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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
Q

Anesthetics cause what to decrease?

A

Elastic recoil and FRC

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26
Q

Examples of respiratory resistance during perioperative period

A

bronchospasm
secretion in ETT
partial circuit obstruction

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27
Q

Two categories of chronic repsiratory disease

A

obstructive and restrictive

28
Q

FEV1/FVC of obstructive disease

A

<80%
(DECREASED)
w/ decreased FEV1

29
Q

FEV1/FVC of restrictive disease

A

NORMAL

30
Q

Wht type of respiratory disease shows mixed obstructive/restrictive pattern?

A

Cystic fibrosis

31
Q

FEV1 >70% severity

A

mild

32
Q

FEV1 50-70%

A

moderate

33
Q

FEV1 30-50%

A

severe

34
Q

FEV1 <30%

A

very severe

35
Q

what anesthetic shoudl you give to someone with low FEV1?

A

ketamine

36
Q

3 disorders of COPD?

A

emphysema
peripheral airway disease
chronic bronchitis

37
Q

What is the dominant clinical feature of chronic respiratory disease?

A

expiratory airflow

38
Q

Mild patients DO or DO NOT have significant dyspnea, hypoxemia, or hypercariba.

A

they SHOULD NOT

39
Q

When do COPD pts have an elevated PaCO2 at rest?

A

w/ moderate to severe COPD

40
Q

WHy do COPD have high PaCo2?

A

inability to maintain the increased work of respiration required to keep it normal in pts w/ mechanically inefficient pulmonary function

41
Q

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 _____.

A

decrease; increase; decreased

42
Q

What is the Haldane effect?

A

property of Hgb in which oxygenation of blood in the lungs displaces CO2 from the Hgb, increasing the removal of CO2

43
Q

All moderate to severe COPD pts need what preop?

A

ABG

44
Q

What occurs in up to 50% of moderate-severe COPD pts?

A

RV dysfunction

45
Q

Dysnfunctional RV cannot tolerate sudden increases in afterload r/t what?

A

chagne from spontaneous to controleld ventilation

46
Q

Does the RV EF increase w/ exercise in normal pts?

A

yes

47
Q

does the RV EF increaes w/ exercise in COPD pts?

A

no

48
Q

Cystic spaces in the lung parenchyma that COPD develop

A

bullae

49
Q

When do bullae become symptomatic?

A

Occupay >50% of the hemithorax

50
Q

With symptomatic bullae a pt will present with obstructive disease. True or False

A

False, will present with obstructive and restrictive

51
Q

What is avbullae?

A

localized area of loss of structural support tissue in teh lung w/ elastic recoil of surrounding parenchyma

52
Q

Can you use positive pressure w/ bullae?

A

Yes, if kept low and CT equipment is avaliable

53
Q

Incomplete expiration by COPD pts is due to what 3 things?

A
  1. flow limitation
  2. increase work of breathing
  3. increased airway resistance
54
Q

Elevation of the end-expiratory lung volume above the FRC is called?

A

auto-PEEP

55
Q

What counteracts auto-PEEP during spontaneous respiration

A

the intrapleural pressure will have to be decreased to a level

56
Q

Auto-peep is direclty propertional to what during mechanical ventilation

A

TV

57
Q

auto PEEP is inversely propotional to what during mechanical ventilation

A

expiratory time

58
Q

How can auto-PEEP be measured?

A

by end-expiratory flow interruption

59
Q

What type of surgery does auto-PEEP often develop?

A

one-lung ventilation

60
Q

Mild-moderate restrictive lung disease is ____ of a problem than COPD to manage periop.

A

less

61
Q

Mild-moderate restrictive lung disease is _____ of a problem than COPD to manage postop.

A

more

62
Q

Due to a decreased FRC w/ restrictive lung disease, these patients develop what during anesthesia?

A

increased shunt

63
Q

What is a problem post op for restrictive lung disease?

A

restoration of FRC

64
Q

Use of regional anesthesia, short acting opioids/muscle relaxants, and noninvasive ventilation are good for restrictive lung disease. True or falst

A

true

65
Q

What is used for OLV?

A

double-lumen endobronchial tube or a bronchial blocker w/ a standard ETT

66
Q

What is a major concern w/ OLV?

A

hypoxemia

Pharmacology (4 decks)

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