Barry OB
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| Name the 4 stages between oocyte and implantation | show 🗑
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| show | 3rd week
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| show | 9th week
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| 1951, Lady Euphame Macalyane | show 🗑
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| Dr. grupert Lyons, France April, 19, 1836 | show 🗑
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| show | First OB anesthetic..Ether 19 jan 1847
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| Charles D Meigs | show 🗑
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| James Young Simpson | show 🗑
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| show | First physician anesthetist, chloroform, queen victoria
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| Nathan Keep | show 🗑
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| show | Ether 1842-wife's delivery
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| show | 1900-1940's scopolamine-morphine
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| show | Cyprane, Penthrane, N2O & O2
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| Dr. Oskar Kreis | show 🗑
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| 1st C/S with SAB | show 🗑
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| show | Procaine
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| 1st Pudendal Block | show 🗑
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| 1st Paracervical block | show 🗑
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| show | 1884
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| Sinal Anes OB | show 🗑
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| Cleland 1928 | show 🗑
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| First reported labor epidural | show 🗑
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| show | 1943
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| show | 17% or 12kg
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| Uterus ?kgAmniotic fluid ?kgFetus/Placenta ?kgBlood volume ?kgInterstitial fluid? kgNew fat and protein? kg | show 🗑
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| show | Diaphragm elevation, reduced FRC,capillary engorge. of airways, progesterone induced tracheal and bronchial dilation, cheest expands A/P and transverse diameters
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| show | Decreases-airway resis, TPR,TC,ERV, RV, FRC Increases-MV,AV,TV,RR,ILC,O2 consumption No change VC, CC
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| In pregnancy base line arterial PO2 increase/decrease by ?mmHg?Arterial PH?Arterial PCO2? | show 🗑
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| Closing volume | show 🗑
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| In supine position what happens to a preg. womans closing volume | show 🗑
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| show | sensitizes resp center to CO2, Resp stimulant, reduces airway resistance due to relaxant effect on bronchial smooth muscle
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| Ventilatory changes during pregnancy | show 🗑
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| The oxy hb curve shifts R/L during a normal pregnancy | show 🗑
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| show | A smaller more fragile airway, smaller ETT careful suctioning
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| In Preeclampsia we can expect the airway | show 🗑
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| show | decreased FRC, so decreased O2 storage,& decrease CO when supine
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| show | decreased 25-40%
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| hyperventilation w/ pain during labor inc/dec uterine BF | show 🗑
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| show | normalizes oxygenation and decreases MV and O2 consumption
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| show | preg.-15 Labor-22-70
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| TV ml preg vs. labor | show 🗑
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| MV L/M preg vs. labor | show 🗑
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| PaCO2 preg vs. Labor | show 🗑
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| show | preg-105mmHg Labor-100-108
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| compare preg. abg to non preg | show 🗑
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| Significance to the anesthetist | show 🗑
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| show | CONSTRICTION UMBILICAL & UTERINE ARTERIES. FETAL ACIDOSIS HYPOCAPNIA MATERNAL HEMOGLOBIN DISSOCIATION CURVE TO THE LEFT (metabolic alkalosis)
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| show | left
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| CV system BV, CO,SVR changes in preg | show 🗑
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| Why is the SVR decreased? | show 🗑
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| Explain physiological anemia of pregnancy | show 🗑
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| show | True
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| show | True
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| in a normal pregnancy Blood pressure is increased 10-20% T/F | show 🗑
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| show | 500-1000
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| EDG changes during pregnancy | show 🗑
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| most common dysrhythmias of pregnancy | show 🗑
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| mechanisms for ECG changes in pregnancy | show 🗑
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| What happens to SV, HR, CO when transitioning from supine in the first stage of labor to lithotomy in the second stage during contractions | show 🗑
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| 2 components of aortocaval compression | show 🗑
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| show | after 24 weeks gest. alternative circulation azygous vein/paravertebral system**compensatory decrease in sympathetic tone and HR
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| show | **arterial side compressionNO maternal symptomsplacental BF decreasesFemoral flow vs. Brachial flow-BP normal in arm, low in femoral, causing early or late decells in baby
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| show | plasma protein decreases so colloid osm. pressure decreases.leukocyte count increases 12k-20k. All factors increase xcept XI and XIII. enhanced fibrinolysis
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| Effects of Blood constituent changes | show 🗑
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| mendelsons recommendations | show 🗑
