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Did you know the biweekly program is about to start? Wow so looking forward to it! What are the hot topics? Of course, there is anesthesia nursing literature that everyone is most concerned about.
Please look forward to it.
Please look forward to it~ Questioner 1.
The organ that receives the most cardiac output at rest is __________
.
Analysis of the Lung Analysis: In the absence of an intracardiac shunt, the lung can receive 100% of the cardiac output because the entire cardiac output of the right ventricle flows through the pulmonary vasculature
.
The cardiac output of other organs is shown in the table below
.
Organ Cardiac Output Skeletal Muscle 15-20% Kidney 20% Heart 4-5% Brain 15% Skin 4-5% Liver 6% Gastrointestinal System, Spleen 20% Questioner 7.
One patient appeared shortly after induction of general anesthesia In the presence of bronchospasm, a 50% reduction in the diameter of the large airway in this patient will cause a __________-fold increase in airway resistance
.
Resolution 32 times resolution: The airflow in the lungs depends on several factors
.
It is important to realize that there are 2 different airflow patterns
.
Laminar flow is an ordered pattern in which all the molecules move layered and straight along the pipe
.
In laminar flow, the velocity is fastest in the center and slowest in the periphery (see Figure 4)
.
In the pulmonary system, laminar flow occurs mainly in the small airways (<1mm)
.
Turbulence is a chaotic form of motion, and there are often vortices in the lumen, mainly in large and medium airways, bifurcations, obstructions, and sudden narrowing of the lumen
.
These vortices impede forward molecular flow, increasing the energy input required to achieve a given flow rate
.
Figure 4 For laminar and turbulent laminar flow in the tube, the resistance is calculated by the following formula: resistance = (8×length×viscosity)/(π×)
.
Since the drag is inversely proportional to the 4th power of the radius of the pipe, in other words, the radius is reduced by half and the drag increases by a factor of 16 in laminar flow
.
Obviously, the pipe radius is the most important influencing factor in the above formula
.
In contrast, drag in turbulent flow depends on the airflow velocity, and as the flow velocity increases, the drag increases proportionally
.
Furthermore, the drag force in turbulent flow is inversely proportional to the 5th power (32 times) of the pipe radius with the following formula: pressure gradient ≈ × (density/half).
Therefore, the drag force in turbulent flow is strongly dependent on the airway radius
.
Question 8.
The mixed venous oxygen content of a 70kg healthy adult is __________ml/L
.
Analysis of 150 ml/L: The relationship between cardiac output and oxygen consumption is described by the Fick formula, as follows: V=CO×(Ca-Cv) V is oxygen consumption, CO is cardiac output, Ca is the arterial oxygen content and Cv is the mixed venous oxygen content
.
Substitute the above data into Fick's formula to get: 4ml/(kg.
min) ×70kg=5.
6L/min×(200ml/L - Cv)280 ml/min/5.
6L/min=200 ml/L - Cv50 + Cv=200 ml/LCv=150 ml/L Questioner 9.
Respiratory Expiratory Volume (ERV) + Tidal Volume (VT) + Inspiratory Respiratory Volume (IRV), the sum of which is equal to the following __________
.
Analysis of lung capacity analysis: The lung can be considered to be composed of 4 "static" lung volumes that cannot be further divided (Figure 5)
.
Tidal volume (VT) is the capacity of the lungs during normal quiet breathing
.
Expiratory supplemental volume (ERV) is the volume of gas that is further excreted from the lungs on the basis of calm exhalation when the human body exhales deeply
.
The amount of gas remaining in the lungs after trying to exhale is called residual volume (RV)
.
Inspiratory replacement volume (IRV) is the maximum amount of air that can be inhaled at the end of a quiet inspiratory effort
.
Two or more static lung volumes can be combined to form a lung volume
.
For example, functional residual capacity (FRC) is formed by the combination of RV and ERV
.
Vital capacity (VC) is composed of ERV plus VT plus IRV
.
