麻醉生理学名词解释考试重点双语
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[VIP专享]⿇醉⽣理学重点名词解释1.内环境:是指机体内围绕在各细胞周围的细胞外液,因它居于机体的内部,为机体的细胞提供⼀个适宜的⽣活环境⽽得名。
2.内环境稳态:内环境的各种物理、化学性质(如温度、pH、渗透压、各种成分等)保持相对恒定的状态。
3.⾃⾝调节:许多组织细胞⾃⾝能对环境变化发⽣适应性的反应,这种反应是组织细胞本⾝的⽣理特性,并不依赖于外来的神经和体液因素的调节,所以称为⾃⾝调节。
4.应激反应:是指⼈体对⼀系列有害刺激作出的保护⾃⼰的综合反应,⼜称适应综合征。
5.脑电图:在头⽪表⾯⽤双极或单极电极缩记录的⽆明显刺激情况下⾃发产⽣的脑电波称为脑电图,正常⼈脑电图可分为δ、θ、α、β波四种。
6.α阻断:正常⼈的α波是⽪层处于安静状态时脑电图的主要表现,通常在成⼈清醒、安静并闭眼时出现。
睁眼或接受刺激时,α波⽴即消失⽽呈现快波(β波)的现象称为α阻断。
7.诱发电位(EP):当外周感受器、感觉神经、感觉通路或感觉系统的有关结构或脑的某⼀部分在给予或者撤除刺激时,在中枢神经系统内产⽣有锁时关系的电位变化统称为诱发电位。
8.暴发性抑制:⿇醉状态下或昏迷时脑电图发⽣特征性改变,即随着⿇醉深度的增加脑电波形表现为基础频率变慢、波幅进⾏性增加和等电位周期性出现,并伴有电活动的突然改变。
9.意识:是机体对外部世界和⾃⾝⼼理、⽣理活动等客观事物的觉知或体验。
⼈的意识包括意识内容和觉醒状态两个组成部分,意识内容包括语⾔、思维、学习、记忆、定向和感情。
10.意识障碍:指⼤脑功能活动变化所引起的不同程度的意识改变,意识障碍分两类:意识内容改变为主的意识障碍和觉醒度改变为主的意识障碍。
11.疼痛:是⼀种与组织损伤或潜在损伤相关的不愉快的主观感觉和情感体验,是⼤多数疾病的共有症状,为⼈类共有且差异很⼤的⼀种不愉快的感觉,包括痛觉和痛反应两种成分。
12.痛觉:是指躯体某⼀部分厌倦和不愉快的感觉,主要发⽣在脑的⾼级部位,即⼤脑⽪层。
《麻醉生理学》试题及答案第一章绪论1、麻醉生理学研究的目的与内容是什么?2、名词解释:稳态、内环境、反馈、应急、应激3、手术对人体生理功能有哪几方面的影响?麻醉的目的是什么?第二章麻醉与神经系统1、简述静息电位和动作电位形成的基本条件。
2、局部电位和动作电位的特征是什么?3、简述正常脑电图和诱发电位的定义、基本波形。
4、简述脑诱发电位的特征。
5、麻醉与手术对神经系统生物电活动有何影响?6、何谓意识?意识的组成部分是什么?意识内容的核心是什么?7、觉醒状态包括哪些?觉醒状态是如何维持的?8、简述正常意识及其特征。
9、病人出现昏睡时,反射、角膜反射和瞳孔对光反射是否存在?10、麻醉状态下的意识活动和感觉是如何变化的?全麻药作用的主要靶区在哪?11、简述疼痛的概念与生物学意义。
13、参与人体镇痛的物质有哪些?最重要的是什么?14、痛觉阈、痛反应阈、耐痛阈的定义,临床病人疼痛测量的方法是什么?15、简述全麻药对躯体运动的主要影响。
16、肌松药主要作用与什么部位?作用机制是什么?17、简述自主神经系统的结构和功能特点。
18、脊髓中枢调节哪些内脏反射活动?19、麻醉病人瞳孔对光反射消失,表明麻醉中枢的部位已达何处?20、何谓眼心反射?手术牵拉内脏引起循环系统哪些变化?21、有关麻醉深度的反射有哪些?各定位在哪里?第三章麻醉与呼吸1、呼吸道包括哪些部分?何谓上、下呼吸道?2、气管切开有哪些优缺点?3、叙述肺泡表面活性物质的生理功能。
4、肺循环有哪些特点?5、列举能使支气管扩张的常用麻醉药物。
6、叙述气道阻力的大体分布。
7、影响气道阻力有哪些因素?8、麻醉期间有哪些情况可增加气道阻力而影响肺通气?采用哪些措施可使呼吸道通畅?9、名词解释:气道跨壁压、机械无效腔、FVC、FVC1/FVC%、MMFR、CC、CV、D L、A-aDO2、P50、无呼吸氧合。
10、何谓通气效率?若比值大能提示通气效率高吗?11、在作气管插管时对病人常采用什么手法?此手法对气道阻力和无效腔有何影响?13、什么叫功能残气量?体位与麻醉对其有何影响?14、PaCO2、PaO2、H+如何影响肺通气?15、麻醉对肺通气是如何影响的?16、常用的吸入和静脉麻醉药对肺通气的影响是如何的?17、PEEP对呼吸、循环、颅内压的影响是如何的?18、何谓通气/血流比值?为何说该比值必须匹配?19、如何防止气管插管时病人出现无呼吸氧合?20、何谓流动氧量?它受哪三种因素的影响?21、简述麻醉期间缺氧的因素。