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| Clinical implications for risk of aspiration | show 🗑
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| show | no particulate antacids use Bicitradefined risk as >25ml gastric volume and ph<2.5
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| show | ^gastric acid production and pepsin secretion. dec. gastric emptying(w/opioids)incompetence of lower esoph sphincter tone. anatomic displacement
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| opioid related aspiration risks | show 🗑
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| show | Ranitidine (Zantac)Metoclopromide (Reglan)Oral sodium citrate, 0.3M Bicitra
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| show | RSI with Cricoid PressureAnatomical positioningEndotracheal intubations beyond 8-12 weeks and up to 6 weeks post partumNO nasal intubationsGastric suctioning prior to emergenceAwake extubationsDecrease size of endotracheal tubes
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| show | URETERS DILATE WK 12 - (a state of hydronephrosis may occur in 80% of women by mid-pregnancy)RBF & GFR INCREASE 50% (^renal blood flow)^Total protein & urinary albumin excretion ^ excretion of glucose^ bicarbonate excretion
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| show | ^UTI, glycosuria, aldosterone ^total body water and Na levels,normal lab studies may indicate renal problems(bun/Cr should be lower)
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| Significance to the Anesthetists (renal) | show 🗑
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| show | MINOR INCREASES IN SGOT & LDHBLOOD FLOW UNCHANGEDPLASMA CHOLINESTERASE LEVELS INCREASESCOLLOID ONCOTIC PRESSURES decrease COAGULATION FACTORS INCREASE
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| CLINICAL IMPLICATIONS HEPATIC SYSTEM | show 🗑
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| CENTRAL NERVOUS SYSTEM | show 🗑
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| show | Swelling of epidural veins decreases volume of CSF in vertebral column. Labor induced increases in CSF pressures. Increased neurosensitivity to local anesthetics.
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| show | LA dose dec. 20-30%MAC decreased 25-40%
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| show | Progesterone and Beta-endorphins systems contribute to decreased anesthetic requirementsincreased risk for LA toxicity
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| increase in uterine BF | show 🗑
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| UBF is directly proportional to | show 🗑
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| UBF is inversely proportionate to | show 🗑
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| UBF= | show 🗑
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| Placenta increta | show 🗑
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| show | outside uterus
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| show | true
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| If they can't stop bleeding after birth what artery do they tie off? | show 🗑
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| show | increases
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| show | decreases
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| show | blood flow in the pelvis is preferentially redistributed toward the uterus
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| When is the best time to administer an opioid to mom and avoid baby getting doped up | show 🗑
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| Factors Causing Decreased Uterine Blood Flow | show 🗑
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| Vasopressor of choice | show 🗑
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| show | Beta adrenergic for inc. CO as opposed to vasoconstriction although it has been found to decrease umbilical cord PH 7.3-7.4
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| show | causes uterine artery constriction & bradycardia, but it does leave umbilical cord PH higher than ephedrine
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| Regional anes effect on uterine BF | show 🗑
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| show | 2mg/kg
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| What effect does Thiopental have on UBF | show 🗑
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| show | decreased UBF, use 1mg/kg
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| inhalation agents effect on UBF | show 🗑
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| hyperventilation effect on uterine BF | show 🗑
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| Function of placenta | show 🗑
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| Size of placenta | show 🗑
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| show | higher concentration, low ionization, higher lipid solubility, and lower MW.low protein binding. If it passes BBB it will pass placenta.
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| show | carrier mediated lipid soluble molecules-more stereo specific temp regulated
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| show | movement of any substance accross a call membrane-a.a. proteins-sim to translocation-Na/K atpase pump
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| show | transport immunoglobulins, larger macromolecules, inc. energy to get accross
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| lidocaine protein binding? | show 🗑
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| show | High..doesn't pass, but takes too long.
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| show | chloroprocaine
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| ion trapping | show 🗑
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| show | Thiopental
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| show | decrease temp regulation and hypotonia of baby
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| NDMR cross placenta? | show 🗑
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| anticholinergic of choice | show 🗑
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| opioids cross placenta? | show 🗑
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| Anticholinesterase cross? | show 🗑
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| antihypertensives/vasopressors | show 🗑
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| show | increase
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| show | reduced by causing hypotension and increased by relieving pain,dec symp activity and dec.hypervent.
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| show | If delivery will be within 1 hour or 4 hours after administration..also can accumulate and cause seizures
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Created by:
jenbirne69
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