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Pharmacology > Pharm 2 - Exam 1 > Flashcards

Pharm 2 - Exam 1 Flashcards

1
Q

CN IX

A

glossopharyngeal

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2
Q

CN X

A

vagus

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3
Q

CN V

A

trigeminal

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4
Q

Where does the larynx receive its blood supply from?

A

superior and inferior laryngeal arteries

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5
Q

The superior and inferiro laryngeal arteries are branches of the ________ arteries.

A

superior and inferior thyroid

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6
Q

What innervates the diaphragm?

A

phrenic nerve

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7
Q

What are the accessory msucle of repsiratrion?

A

sternocleidomastoids, scalenes

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8
Q

What muscles of the abdomen contribute to respiration?

A

rectus abdominis, external oblique, internal oblique, transverse abdominis

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9
Q

The CC = ___ + ___

A

closing volume and residual volume

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10
Q

What is the closing volume?

A

the lung volume below which small airways begin to close during expiration

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11
Q

Is closure of small airways in the SUPERIOR portion of the lung during deep expiration normal due to gravity?

A

NO - it is normal in basal portions of the lung

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12
Q

Why is closure of small airways normal in basal portion of the lungs during deep expiraiton?

A

D/t gravity-dependent increase in pleural pressure at the bases and d/t lack of parenchymal support in distal airways

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13
Q

Does CC increase with age?

A

Yes

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14
Q

Why does CC increase with age?

A

D/t loss of structural parenchymal support tissue in the lung and an increase in RV

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15
Q

What is greater the increase in FRC or the increase in CC for elderly?

A

CC

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16
Q

Does FRC increase with age?

A

slightly

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17
Q

How long can you manipulate the airway until brain damage?

A

4 minutes

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18
Q

How long does it take the CC to change?

A

very slowly over time

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19
Q

HOw long does it take the FRC to change?

A

changes minute to minute

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20
Q

What determines teh FRC change?

A

lung and chest wall

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21
Q

When does the CC exceed FRC in teh supine position?

A

by age 45

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22
Q

When does the CC exceed FRC in teh upright position?

A

65

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23
Q

What anesthetic does not decrease the elastic recoil of the chest wall?

A

Ketamine

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24
Q

WHy do anesthetics decrease the elastic recoil of the chest wall?

A

muscle relaxing effects

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25
Anesthetics cause what to decrease?
Elastic recoil and FRC
26
Examples of respiratory resistance during perioperative period
bronchospasm secretion in ETT partial circuit obstruction
27
Two categories of chronic repsiratory disease
obstructive and restrictive
28
FEV1/FVC of obstructive disease
<80% (DECREASED) w/ decreased FEV1
29
FEV1/FVC of restrictive disease
NORMAL
30
Wht type of respiratory disease shows mixed obstructive/restrictive pattern?
Cystic fibrosis
31
FEV1 >70% severity
mild
32
FEV1 50-70%
moderate
33
FEV1 30-50%
severe
34
FEV1 <30%
very severe
35
what anesthetic shoudl you give to someone with low FEV1?
ketamine
36
3 disorders of COPD?
emphysema peripheral airway disease chronic bronchitis
37
What is the dominant clinical feature of chronic respiratory disease?
expiratory airflow
38
Mild patients DO or DO NOT have significant dyspnea, hypoxemia, or hypercariba.
they SHOULD NOT
39
When do COPD pts have an elevated PaCO2 at rest?
w/ moderate to severe COPD
40
WHy do COPD have high PaCo2?
inability to maintain the increased work of respiration required to keep it normal in pts w/ mechanically inefficient pulmonary function
41
The PACO2 rises in COPD pts when supplemental FIO2 is administered d/t a relative _____ in alveolar ventilation and an _____ in alveolar deadspace. and shunt by redistribution of perfusion away from lung areas of relatively normal to low V/Q mismatch b/c regional HPV is _____.
decrease; increase; decreased
42
What is the Haldane effect?
property of Hgb in which oxygenation of blood in the lungs displaces CO2 from the Hgb, increasing the removal of CO2
43
All moderate to severe COPD pts need what preop?
ABG
44
What occurs in up to 50% of moderate-severe COPD pts?
RV dysfunction
45
Dysnfunctional RV cannot tolerate sudden increases in afterload r/t what?
chagne from spontaneous to controleld ventilation
46
Does the RV EF increase w/ exercise in normal pts?
yes
47
does the RV EF increaes w/ exercise in COPD pts?
no
48
Cystic spaces in the lung parenchyma that COPD develop
bullae
49
When do bullae become symptomatic?
Occupay >50% of the hemithorax
50
With symptomatic bullae a pt will present with obstructive disease. True or False
False, will present with obstructive and restrictive
51
What is avbullae?
localized area of loss of structural support tissue in teh lung w/ elastic recoil of surrounding parenchyma
52
Can you use positive pressure w/ bullae?
Yes, if kept low and CT equipment is avaliable
53
Incomplete expiration by COPD pts is due to what 3 things?
1. flow limitation 2. increase work of breathing 3. increased airway resistance
54
Elevation of the end-expiratory lung volume above the FRC is called?
auto-PEEP
55
What counteracts auto-PEEP during spontaneous respiration
the intrapleural pressure will have to be decreased to a level
56
Auto-peep is direclty propertional to what during mechanical ventilation
TV
57
auto PEEP is inversely propotional to what during mechanical ventilation
expiratory time
58
How can auto-PEEP be measured?
by end-expiratory flow interruption
59
What type of surgery does auto-PEEP often develop?
one-lung ventilation
60
Mild-moderate restrictive lung disease is ____ of a problem than COPD to manage periop.
less
61
Mild-moderate restrictive lung disease is _____ of a problem than COPD to manage postop.
more
62
Due to a decreased FRC w/ restrictive lung disease, these patients develop what during anesthesia?
increased shunt
63
What is a problem post op for restrictive lung disease?
restoration of FRC
64
Use of regional anesthesia, short acting opioids/muscle relaxants, and noninvasive ventilation are good for restrictive lung disease. True or falst
true
65
What is used for OLV?
double-lumen endobronchial tube or a bronchial blocker w/ a standard ETT
66
What is a major concern w/ OLV?
hypoxemia

Pharmacology (4 decks)

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