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2014-01-28 16:08:52
Anesthesia Surgery

key points
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  1. functions of the cardiosystem
    • carry O2 and nutrients
    • remove waste (CO2)
    • maintain homeostasis (temp, hydration, osmosis)
  2. narrow opening
  3. most common stenosis
    • *mitral
    • pulmonary
  4. most common inherited morphology in animals
    patent ductus arteriosus

    2nd- pulmonic stenosis
  5. forces that act on SA node
    • spontaneous originating impulses
    • vagal nerve
    • sympathetic fibers
  6. heart block
    • any interruption of impulse pathway
    • AV Bundle most common
  7. P wave represents
    atrial depolarization
  8. P-R interval represents
    filling time for ventricles
  9. QRS Complex represents
    • atrial repolarization
    • ventricular depolarization
  10. S-T segment represents
    filling time for atrium
  11. T wave represents
    ventricular repolarization
  12. cardiac reserve
    diff between the work capability at rest and that during max physical exertion
  13. O2 available to tissues is dependent on these 2 things:
    • cardiac output
    • amount of O2 extracted from blood
  14. two systems generate blood pressure:
    • general vascular system- LV
    • pulmonary vascular system- RV
  15. arterial blood pressure is maintained by
    • cardiac output
    • peripheral vascular resistance
  16. if blood pressure on arterial side is low, do this:
    • give fluids to increase cardiac output
    • epinephrine to cause vasoconstriction and increase BP
  17. humoral agents that regulate arterial pressure and cardiac output
    • renin
    • atrial natriuretic peptides (ANP)
    • NT-ProBNP (predictor of heart failure)
  18. paracrine agents that regulate arterial pressure
    • nitric oxide
    • endothelin- peptide secreted by endothelial cells, constricts vascular smooth muscle of arterioles
  19. venous side contains what percentage of the total blood vol
  20. types of capillaries
    • arterio-venous "thorough-fare" capillaries- blood flow is continuous, controlled by sphincters in arterioles and along the capillary wall
    • secondary capillaries "true" capillaries- no muscle, passive diffusion
  21. venous return controlled by
    • inspiration
    • venous contraction
    • valves

    other factors: heart beat, muscular activity, peristalsis of intestinal tract, and gravity
  22. nerve fibers that secrete acetylcholine are said to be
  23. nerve fibers that secrete nor-epinephrine are said to be
  24. explains that some postganglionic fibers of the sympathetic system are cholinergic (release acetylcholine)
    Grey Rami
  25. piloerector muscles
    make the hair stand up on the back of the cat
  26. parasympathetic

    • neurotransmitter: acetylcholine
    • receptors: nicotinic, muscarinic
  27. sympathetic
  28. acetylcholine activates two diff types of receptors
    • muscarinic
    • nicotinic
  29. poison from toadstools
    • muscarine
    • activates only muscarinic receptors
  30. activates only nicotinic receptors
  31. 2 cholinergic receptors
    • nicotinic
    • muscarinic
  32. 2 adrenergic receptors
    • alphas
    • betas

    • epinpehrine excites alpha&beta
    • nor-epi excites alpha
  33. catecholamines
    • epinephrine
    • nor-epi
    • l-dopa
    • dopamine
    • dopaminergic
    • *all originate from adrenal medulla of adrenal gland
  34. alpha receptors sensitive to
    epinephrine and nor-epi
  35. beta receptors sensitive to
    epinephrine only
  36. alpha 1 receptors
    • vasoconstriction
    • blood is shunted from non-essential survival areas to the heart and skeletal muscles
  37. alpha 2 receptors
    associated with analgesia and sedation
  38. beta 1 receptors
    • located in myocardium
    • increase rate and strength of contraction of depolarization wave in heart muscle
  39. beta 2 receptors
  40. what is shock?
    reduced cardiac output and vasodilation
  41. what determines the level of BP in the vascular system?
    cardiac output and peripheral vascular resistance
  42. what happens when we give 1:10,000 epinephrine for shock?
    • compensatory shock reaction:
    • alpha 1- vessels in periphery constrict to raise BP and divert blood flow to vital organs
    • beta 1- increase in strength and contraction rate of myocardium
    • beta 2- bronchodilation for breathing and vascular dilation in the heart to allow for easy blood flow
  43. anaphylactic reaction process
    • injection of foreign protein (ex. penicillin)
    • histamine release (mast cells/basophils)
    • vasodilation of capillaries
    • increase capillary permeability
    • blood plasma moves into tissues
    • decrease blood vol
    • reduced blood flow >hypoxia >death
  44. degrees of shock
    • compensatory phase
    • progressive phase
    • irreversible phase
  45. compensatory phase
    • all arterioles except coronary and cerebral vessels constrict to maintain arterial pressure
    • elevation of pulse and increase in cardiac output
  46. progressive phase
    • heart cannot pump sufficiently due to fatigue
    • decrease cardiac output and O2 to alveoli&respiratory center causing vasodilation
    • body is wanting to vasodilate to reduce friction so blood will flow more easily
  47. irreversible shock
    no treatment effective as heart is irreparable
  48. TX of shock
    • fluids- to increase blood vol and replace some of the blood plasma pressure lost to tissues
    • corticosteroids- restore capillary strength and reduce vasodilation
    • warm body
  49. dog comes in w/ shock, what do you do step-by-step?
    • 1. place indwelling catheter
    • 2. start on LRS @ shock drip
    • 3. solu-delta-cortef (if does not work then..)
    • 4. 1:10,000 epinephrine