《麻醉生理学》名词解释与简答题(—)名词解释1、麻醉生理学:是研究生理学在临床麻醉急救复苏、重症检测、疼痛治疗中的应用及麻醉和手术对机体各种生命活动规律的影响的科学2、内环境Internal Environment:体内细胞直接生存的环境(细胞外液)称为内环境。
3、反射Reflex:在中枢神经系统的参与下,机体对内外环境的刺激产生的规律性应答反应,称为反射。
4、反馈Feedback:在人体生理功能自动控制系统原理中,受控部分不断将信息回输到控制部分,以纠正或调整控制部分对受控部分的影响,从而实现自动而精确的调节,这一过程称为反馈。
有正反馈和负反馈之分。
5、正反馈Positive Feedback:从受控部分发出的反馈信息促进与加强控制部分的活动,称为正反馈。
6、负反馈Negative Feedback:反馈作用与原效应作用相反,使反馈后的效应向原效应的相反方向变化,这种反馈称为负反馈。
7、前馈Feedforward:干扰信号在作用于受控部分引起的输出变量改变的同时,还可以直接通过感受装置作用于控制部分,使输出变量在未出现偏差而引起反馈性调节之前得到纠正。
这种干扰信号对控制部分的直接作用,称为前馈。
8、稳态Homeostasis:内环境理化性质保持相对相对稳定的状态,叫稳态。
9、应激反应Stress:是指人体对一系列有害刺激作出的保护自己的综合反应,又称适应综合征。
些婆虹一种与组织损伤或潜在损伤相关的不愉快的主观感觉和情感体验11、肌紧张:自然环境中因骨骼肌受到重力的持续牵拉引起肌肉持续收缩,所产生的张力使机体得以保持一定的姿势和进行各种复杂的活动12、意识:机体对自身和环境的变化的感知13、皮层下觉醒:觉醒、睡眠交替出现的周期以及情绪自主的功能和内分泌功能等本能反应14、意识障碍:大脑功能活动变化索引气的不同程度的一是改变15、闸门控制学说:闸门控制系统节段性调制着外周传入T细胞的冲动,一旦刺激达到或者超过临界值,就会激活系统引发痛觉和一系列痛反应16、生物节律:生命现象中的节律性变化17、颈动脉窦综合征:在某些病理情况下,如压力感受器敏感性过高,对轻微刺激(如急剧转颈、穿高领衣服等)可反射性地引起动脉血压下降、心跳减慢甚至停跳等。
生理学名词中英文对照第一章绪论1.机体的内环境(internal environment)2.稳态(homeostasis)3.反射(reflex)4.反射弧(reflex arc)5.旁分泌调节(paracrine regulation)6.自身调节(autoregulation)7.负反馈(negative feedback) 8.正反馈(positive feedback)9.前馈(feed-forward)第二章细胞的基本功能10. 被动转运(passive transport) 11. 单纯扩散(simple diffusion)12. 经载体易化扩散(facilitated diffusion via carrier)13. 经通道易化扩散(facilitated diffusion via ion channel)14. 电压门控通道(voltage gated ion channel)15. 离子通道(ion channel)16. 化学门控通道(chemically gated ion channel)17. 机械门控通道(mechanically gated ion channel)18. 原发性主动转运(primary active transport)19. 继发性主动转运(secondary active transport)20. 同向转运(symport) 21. 反向转运(antiport)22. 出胞(exocytosis) 23. 入胞(endocytosis)24. 跨膜信号转导(transmembrane signal transduction)25. 刺激(stimulation) 26. 兴奋(excitation)27. 兴奋性(excitability) 28. 阈值(threshold)29. 极化(polarization) 30. 去极化(depolarization)31. 超极化(hyperpolarization) 32. 复极化(repolarization)33. 内向电流(inward current) 34. 外向电流(outward current)35. 电化学驱动力(electrochemical driving force)36. 静息电位(resting potential) 37. K+平衡电位(K+ equilibrium potential)38. 动作电位(action potential) 39. 超射(overshoot)40. “全或无”现象(“all or none”phenomenon)41. 