Blueprints surgery by Seth J Karp; James Morris; Stanley Zaslau

By Seth J Karp; James Morris; Stanley Zaslau

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70 PaO2 100 CONTROL OF VENTIL ATION 5 40 PaCO2 (mmHg) Effect of O2 and CO2 ventilatory response. The normal ventilatory response to CO2 is enhanced by hypoxia; both the threshold (extrapolated X-intercept) and the sensitivity (slope of response) are affected. From Berne RM, Levy MN. Principles of Physiology, 3rd edition, 2000, London, with permission from Elsevier 11. What happens to the PaO2, PaCO2 and arterial pH during exercise? ᭹ PaO : there is usually a slight increase, but during 2 strenuous and persistent exercise, it may fall slightly ᭹ PaCO : this changes little and in strenuous exercise 2 may fall ᭹ pH: this remains constant.

Give a normal resting value for the CO. 5–6 LminϪ1. 4. Which factors influence the stroke volume? ᭹ Preload ᭹ Afterload ᭹ Myocardial contractility ᭹ Heart rate CARDIAC OUTPUT 3. How do the outputs of the two ventricles compare to one another? In the normal state, the outputs of both ventricles are essentially equal – both being 5–6 LminϪ1. 5. What determines the preload? This is determined by the venous return to the heart. The amount of venous return itself depends on the difference between the systemic filling pressure (driving blood back to the heart) and the central venous pressure (CVP) (working against the venous return).

8. Do you know of any other factors influencing the pattern of ventilation? Yes! The pattern of ventilation is also influenced by the signals from a number of receptors located in and around the respiratory apparatus. ᭹ Mechanical receptors: such as pulmonary stretch receptors and J receptors. The former are involved in the Hering-Breuer inflation reflex, where distension DRAMROO ᭢ 51 APPLIED SURGICAL PHYSIOLOGY VIVAS C ᭹ of the lung leads to slowing of inspiration and increased expiratory time.

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