PBL Unseen 2 Flashcards
what is the definition of low blood pressure
Low blood pressure is defined as having blood pressure below 90/60 consistently
what are the symptoms of hypotension
- Dizziness
- Feeling sick
- Blurred vision
- Feeling weak
- Confusion
- Fainting
what is postural hypotension
- a sudden change in position and then you feel dizzy
How do you improve symptoms of low blood pressure
- Get up slowly from sitting to standing
- Take care when getting out of bed
- Raise the head of the bed by 15cm
- Eat small frequent meals
- Increase the amount of water that you drink
what re the causes of hypotension
- Being pregnancy – circulatory system expands rapidly during pregnancy so blood pressure drops
- Diabetes
- Some types of medication – water pills, alpha blcokers, ebta blockers such as atenolol and propanol, antidepressants including doxepin
- Heart problems – low heart rate, heart valve problems, heart attack and failure
- Endocrine problems – thyroid condtions such as parathyroid disease, low blood sugar
- Dehydration – body loses more water than it takes it, it can cause weakeness dizziness and fatigue,
- Blood loss – losing a lot of blood can lead to a severe drop in blood pressure
- Infection – septic shcok
- Allergic reaction
- Lack of nutrients – lack of B12 and folate can keep the body from producing enough red blood cells causing low blood pressure
what is the thumb innervated by
- the median nerve
- C5-C7
- get atrophy of the thenar muscle if the nerve is low and you get hand of benediction if there is high median nerve damage
How can sedation cause low blood pressure
1) propofol induces predominance of parasympathetic activity, leading to decreased HR and BP, and
2) midazolam induces predominance of sympathetic activity, leading to increased HR and decreased BP
How does oedema cause nerve function
- Serve swelling can cause permanent damage to the nerves resulting in peripheral neuropathy
- Nerve swelling can cause oedema when there is damage to the nerve
- Compressive the nerve as it is only temporary
what is oedema caused by
- Lymphatic obstruction
- Increase in capillary permeability
- Decrease in plasma proteins in the capillary
- Increase in hydrostatic pressure forcing fluid out of the capillary
what is oedema
- excess fluid in the interstitial tissue
How do the nerves regenerate in the PNS
- Dorsal root ganglion is turned into a pro growth from its static state
- Leads to reformation of functional growth coen and regeneration
- Axons is governed by chemotactic factors secreted from schwann cells
- Macrophages and phagocytes go to the lesion and clear away debris
- Retrograde Degradation at the proximal end but once the debris is cleared it begins to sprout axons and the presence of growth cones is detected
How do nerves regenerate in the CNS
- Glial scar limits formation
- Hostile environment
- Myelin associated inhibitor proteins Nogo, MAG, Ompg
- Axons cannot grow through the glial scar
- Thus don’t tend to regenerate
- Growth factors are not expressed
- Slower degeneration meaning that the myelin and axonal debris are not cleared away as quickly
what is the difference between nerve regeneration in the PNS and CNS
PNS
- Dorsal root ganglion is turned into a pro growth from its static state
- Leads to reformation of functional growth coen and regeneration
- Axons is governed by chemotactic factors secreted from schwann cells
- Macrophages and phagocytes go to the lesion and clear away debris
- Retrograde Degradation at the proximal end but once the debris is cleared it begins to sprout axons and the presence of growth cones is detected
CNS
- Glial scar limits formation
- Hostile environment
- Myelin associated inhibitor proteins Nogo, MAG, Ompg
- Axons cannot grow through the glial scar
- Thus don’t tend to regenerate
- Growth factors are not expressed
- Slower degeneration meaning that the myelin and axonal debris are not cleared away as quickly
what is the definition of labour
Presence of regular painful uterine contractions becoming progressively stronger and more frequent, accompanied by effacement and progressive dilatation of the cervix and descent of the head through the cervix into the vagina and out
when does labour begin
bloody mucoid show,
end with explusion of baby and other products of conception
what are the hormonal changes that take place that lead to increased labour contractions
- foetal itself is producing some of hormones such as oxytocin, this feds back to the myometrium to increase oxytocin receptor which increases contraction, mothers oxytocin does the same thing
- Oestrogen – pro smooth muscle contraction, increase in the amount of oestrogen and the amount of progesterone decreases
- Relaxin is also produced by the placenta, it relaxes the ripening of the cervix and the softening of the cervix, also causes softening of the pubic symphysis to allow the joint to move further apart
- Also local prostaglandin production – this causes relaxation and causes the contraction of the uterus
describe the stages of labour
Latent
- 0-4 cm cervix dilation
- Duration not easily determined nothing to show other than cramps and possible backache,
- Often long, especially in women having their first baby
- Contractions last 30-60 second and are 5-20 mins apart
- average duration is 12 hours
Active
- 4-10cm dilatation
- Established labour
- Cervix dilates at the rate of about 0.5 – 1 cm/hour
- May be faster in multiparous women or slower in first
- Average duration – 12 hrs
- Contractions last 45-60 seconds and are 2-5 mins apart
- Transistion contractions last 60-90 seconds and are 2-3 mins apart
2ndstage
- Within 3 hrs for first
- Within 2 hrs for multiparous and often much quicker
- Contractions last 45-90 secs and 3-5 mins apart
Third stage
- After the delivery of the baby to the delivery of the placenta and amniotic membranes
- Usually within 30 min