阈电位(threshold potential) 42. 局部电位(local potential)43. 时间性总和(temporal summation) 44. 空间性总和(spatial summation)45. 量子释放(quantal release)46. 兴奋-收缩耦联(excitation-contraction coupling)47. 等长收缩(isometric contraction) 48. 等张收缩(isotonic contraction)49. 前负荷(preload) 50. 后负荷(afterload)51.肌肉收缩能力(contractility) 52.不完全强直收缩(incomplete tetauns)53.完全强直收缩(complete tetanus) 54.运动单位(motor unit)第三章血液55. 血细胞比容(hematocrit) 56. 血浆渗透压(plasma osmotic pressure)57. 血浆晶体渗透压(plasma crystal osmotic pressure)58. 血浆胶体渗透压(plasma colloid osmotic pressure)59. 悬浮稳定性(suspension stability)60.红细胞沉降率(erythrocyte sedimentation rate)61.红细胞渗透脆性(osmotic fragility) 62.血小板黏附(platelet adhesion)63.血小板聚集(platelet aggregation) 64.生理性止血(hemostasis)65.出血时间(bleeding time) 66.凝血时间(clotting time)67.血液凝固(blood coagulation) 68.血清(serum)69.凝血因子(clotting factor) 70.内源性凝血途径(intrinsic pathway)71.外源性凝血途径(extrinsic pathway) 72.纤维蛋白溶解(fibrinolysis)73.血型(blood group) 74.红细胞凝集(agglutination)75.凝集原(agglutinogen)76.凝集素(agglutinin)77.交叉配血试验(corss-match test)第四章血液循环78. 心动周期(cardiac cycle)79. 等容收缩期(period of isovolumic contraction)80. 等容舒张期(period of isovolumic relaxation)81. 每搏输出量(stroke volume)82. 射血分数(ejection fraction)83. 心输出量(cardiac output)84 心指数(cardiac index)85. 异长调节(heterometric regulation)86.心室功能曲线(ventricular function curve)87.心肌收缩能力(myocardial contractility)88.等长调节(homometric regulation)89.快反应细胞(fast response cell) 90.慢反应细胞(slow response cell)91.期前收缩(premature systole) 92.代偿间歇(compensatory pause)93.自动节律性(autorhythmicity) 94.正常起搏点(normal pacemaker)95.潜在起搏点(latent pacemaker) 96.异位起搏点(ectopic pacemaker)97.房室延搁(atrioventricular delay)98.膜反应曲线(membrane responsiveness curve)99.钙触发钙释放(calcium-induced Ca2+ release)100.外周阻力(peripheral resistance)101.动脉血压(arterial blood pressure)102.收缩压(systolic pressure)103.舒张压(diastolic pressure) 104.平均动脉压(mean arterial pressure)105.中心静脉压(central venous pressure)106.微循环(microcirculation) 107.压力感受性反射(baroreceptor reflex)第五章呼吸108.肺通气(pulmonary ventilation) 109.肺换气(gas exchange in lungs)110.呼吸运动(respiratory movement) 111.