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Autonomic Nervous System > ANS Pathophysiology > Flashcards

ANS Pathophysiology Flashcards

1
Q

What determines HR in patients who have had a heart transplant?

A

The intrinsic rate of the SA node (100-120 bpm)

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2
Q

What determines cardiac output in patients who have had a heart transplant?

A

Preload; HR is fixed and CO = SV x HR

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3
Q

Drugs that can increase HR in patients who have had a heart transplant

A

Drugs that directly stimulate SA node:
Epinephrine
Isoproterenol
Glucagon

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4
Q

Drugs that will not increase HR in patients who have had a heart transplant

A

Indirect- acting drugs:
Atropine
Glycopyrrolate
Ephedrine

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5
Q

Effect on recipient heart: Digitalis

A

Normal increase in contractility

Minimal effect on AV node

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6
Q

Effect on recipient heart: atropine

A

None

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7
Q

Effect on recipient heart: epinephrine

A

Increased inotropy
Increased chronotropy

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8
Q

Effect on recipient heart: norepinephrine

A

Increased inotropy
Increased chronotropy

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9
Q

Effect on recipient heart: isoproterenol

A

Normal increase in inotropy
Normal increase in chronotropy

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10
Q

Effect on recipient heart: qunidine

A

No vagolytic effect

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11
Q

Effect on recipient heart: verapamil

A

AV block

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12
Q

Effect on recipient heart: nifedipine

A

No reflex tachycardia

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13
Q

Effect on recipient heart: hydralazine

A

No reflex tachycardia

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14
Q

Effect on recipient heart: beta blocker

A

Increased antagonist effect

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15
Q

What reflex is preserved in the transplanted heart?

A

Bainbridge reflex (d/t SA node stretch response)

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16
Q

Most common cause of cardiac denervation in non-cardiac surgery patients

A

Diabetes

17
Q

Neuroendocrine tumors that arise from neural crest cells

A

Paragangliomas

18
Q

What is the difference between paragangliomas and pheochromocytomas?

A

Paragangliomas exist in extra-adrenal locations and rarely secrete vasoactive substances

19
Q

Common sites of paraganliomas

A

Neuroendocrine tissues surrounding the aorta or within the lung

Head and neck near carotid artery, glossopharygeal nerve, jugular vein, and middle ear

20
Q

Most common vasoactive substance paragangliomas secrete

A

Norepinephrine

21
Q

Anesthetic concern for paraganglioma that has invaded the IJ

A

Air embolism

22
Q

Anesthetic concern for paragangliomas of glossopharyngeal, vagus, or hypoglossal nerves

A

Airway obstruction, swallowing impairment –> aspiration

23
Q

Degeneration and dysfunction of diverse CNS structures (basal ganlia, cerebellar cortex, locus coeruleus, pyramidal tracts, and vagal motor nuclei)

A

Multiple system atrophy

24
Q

Signs and symptoms of multiple system atrophy with autonomic dysfunction

A

Urinary retention
Bowel dysfunction
Impotence
Postural hypotension
Sluggish pupillary reflexes
Control of breathing may be abnormal
Failure of baroreceptor reflexes

Autonomic Nervous System (13 decks)

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