Total lung capacity (TLC) is composed of 4 static volumes
.
Figure 5 Respiratory tracings Questioner 10.
Assuming that under normal body temperature, the brain can withstand 4min of ischemia, then at 27°C, the brain can withstand __________min of ischemia
.
Analysis 9min Analysis: Hypothermia can reduce the metabolic and functional activity of the brain.
For every 1°C decrease in body temperature, the cerebral oxygen metabolism rate decreases by about 7%
.
However, within the range of clinical body temperature, the relationship is not linear
.
The relationship between the two can be expressed by a body temperature coefficient (Q10), that is, the decrease in brain metabolism for every 10°C decrease in body temperature
.
When the body temperature is 27-37°C, Q10 is approximately equal to 2.
3
.
In other words, when the patient's body temperature was lowered to 27°C, the cerebral oxygen metabolism rate (CMR) was 57%
.
In the above problem, the human brain can withstand 4 minutes of ischemia time at normal body temperature (37°C).
.
When the body temperature is below 27°C, the Q10 is 4.
5
.
At this time, neuronal function gradually becomes dull, and the clinical manifestation is isoelectric (when the body temperature is 18-21 °C).
According to the linear relationship model, the brain at this time may endure longer ischemia
.
Mild hypothermia can reduce the damage to brain cells caused by cerebral ischemia
.
Possible mechanisms include reducing calcium influx, reducing glutamate release, maintaining blood-brain barrier integrity, and preventing lipid peroxidation
.
It is important to avoid hyperthermia in patients with severe traumatic brain injury, and thus in such patients, hyperthermia can lead to increased CMR and further aggravation of ischemic brain injury
.
Recommended reading [Monday] Key points you can't miss · Anesthesiology senior professional title test center 01 [Monday] Anesthesia junior and intermediate test center Intensive lecture 01 Please look forward to more exciting content~ Scan the code to pay attention to the role of books in the inheritance of civilization is unprecedented
.
.
Did you know the biweekly program is about to start? Wow so looking forward to it! What are the hot topics? Of course, there is anesthesia nursing literature that everyone is most concerned about.
Please look forward to it.
Please look forward to it~ Questioner 1.
The organ that receives the most cardiac output at rest is __________
.
Analysis of the Lung Analysis: In the absence of an intracardiac shunt, the lung can receive 100% of the cardiac output because the entire cardiac output of the right ventricle flows through the pulmonary vasculature
.
The cardiac output of other organs is shown in the table below
.
Organ Cardiac Output Skeletal Muscle 15-20% Kidney 20% Heart 4-5% Brain 15% Skin 4-5% Liver 6% Gastrointestinal System, Spleen 20% Questioner 7.
One patient appeared shortly after induction of general anesthesia In the presence of bronchospasm, a 50% reduction in the diameter of the large airway in this patient will cause a __________-fold increase in airway resistance
.
Resolution 32 times resolution: The airflow in the lungs depends on several factors
.
It is important to realize that there are 2 different airflow patterns
.
Laminar flow is an ordered pattern in which all the molecules move layered and straight along the pipe
.
In laminar flow, the velocity is fastest in the center and slowest in the periphery (see Figure 4)
.
In the pulmonary system, laminar flow occurs mainly in the small airways (<1mm)
.
Turbulence is a chaotic form of motion, and there are often vortices in the lumen, mainly in large and medium airways, bifurcations, obstructions, and sudden narrowing of the lumen
.
These vortices impede forward molecular flow, increasing the energy input required to achieve a given flow rate
.
Figure 4 For laminar and turbulent laminar flow in the tube, the resistance is calculated by the following formula: resistance = (8×length×viscosity)/(π×)
.
Since the drag is inversely proportional to the 4th power of the radius of the pipe, in other words, the radius is reduced by half and the drag increases by a factor of 16 in laminar flow
.
Obviously, the pipe radius is the most important influencing factor in the above formula
.