弹性阻力(elastic resistance)112.顺应性(compliance) 113.肺的静态顺应性(static compliance)114.比顺应性(specific compliance) 115.肺表面活性物质(pulmonary surfactant)116.气道阻力(airway resistance) 117.潮气量(tidal volume)118.余气量(residual volume)119.功能余气量(functional residual capacity)120.肺活量(vital capacity) 121.用力肺活量(forced vital capacity) 122.用力呼气量(forced expiratory volume)123.肺通气量(pulmonary ventilation)124.解剖无效腔(anatomical dead space) 125.肺泡无效腔(alveolar dead space) 126.肺泡通气量(alveolar ventilation)127.通气/血流比值(ventilation/perfusion ratio)128.血氧容量(oxygen capacity) 129.血氧含量(oxygen content)130.血氧饱和度(oxygen saturation) 131.氧解离曲线(oxygen dissociation curve) 132.肺牵张反射(pulmonary stretch reflex)第六章消化与吸收133.消化(digestion) 134.机械性消化(mechanical digestion)135.化学性消化(chemical digestion) 136.吸收(absorption)137.慢波(slow wave) 138.胃肠激素(gastrointestinal hormone)139.脑-肠肽(braingut peptide)140.黏液-碳酸氢盐屏障(mucus bicarbonate barrier)141.胃黏膜屏障(gastric mucosal barrier)142.容受性舒张(receptive relaxation)143.紧张性收缩(tonic contraction) 144.胃的排空(gastric emptying)145.肠-胃反射(entero-gastric reflex) 146.分节运动(segmentation contraction)147.胆盐的肠-肝循环(enterohepatic circulation of bile salt)第七章能量代谢与体温148. 能量代谢(energy metabolism)149. 食物的热价(thermal equivalent of food)150. 氧热价(thermal equivalent of oxygen)151. 呼吸商(respiratory quotient) 152. 基础代谢率(basal metabolic rate) 153. 体温(body temperature) 154.温热性发汗(thermal sweating)155.精神性发汗(mental sweating 156.热敏神经元(warm-sensitive neuron) 157.冷敏神经元(cold-sensitive neuron)第八章尿的生成和排出158. 管-球反馈(tubuloglomerular feedback)159. 肾小球滤过率(glomerular filtration rate)160. 滤过分数(filtration fraction)161. 有效滤过压(effective filtration pressure)162. 肾糖阈(renal threshold for glucose)163. 葡萄糖吸收极限量(transfer maximum of glucose)164. 渗透性利尿(osmotic diuresis)165. 球-管平衡(glomerulotubular balance) 166. 水利尿(water diuresis) 167.清除率(clearance)第九章感觉器官的功能168. 感受器(receptor) 169. 感觉器官(sense organ)170. 适宜刺激(adequate stimulus) 171. 换能作用(transducer function)172. 瞳孔对光反射(pupillary light reflex)173.互感性对光反射(consensual light reflex)174. 瞳孔近反射(near reflex of the pupil)175.