Physiologic Response to Surgery

Question 1

↑ ACTH after surgery stimulates

Answer 1

release of cortisol and glucocorticoids from the adrenal medulla

Question 2

ADH levels post opp

Answer 2

Promotes water retention and concentrated urine

Increased secretion for 3-5 days post op

Question 3

Renin

Answer 3

Released from the juxtaglomerular cells of the kidney
Stimulates production of angiotensin II
Stimulates the release of aldosterone from the adrenal cortex
Na+ and water resorption at the DCT
K+ loss

Question 4

Anesthetic drugs

Answer 4

Etomidate: Suppresses cortisol production
Benzodiazepines: May inhibit steroid production at the level of the pituitary
Clonidine: Inhibit stress responses mediated by the sympathetic nervous system

Question 5

Dehiscence

Answer 5

Wound rupture along the surgical suture

Question 6

Evisceration

Answer 6

Complete dehiscence of an abdominal wound can lead to evisceration where the abdominal organs are protruding out of the wound

Question 7

Forms of gangrene

Answer 7

Wet: tissue infected, swollen, fetid smell
Dry: ischemia without infection
Gas: bacterial infection that produces gas in the tissues. Think clostridium perfringens
Other: necrotizing fasciitis. Spreads deep along the tissue planes