In contrast, drag in turbulent flow depends on the airflow velocity, and as the flow velocity increases, the drag increases proportionally
.
Furthermore, the drag force in turbulent flow is inversely proportional to the 5th power (32 times) of the pipe radius with the following formula: pressure gradient ≈ × (density/half).
Therefore, the drag force in turbulent flow is strongly dependent on the airway radius
.
Question 8.
The mixed venous oxygen content of a 70kg healthy adult is __________ml/L
.
Analysis of 150 ml/L: The relationship between cardiac output and oxygen consumption is described by the Fick formula, as follows: V=CO×(Ca-Cv) V is oxygen consumption, CO is cardiac output, Ca is the arterial oxygen content and Cv is the mixed venous oxygen content
.
Substitute the above data into Fick's formula to get: 4ml/(kg.
min) ×70kg=5.
6L/min×(200ml/L - Cv)280 ml/min/5.
6L/min=200 ml/L - Cv50 + Cv=200 ml/LCv=150 ml/L Questioner 9.
Respiratory Expiratory Volume (ERV) + Tidal Volume (VT) + Inspiratory Respiratory Volume (IRV), the sum of which is equal to the following __________
.
Analysis of lung capacity analysis: The lung can be considered to be composed of 4 "static" lung volumes that cannot be further divided (Figure 5)
.
Tidal volume (VT) is the capacity of the lungs during normal quiet breathing
.
Expiratory supplemental volume (ERV) is the volume of gas that is further excreted from the lungs on the basis of calm exhalation when the human body exhales deeply
.
The amount of gas remaining in the lungs after trying to exhale is called residual volume (RV)
.
Inspiratory replacement volume (IRV) is the maximum amount of air that can be inhaled at the end of a quiet inspiratory effort
.
Two or more static lung volumes can be combined to form a lung volume
.
For example, functional residual capacity (FRC) is formed by the combination of RV and ERV
.
Vital capacity (VC) is composed of ERV plus VT plus IRV
.
Total lung capacity (TLC) is composed of 4 static volumes
.
Figure 5 Respiratory tracings Questioner 10.
Assuming that under normal body temperature, the brain can withstand 4min of ischemia, then at 27°C, the brain can withstand __________min of ischemia
.
Analysis 9min Analysis: Hypothermia can reduce the metabolic and functional activity of the brain.
For every 1°C decrease in body temperature, the cerebral oxygen metabolism rate decreases by about 7%
.
However, within the range of clinical body temperature, the relationship is not linear
.
The relationship between the two can be expressed by a body temperature coefficient (Q10), that is, the decrease in brain metabolism for every 10°C decrease in body temperature
.
When the body temperature is 27-37°C, Q10 is approximately equal to 2.
3
.
In other words, when the patient's body temperature was lowered to 27°C, the cerebral oxygen metabolism rate (CMR) was 57%
.
In the above problem, the human brain can withstand 4 minutes of ischemia time at normal body temperature (37°C).
.
When the body temperature is below 27°C, the Q10 is 4.
5
.
At this time, neuronal function gradually becomes dull, and the clinical manifestation is isoelectric (when the body temperature is 18-21 °C).
According to the linear relationship model, the brain at this time may endure longer ischemia
.
Mild hypothermia can reduce the damage to brain cells caused by cerebral ischemia
.
Possible mechanisms include reducing calcium influx, reducing glutamate release, maintaining blood-brain barrier integrity, and preventing lipid peroxidation
.
It is important to avoid hyperthermia in patients with severe traumatic brain injury, and thus in such patients, hyperthermia can lead to increased CMR and further aggravation of ischemic brain injury
.
Recommended reading [Monday] Key points you can't miss · Anesthesiology senior professional title test center 01 [Monday] Anesthesia junior and intermediate test center Intensive lecture 01 Please look forward to more exciting content~ Scan the code to pay attention to the role of books in the inheritance of civilization is unprecedented
.