视敏度(visual acuity)176.暗适应(dark adaptation) 177.明适应(light adaptation)178.视野(visual field) 179.听阈(hearing threshold)180.耳蜗内电位(endocochlear potential)181.耳蜗微音器电位(cochlear microphonic potential)182.眼球震颤(nystagmus)第十章神经系统的功能183.突触(synapse) 184.经典的突触(classical synapse)185.兴奋性突触后电位(excitatory postsynaptic potential)186.抑制性突触后电位(inhibitory postsynaptic potential)187.非定向突触(non-directed synapse) 188.电突触(electric synapse)189.神经递质(neurotransmitter) 190.神经调质(neuromodulator)191.受体(receptor) 192.激动剂(agonist)193.拮抗剂(antagonist) 194.上调(up regulation)195.下调(down regulation) 196.胆碱能纤维(cholinergic fiber)197.肾上腺素能纤维(adrenergic fiber) 198.突触后抑制(postsynaptic inhibition)199.传入侧支性抑制(afferent collateral inhibition)200.回返性抑制(recurrent inhibition) 201.突触前抑制(presynaptic inhibition)202.特异投射系统(specific projection system)203.非特异投射系统(nonspecific projection system)204.牵涉痛(referred pain) 205.脊休克(spinal shock)206.牵张反射(stretch reflex) 207.腱反射(tendon reflex)208.肌紧张(muscle tonus) 209.去大脑僵直(decerebrate rigidity)210.α僵直(α-rigidity) 211.γ僵直(γ-rigidity)212.自发脑电活动(spontaneous electric activity of the brain)213.脑电图(electroencephalogram)214.脑干网状结构上行激动系统(ascending reticular activating system) 215.慢波睡眠(slow wave sleep) 216.异相睡眠(paradoxical sleep)第十一章内分泌217. 激素(hormone) 218. 允许作用(permissive action) 219. 长反馈(long-loop feedback) 220. 短反馈(short-loop feedback)221. 超短反馈(ultra-short-loop feedback)222. 下丘脑调节肽(hypothalamic regulatory peptides)223. 应激反应(stress reaction) 224.应急反应(emergency reaction)第十二章生殖225. 月经(menstruation) 226. 月经周期(menstrual cycle)227. 增生期(proliferative phase) 228. 黄体期(luteal phase)。
麻醉生理学名词解释第一章绪论1、内环境Internal Environment体内细胞直接生存得环境(细胞外液)称为内环境、2、稳态Homeostasis内环境理化性质保持相对相对稳定得状态,叫稳态。
3、反射Reflex在中枢神经系统得参与下,机体对内外环境得刺激产生得规律性应答反应,称为反射。
4、反馈Feedback在人体生理功能自动控制系统原理中,受控部分不断将信息回输到控制部分,以纠正或调整控制部分对受控部分得影响,从而实现自动而精确得调节,这一过程称为反馈、有正反馈与负反馈之分、5、正反馈Positive Feedback从受控部分发出得反馈信息促进与加强控制部分得活动,称为正反馈、6、负反馈Negative Feedback反馈作用与原效应作用相反,使反馈后得效应向原效应得相反方向变化,这种反馈称为负反馈。
7、前馈Feedforward干扰信号在作用于受控部分引起得输出变量改变得同时,还可以直接通过感受装置作用于控制部分,使输出变量在未出现偏差而引起反馈性调节之前得到纠正。
