal muscle lost before adipose tissue?

gluconeogenesis is easier from protein than lipid

6

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

1. expansion of ECF--Vd of drugs!!! aminoglycosides

7

What changes occur in response to injury?

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

8

What does endotoxin cause release of?

TNF
cyclooxgenase (prostaglandins)
constrition and dilation in different orgnans

9

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

weight loss
immune suppression

10

What are contronllable factors with major trauma?

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

11

What are the factors of the pain management?

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