The tauma of major surgery

Question 1

What are systemic responses to injury?

Answer 1

1. increased cardiac output
2. increased minute ventilation
3. febrile
4. increased metabolic rate

Question 2

What happens to supply the increased energy demand of wounds?

Answer 2

1. accelerated lipolysis
2. accelerated proteolysis
3. amino acids–wound healing, acute phase proteins)
4. glucose–vital organs, wound healing

Question 3

What role does pain play in trauma?

Answer 3

1. increased metabolic rate

Question 4

What are factors that play a role in the energy and nitrogen balance?

Answer 4

1. endocrine system
2. nervous system
3. tissue factors

Question 5

why is skeletal muscle lost before adipose tissue?

Answer 5

gluconeogenesis is easier from protein than lipid

Question 6

What happens the the fluid compartments in response to major trauma?

Answer 6

1. expansion of ECF–Vd of drugs!!! aminoglycosides

Question 7

What changes occur in response to injury?

Answer 7

1. volume loss
2. underperfusion
3. starvation
4. tissue damage
5. infection

Question 8

What does endotoxin cause release of?

Answer 8

TNF
cyclooxgenase (prostaglandins)
constrition and dilation in different orgnans

Question 9

increased metabolic rate, endocrine response, decreased nutritional state lead to what?

Answer 9

weight loss

immune suppression

Question 10

What are contronllable factors with major trauma?

Answer 10

1. volume loss
2. underperfusion
3. starvation
4. tissue damage
5. infection

Question 11

What are the factors of the pain management?

Answer 11

1. preemptive
2. systemic analgesia
3. local pain control–epidurals, intraarticular analgesia