这种干扰信号对控制部分得直接作用,称为前馈、第二章细胞得基本生理1、液态镶嵌模型Fluid Mosaic Model膜以液态得脂质双分子层为骨架,其中镶嵌着许多具有不同分子结构与功能得蛋白质。
2、动作电位Action Potential(AP)可兴奋细胞受外来得适当刺激时,膜电位在原静息电位基础上发生得一次膜电极得快速而短暂得逆转并且可以扩布得电位变化。
3、静息电位RestingPotential活细胞处于安静状态就是存在于细胞两侧得电位差,在大多数细胞中表现为稳定得内负外正得极化状态。
4、简单扩散Simple Diffusion脂溶性得小分子物质顺浓度差得跨膜转运得过程。
5、易化扩散Facilitated Diffusion某些非脂溶性或脂溶性较小得物质,在特殊膜蛋白得协助下,顺浓度差转运得过程。
6、主动转运ActiveTransport通过耗能,在膜上特殊蛋白质得协助下,将某些物质分子或离子逆浓度差转运得过程、有原发性主动转运与继发性主动转运之分。
麻醉学专业名词解释考试重点考点1、呼吸性酸中毒即高碳酸血症,PaCO2>45mmHg。
主要由于肺泡有效通气量不足,体内CO2蓄积所致。
麻醉期间CO2蓄积的常见原因包括:麻醉药的呼吸抑制、呼吸管理不善、麻醉器械故障或CO2吸收装置失效等。
2、meyer-overton法则本世纪初meyer和overton先后测定了常用吸入麻醉药如乙醚、氧化亚氮和氯仿等在橄榄油中的溶解度,并比较它们的脂溶性与全麻效能之间的关系,结果发现吸入全麻药均具有较高的亲脂性,并与其效能成正比。
因此认为全麻药是和神经中的脂质成分发生松散的物理-化学结合,致使神经细胞中各种成分的正常关系发生变化,产生麻醉作用,称之为meyer-overton法则。
3、PCA即病人自控镇痛,通过特定的PCA控制系统允许病人自行给予一定量的镇痛药物,在预先设定的时间内控制系统对病人的第二次给药要求不会作出反应,因此,可以有效地控制药物过量。
当采用PCA时,每当阿片类药物的血药浓度低于最低有效镇痛浓度(MEAC)时,病人即可自行给药进行镇痛,有效避免了传统镇痛方法不灵活、依赖性、不及时的缺点。
4、癌性镇痛三级用药阶梯癌痛三阶梯镇痛方案的给药原则是:阶梯给药、口服给药、按时给药、用药个体化、辅助用药。
(1)第一阶梯:轻度癌痛,第一线镇痛药为非阿片类镇痛药如阿司匹林等NSAIDs,必要时加用辅助药;(2)第二阶梯:中度癌痛及第一阶梯治疗效果不理想时,可选用弱阿片类药如可待因,也可并用第一阶梯的镇痛药或辅助药;(3)第三阶梯:对第二阶梯治疗效果不好的重度癌痛,选用强效阿片类药物如吗啡,也可辅助第一、第二阶梯药物。
5、TOF即四个成串刺激,是一串由四个频率为2Hz,波宽为0.2~0.3ms的矩形波组成的成串刺激波,四个成串刺激引起四个肌颤搐(T1、T2、T3、T4),连续刺激时串间距离为10~12s。
神经肌肉传递功能正常时,四个肌颤搐幅度相等,但当部分非除极化阻滞时出现衰减,四个肌颤搐的幅度依次减弱。
名词解释1.内环境:是指机体内围绕在各细胞周围的细胞外液,因它居于机体的内部,为机体的细胞提供一个适宜的生活环境而得名。
2.内环境稳态:内环境的各种物理、化学性质(如温度、pH、渗透压、各种成分等)保持相对恒定的状态。
3.自身调节:许多组织细胞自身能对环境变化发生适应性的反应,这种反应是组织细胞本身的生理特性,并不依赖于外来的神经和体液因素的调节,所以称为自身调节。
4.应激反应:是指人体对一系列有害刺激作出的保护自己的综合反应,又称适应综合征。
5.脑电图:在头皮表面用双极或单极电极缩记录的无明显刺激情况下自发产生的脑电波称为脑电图,正常人脑电图可分为δ、θ、α、β波四种。
6.α阻断:正常人的α波是皮层处于安静状态时脑电图的主要表现,通常在成人清醒、安静并闭眼时出现。
睁眼或接受刺激时,α波立即消失而呈现快波(β波)的现象称为α阻断。
7.诱发电位(EP):当外周感受器、感觉神经、感觉通路或感觉系统的有关结构或脑的某一部分在给予或者撤除刺激时,在中枢神经系统内产生有锁时关系的电位变化统称为诱发电位。
8.暴发性抑制:麻醉状态下或昏迷时脑电图发生特征性改变,即随着麻醉深度的增加脑电波形表现为基础频率变慢、波幅进行性增加和等电位周期性出现,并伴有电活动的突然改变。
9.意识:是机体对外部世界和自身心理、生理活动等客观事物的觉知或体验。
人的意识包括意识内容和觉醒状态两个组成部分,意识内容包括语言、思维、学习、记忆、定向和感情。
10.意识障碍:指大脑功能活动变化所引起的不同程度的意识改变,意识障碍分两类:意识内容改变为主的意识障碍和觉醒度改变为主的意识障碍。
