Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Physiology_test 2 > Perioperative HTN > Flashcards

Perioperative HTN Flashcards

0
Q

What population in US is effected by HTN?

A

30 % or 72 million adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Which organs does HTN impact?

A

Every organ system in body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How many people are effected worldwide by HTN?

A

1 billion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How much more common is HTN in African Americans?

A

2 times

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

True or False. There is an increased peri operative morbidity and mortality associated with patients not under good HTN control before going to OR.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What three things maintain BP?

A
  1. Cardiac Ejection
  2. Intravascular volume
  3. Vascular tone/elasticity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Does the ANS have direct or indirect effects on cardiac system?

A

Direct; as well as on vascular smooth muscle which leads to vascular tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is MAP calculated?

A

(2DBP + SBP)/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does neosynephrine do?

A

Constricts blood vessels by acting on alpha 1 receptors or ANS outflow —> allows maintenance of BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do we increase BP?

A
  1. Constrict outflow in atrial system
  2. Increase inflow in system (incr CO, incr cardiac ejection)
  3. Also depends on adequacy of blood volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is pulse pressure and how is it calculated?

A

Proportional to amount of blood ejected during each cardiac cycle.

PP = SBP - DBP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A pre-hypertensive patient has what values for SBP, DBP, and MAP?

A

SBP > 120
DBP > 80
MAP = 93

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A hypertensive stage 1 patient has what values for SBP, DBP, and MAP?

A

SBP > 140
DBP > 90
MAP > 93 (if you do math actually closer to 106)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A hypertensive crisis patient has what values for SBP and DBP?

A

SBP > 180
DBP > 110

*we want to drop this BP but not too rapidly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

There are three categories of HTN, what are they and which is most common?

A
  1. Essential HTN **most common
  2. Chemical HTN
  3. Renal-Vascular HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A hypertensive emergency patient can lead to…?

A

Organ dysfunction or damage (stroke, arteriosclerosis, heart attack, kidney failure). Want to drop BP more rapidly than in crisis

16
Q

What is the etiology of essential HTN? And what are possible treatments?

A

No clear etiology

Beta blockers, diuretics, calcium channel blockers

17
Q

Chemical HTN can be due to…?

A

Cushing’s disease, Addison’s disease, Na+ metabolism/excretion problems, CNS, ANS problems

19
Q

Essential HTN is…?

A

dealing with contractility of vessels and fluid retention

Responsiveness/reactivity of smooth muscle in arterial walls and regulation of electrolytes throughout the body itself

20
Q

Chemical HTN is…?

A

poor electrolyte control

Changes in fluid/electrolyte retention/storage in body leading to increased intravascular volume, reactivity, tone

21
Q

Renal-Vascular HTN is…?

A

due to kidney disease or poor kidney perfusion and poor fluid control

(Feedback/regulation of renal perfusion and fluid/electrolytes at kidney level because lack of perfusion or stenosis of renal artery can cause problems and excessive elevation in BP)

21
Q

During surgical stimulation under anesthesia, what are the changes in a normal person’s and a hypertensive person’s BP and HR?

A

Normal: incr BP 20-30 mmHg, incr HR 15-20 beats

HTN: incr BP 90 mmHg, incr HR 40 beats

22
Q

Renal-Vascular HTN can be caused by…?

A

Phenochromocytoma (tumor on adrenal gland causing large release of catecholamines)

23
Q

What happens to auto regulation of BP in a chronically HTN patient?

A

Shifts to the right.

**reason we keep patient within 20% of their normal BP - auto regulation is shifted and we want to make sure we are still perfusing the organs

24
Q

True or False. Problems with HTN in could cause a delay or cancellation of surgery. If so, why?

A

True.

Because of cardiac complications being increased risk in people undergoing surgery. In study, preop HTN 4 times more likely to die of CV complications.

25
Q

What changes happen to effect BP in anesthesia?

A
  1. Baroreceptor response blunting
  2. Vasodilation
  3. Intravascular volume reduction
  4. Cardiac depression
  5. Sympathetic inhibition
26
Q

What changes happen to BP at induction?

A
  1. Tachycardia (stimulation with laryngoscope)
  2. Vasoconstriction
  3. SNS release
  4. PNS blockade
  5. Multifactoral stimulation
27
Q

What happens to BP on emergence?

A
  1. Restoration of vascular tone
  2. Pain
  3. Bladder distention –> HTN
  4. Fluid overload
  5. Hypercarbia
  6. Hypoxia
  7. Agitation
28
Q

What is the difference in normotensive and well controlled hypertensive patients?

A

None really.

Less variability in BP fluxes, similar complications and risks, no reason not to perform surgery

30
Q

Which pressures (SBP and DBP) are independent risk factors during operation?

A

> 170 SBP
110 DBP
Or really a combination of both

31
Q

How do we increase MAP?

A

incr CO or vascular resistance (or both)

32
Q

What is autoregulation?

A

the body’s attempt to maintain organ perfusion

33
Q

If MAP decreases, SNS output increases causing…?

A

incr CO -> vessels in organs dilate to increase flow and decrease resistance

34
Q

If MAP increases, organs vasoconstrict it’s vessels causing…?

A

incr resistance -> decrease flow

Physiology_test 2 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions