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Fall'20 Advanced Principles II > alpha & beta receptors > Flashcards

alpha & beta receptors Flashcards

1
Q

where are alpha 1 receptors? presynaptic or postsynpatic

A

postsynaptic

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2
Q

where are alpha 1 receptors located throughout the body

A

smooth muscle throughout the body

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3
Q

what is the most important cardiovascular effect of alpha 1 stimulation

A

vasoconstriction

increase PVR, after load and BP

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4
Q

what is the negative effect of alpha 1 stimulation

A

bronchoconstriction

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5
Q

are alpha 2 receptors presynaptic postsynaptic

A

presynaptic

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6
Q

what does stimulation of alpha 2 receptors in the CNS cause

A

sedation and reduces sympathetic outflow, leading to peripheral vasodilation and lower bp

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7
Q

are beta 1 presynaptic or post synpatic

A

postsynaptic

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8
Q

what is the result of simulating beta 1 receptros

A

positive chronotropic
positive dromotropic
positive inotropic

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9
Q

are beta 2 pre or post

A

postsynaptic

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10
Q

beta 2 stimulation creates what effect?

A

relaxes smooth muscle, bronchodilator, vasodilation and relaxation of the uterus.

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11
Q

what does beta 2 do to electrolytes

A

activates Na/K pump, which drives potassium intracellularly which can induce hypokalemia and dysrhythmias

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12
Q

what is the effect of volatile anesthetics on BP

A

dose dependent decreases in Systemic BP

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13
Q

what does nitrous oxide (not volatile) do to BP

A

direct mild myocardial depression BUT also causes sympathetic activation

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14
Q

what do volatile anesthetics do at the cellular levels to produce their cardiac effects

A

influencing L-Type Calcium channels

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15
Q

how do halothane and enflurane predominantly effect blood pressure

A

myocardial contractile function

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16
Q

iso sevo and des predominantly effect blood pressure

A

decreases SVR

17
Q

what is the order that volatile anesthetics lower the arrhythmogenic threshold for EPI

A

halothane >enflurance>sevo>iso>Des

18
Q

how does thiopental affect hemodynamics

A

decreases contractility- from reduced availability of calcium to the myofibrils and decreased venous return

19
Q

why does thiopental increase HR

A

baroreceptor mediated sympathetic reflex stimulation

20
Q

why is thiopental used during CPB

A

cerebral protection

21
Q

which anthesthic drug changes hemodynamic variables the least

A

etomidate

22
Q

what is the dose for adrenal corticosuppression

A

no one knows

23
Q

what is the most common and successful approaches to blocking ketamine induced hypertension and tachycardia

A

prior administration of benzodiazepines

24
Q

what two situations make ketamine the safest and most efficacious drug

A

decreased blood volume or cardiac tamponade

25
Q

ketamine increases?

A

HR, CI, SVR, PAP, and systemic artery pressure

26
Q

with the exception of meperidine what do all opioids produce

A

bradycardia

27
Q

the major advantage of fentanyl and its analogs for patients undergoing cardiac surgery

A

lack of cardiovascular depression(smooth CV induction)

28
Q

what is the most common mediastinal diagnostic procedure

A

cervical mediastinoscopy

29
Q

how is the mediastinoscope inserted

A

toward the carina via blunt dissection

30
Q

what does the innominate artery supply

A

right arm and right common carotid artery

31
Q

patients who do not have good cerebral collateral circulation are at risk for what

A

cerebrovascular ischemia

32
Q

preoperative evaluation for mediastinoscopy includes

A

assessing the patients ability to lie supine or the presence of a cough or dyspnea

33
Q

where do we place the cuff and aline and pulse of a patient getting amediastinoscopy

A

NIBP left
aline-right
pulse ox right
d/t innominate artery

34
Q

what is the most severe complication of mediastinoscopy

A

hemorrhage- may require emergent thoracotomy be prepared

35
Q

if an a line is not necessary in all vases what do we need on the right arm

A

pulse ox

36
Q

what must you do if you suspect recurrent laryngeal nerve damage

A

vocal cords should be visualized whilthe patient is spontaneously breathing

37
Q

what is an abolsute contraindication to mediastinoscopy

A

prior mediastinoscopy

38
Q

what are the relative contraindications to mediastinoscopy

A

superior vena cava obstruction, tracheal deviation, thoracic aortic aneurysm, cerebrovascular disease

Fall'20 Advanced Principles II (7 decks)

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