11.疼痛:是一种与组织损伤或潜在损伤相关的不愉快的主观感觉和情感体验,是大多数疾病的共有症状,为人类共有且差异很大的一种不愉快的感觉,包括痛觉和痛反应两种成分。
12.痛觉:是指躯体某一部分厌倦和不愉快的感觉,主要发生在脑的高级部位,即大脑皮层。
13.牵涉痛:内脏疾患往往引起与疼痛起源部位不同的体表部位发生疼痛或痛觉过敏,称为牵涉痛。
1.生理学的概念:是研究生理学在临床麻醉、急救复苏、重症监测、疼痛治疗中的应用以及麻醉和手术对机体各种生命活动规律的影响的科学。
2. 人体生理功能主要的影响:①产生应激反应(stress):又称适应综合症适应综合征:指机体对一系列伤害性刺激做出的保护自己的综合反应。
特点:下丘脑-腺垂体-肾上腺皮质系统、交感-肾上腺髓质系统和肾素-血管紧张素系统的活动增强。
血液中儿茶酚胺、胰高血糖素、生长素、ACTH、皮质酮、催乳素和加压素水平升高。
②引起出血、疼痛、情绪反应及自主神经系统功能变化:如恶心、呕吐、呼吸、出汗等。
③启动生理性凝血:释放凝血因子:组织因子-促进凝血④局部炎症细胞聚集:组织损伤释放一些细胞肽,如瘤坏死因子、白介素1、2等。
⑤反射引起骨骼肌收缩增强:不利于手术。
(二)麻醉的主要影响主要通过影响神经系统、内分泌腺的活动来实现①镇痛药:激活中枢内下行抑制系统,来抑制脊髓背角痛敏神经元的痛传递。
②肌松药:通过抑制脊髓前角α-运动神经元(N-M接头)③全麻药:抑制大脑皮层功能消除意识和痛感,关闭Na+通道,抑制兴奋产生和传导。
④不良反应:(1)硫喷妥钠快速诱导,可抑制呼吸、甚至呼吸停止,抑制心脏活动。
诱发喉痉挛(2)恩氟烷可抑制呼吸,血管舒张,外周阻力降低,产生低血压(3)安定、镇痛药—芬太尼也可抑制呼吸,产生心动过缓(4)琥珀胆碱可产生高钾血症、眼压升高。
心律失常、心动过缓。
RP产生机制:①安静时细胞膜内外离子分布不均匀,膜内高钾,膜外高钠;②安静时细胞膜对离子的通透性不同,表现为对K+通透为主;③K+借浓度差外流达到电-化学平衡。
动作电位的特点:*“全或无”: AP要么不产生(无),一旦产生即达最大(全)。
*可扩布性:不衰减传导*有不应期:单个细胞的AP不可能融合。
脑诱发电位特点:a.有明确的内外刺激;b.有较恒定的潜伏期;c.各种刺激引起的诱发电位在脑内有一定的空间分布;d.某种刺激引起的诱发电位有一定形式,不同感觉系统其反应形式不同。
麻醉生理学第2章麻醉与神经·经典的负反馈调节:减压反射;正反馈调节:排尿反射、排便反射、分娩、血液凝固·可兴奋细胞:神经细胞、肌细胞、腺细胞·可兴奋细胞兴奋时,共有的特征是:产生动作电位(AP)·ARAS(上行网状激活系统):全麻药靶区,能提高大脑皮层兴奋性,是维持觉醒和产生意识状态的基础·人类区别于动物的主要特征是:具有第一和第二两个信号系统;抑制性:GABA+Gly(甘氨酸)+梭外肌纤维)·腱反射:体内唯一的单突触反射;潜伏期很短;感受器是肌梭;eg:膝反射·根据纤维直径大小及来源,可将传入神经纤维分为:I、II、Ⅲ、Ⅳ类(传入N)·根据传导速度和后电位差异,可将神经纤维分为:A(有髓、最快、运动+快痛)、 B(有髓、内脏自主N 节前)、 C(无髓、自主N节后+慢痛)三类(传出F)·传导慢痛的外周神经纤维主要是:C类纤维·交感神经能促进怀孕子宫的收缩,但使未孕子宫舒张·视觉性语言中枢:优势半球角回;运动性语言中枢:优势半球额下回后部·瞳孔对光反射的中枢位于:中脑;生命基本中枢位于:延髓·下丘脑是调节自主神经与内分泌功能(内脏活动)较高级的中枢·与特异投射系统有关的结构是:丘脑的感觉接替核·体温调节中枢位于:下丘脑;摄食、摄水中枢位于:下丘脑外侧区·与日节律有关的中枢结构是:下丘脑视交叉上核神经元·帕金森病主要受损的中枢是:基底神经节第3章 麻醉与呼吸一、呼吸生理※小气道:内径≤2mm ;没有肺泡的最小呼吸道是:终末支气管※肺表面活性物质:脂蛋白复合物,主要成分:DPPC ;肺泡Ⅱcell 合成。
生理功能:①降低肺泡表面张力;②增加肺顺应性;③稳定肺泡内压,保持大小肺泡稳定,防止肺不张;④防止肺水肿※肺循环:低压低阻高容。
