PBL 1 Flashcards
where does the arterial supply to the upper ib begin?
subclavian atyeru
when does the subclavian artery become the axillary artery?
at the lateral border of the first rib
what are the 6 branches of the axillary artery?
superior thoracic artery thoracoacromial artery lateral thoracic artery subscapular artery (Branches for circumflex scapular ans thoracodorsal) anterior circumflex humeral Posterior circumflex humeral
SOMETIMES LIFE SEEMS A PAIN
when does the axillary artery become the brachial artery?
at the lower border of the teres major muscle
distal to the teres major, what does the brachial artery give rise to?
the produnda brachii (deep brachial artery) - this travels within the the radial groove of the humerus with the radial nerve
what does the profunda brachii artery give rise to?
medial collateral and radial collateral arteries
what does the medial collateral artery anastamose with?
recurrent interosseous artery
what does the radial collateral artery anastamose with?
radial recurrent artery
what does the brachial artery give rise to?
Profunda Brachii Superior Ulnar Collateral Artery Inferior Ulnar Collateral Artery Ulnar Artery Radial Artery
what does the infeiror ulnar collateral artery anastamose with?
the anterior ulnar recurrent and medial collateral arteries
what does the superior ulnar collateral artery anastamose with?
posterior ulnar recurrent artery
what does the thoracoacromial artery supply?
pectoralis major and minor, part of deltoid, skin over clavipectoral fascia
what does the lateral thoracic artery supply?
lateral structures of the thorax and breast
what do the anterior and posterior circumflex humeral artery supply?
teres major ad inor, deltoid, long head of tricep brachii
what does the subscapular artery supply?
muscles and skin of the shoulder, upper extremities and thoracic wall
what does the circumflex scapular artery supply?
deltoid, teres minor, tricep brachii, glenoid labrum, skin over lateral scapula
what does the medial collateral atery supply?
triceps
what does the inferior ulna collteral artery supply?
brachialis, biceps brachii, coracobrachialise
what does the radial recurrent artery supply?
elbow joint, brachialis, brachioradialis
what does the anterior ulna recurrent artery supply?
elbow joint and pronator teres
what does the posterior ulna recurrent artery supply?
elbow joint, flexor carpi ulnaris and palmaris longus
what are the 4 stages of general anaesthesia?
induction
excitement
surgical anaesthesia
medullary paralysis
whats the induction stage of general anaesthetic?
from consciousness to unconsciousness
whats the excitement stage of general anaesthetic?
depression of inhibitory CNS neurones leading to increased excitement, involuntary movement, bp, HR and RR
what is the surgical anaestesia of general anaesthetic?
gradual loss of muscle tone and reflexes, patient is fully unconscious and there is regular breathing
what is the medullary paralysis stage of general anaesthetic?
respiratory and cardiovascular failure which can lead to death if not reversed
what are some intravenous general anaesthetic agent?
propofol, etomidate, ketamine and thiopental sodium
what are IV general anaesthetic agents usef for?
unconsciousness so the induction phase
what are the 3 key things needed for general anaesthesia?
immobility
analgesia
unconsciousness
whats the moa of general anaesthtic IV agents?
bidning to GABA-A rceptors which causes a conformational change which opens a central pore, allowing Ca2+ in and causing hyperpolarization of rsting potential - this makes it more difficult for excitatory neurotransmitters to depolarise the neuron and generate an action potential
what are side effects of etomidate?
adrenal suppression ans transient skeletal muscle movements
what are side effects of propofol?
respiratory deoression and hypotension
what is an example of barbiturates?
thiopental sodium
what are side effects of barbiturates?
apnea, cough, bronchospasms and respiratory depression
what are inhalation general anaesthetic agent examples?
nitrous oxide, xenon, cyclopropane
what are inhalation general anaesthetic agents good for?
analgesia
how do nitrous oxide, xenon and cyclopropane work?
they inhibit NMDA receptors so we get decreased neurotransmission of pain
what are side effects of ketamine?
hypertension, tachycardia, hypersalivationn, emergence phenomena
what are side effects of nitrous oxide and cyclopropane?
dizziness, nausea and vomiting
what are side effects of xenon?
there are no significant side effects
what are examples of halogenated volatile anaesthetics?
halothane, enflurone, isoflurone, sevoflurane, desflurane
what are the moas of halogenated volatile anaesthetics?
bind to GABA-A receptors, activate 2-pore-domain K+ channels, inhibit NMDA receptors etc…
very diverse!
what are side effects of halogenated volatile anaesthetics?
hypotension and reduction in cardiac output - dependant on dose
whats a side effect of sevoflurane?
renal toxicity
whats a side effect of halothane?
cardiac arrythmias and hepatotoxicity
what is malignant hyperthermia?
a rare but potentially lethal complication of anaesthesia
- rise in temp
- increased muscle rigidity
- tachycardia
- acidosis
whats a common trigger of malignant hyperthermia?
voltaile anaesthetics
how do we classify fractures?
the position of bone ends (nondisplaced or displaced)
completeness of break (incomplete or complete)
orientation of break (transverse or linear)
and whether it has penetrated the skin (compound or simple)
what is osteomyelitis?
inflammation of bone or bone marrow, usually caused by staph aureus infection during a fracture
what are the 4 stages of bone healing?
inflammatory stage/hematoma formation
fibrocartilaginous callus formation
bony callus formation
bone remodelling