PAP MAP =13mmHg ,为体循环压力的1/6;PVR=1/10 SVR ;PCWP=7 mmHg ·肺循环的调节:①N 调节;②P A O 2(<70 mmHg →HPV );③血管活性物质(AD 、NE 、Ang 等) ※肺的代谢功能:合成—PG ;活化—Ang ;灭活—PG 、缓激肽(BK )、5-HT※呼吸运动直接驱动力:压力差(肺内压)※腹式呼吸—膈肌,成年男女,小儿;胸式呼吸—肋间外肌,孕妇·顺应性:T PV C 1=∆∆=非弹性阻力气道阻力(2/3)※气道阻力)占10%无效腔生理无效腔(V D)解剖无效腔150ml肺泡无效腔忽略不计机械无效腔呼吸机管道V D/V T=0.3;表示30%的通气停留在无效腔内;通气效率=1-V D/V T肺泡通气量(V A)= (V T-V D)×f;真正有效的气体交换量肺通气的化学性调节中枢化学感受器→延髓腹外侧→H+位于延髓腹外侧浅表部位的中枢化学感受器,其生理刺激是:H+中枢化学感受器较外周对CO2更为敏感;吸入气中CO2超过20%,产生CO2麻醉血液CO2分压升高对呼吸的刺激主要是通过刺激:中枢化学感受器外周化学感受器→颈动脉体和主动脉体→低氧、H+严重肺心病,吸入纯氧易引起呼吸暂停的原因:低氧可通过外周化学感受器反射性兴奋呼吸中枢(保护机制),当吸入纯氧时使此反射减弱肺功能评价指标正常值临床意义FVC 用力肺活量FEV用力呼气量(时间肺活量)FEV1/FVC >80% <70%为异常FRC 功能残气量FRC/TCL=40% 2500ml 缓冲MVV 最大通气量100-120L/min通气储量百分比>93% <70%,术后易发生呼吸功能不全MMFR 最大呼气中期流速FEV 25-75% 3.5L/sCC 闭合容量C V+RVCV 闭合气量(容积)肺底部气道闭合(最先)时,RV以上的肺容量,即肺上部呼出气量评估小气道(=12.5%VC)降低FRC的因素麻醉;卧位;胸腹部手术和术后;肺纤维化;肺水肿;肥胖;腹胀(如妊娠、肿瘤、腹水);胸廓畸形;肌肉松弛增加FRC的因素胸内压增加(如PEEP/CPAP);肺气肿;哮喘;高龄(肺泡弹性减弱)CV↑→静脉血掺杂(V A/Q↓)→P a O2↓·麻醉期间,FVR降低、CC增高,以致在潮气量通气时气道即可闭合→肺不张+V/Q↓·关于气道闭合哪一项是错误的(D)A.老年人正常呼吸时就有气道闭合B.气道闭合首先发生在肺下区C.当肺容量减少至FRC时,0.5-0.9mm小气道趋于闭合D.当闭合气量小于潮气量时,平静呼吸过程中气道即闭合(全部开放)E.任何相对减少FRC或相对增加闭合容量均易引起肺不张·反应小气道功能障碍最敏感的指标是:FDC·反应小气道阻塞程度最敏感的指标是:MMFR※麻醉对肺通气的影响:Enf>Iso>氟烷>N20(Enf抑制肺通气作用最强)·下列药物抑制呼吸的强度依次为:恩氟烷>异氟烷>氟烷·病人麻醉后肺泡通气是:不论自主呼吸还是控制呼吸都是上肺好于下肺。
麻醉生理学试题及答案第四章麻醉与循环一、填空1.在心功能障碍病人可用扩血管药物,这是因为引起后负荷增加使心输出量进一步降低。
2.运动时心率加快和心肌收缩力量增强的机制,主要是由于心交感中枢兴奋和心迷走中枢理蒯。
3.保护缺血心肌的基本途径是增加能量供应、减小心肌能量消耗。
4.颅内高压患者常以动脉血压升高,心率降低为特征。
5.电击复律术治疗心律失常时,要使刺激不落入心室的易损期内,以免引起心室颤动。
6.儿茶酚胺可诱发早期后除级和延迟后除极引起自律型心律失常。
7.循环衰竭包括:心力衰竭和周围循环衰竭。
8.椎管内麻醉时,心输出量减少o二、选择题1.Starling机制是指心脏的每搏输出量取决于DA平均动脉压;B心率贮备;C心力贮备;D心室舒张末期容积;E心室收缩末期容积2.房室延搁的生理意义是DA使心室肌不会产生完全强直收缩;B增强心室肌收缩力;C使心室肌有效不应期延长;D使心房、心室不会同时收缩;E使心肌动作电位幅度增加3.麻醉药物对心排出量的抑制程度从轻到重的顺序为AA氧化亚氮〉乙蟋〉异氟烷〉窥烷;B乙醍〉氧化亚氮〉异氟烷〉氟烷;C异氟烷〉氟烷〉氧化亚氮〉乙醒;D氧化亚氮>乙醒〉氟烷〉异氟烷;E乙醒〉异氟烷〉氟烷〉氧化亚氮4.奎尼丁可抑制下列哪种通道使心肌兴奋性降低EA Ca> BIC; C Cl-; D Mg2 * ; ENa「5.关于冠脉循环的解剖生理特点叙述错误的是:DA毛细血管丰富,与心肌纤维数的比例为1:1; B各冠状血管之间有吻合支存在;C血流丰富,60〜80ML/(100g・min) D;心肌血流分布均匀;E心室腔内存在腔血管6.下列哪项不是麻醉期间发生心律失常的原因?EA自主神经平衡失调;B电解质紊乱;C麻醉用药;D手术刺激心脏;E输血7.眼科手术时可引起心功能过缓甚至停搏的反射是BA眨眼反射;B眼心反射;C眼睑反射;D瞳孔对光反射;E主动脉弓和颈动脉窦的压力感受性反射8.心室肌有效不应期的长短取决于DA动作电位0期去极的速度;B阈电位水平的高低;C动作电位2期的长短;D动作电位复极末期的长短;E钠-钾泵的功能9.麻醉后体位由平卧转为直立位时,循环系统发生什么变化?EA血压下降;B血压升高;C血压不变;D心率减慢;E 以上都不正确10.保持脑血流量相对恒定的调节方式是CA神经调节;B体液调节;C自身调节;D前馈调节;E神经-体液调节三、名词解释:易损期:在相对不应期的开始之初有一个短暂的时间,在此期间应用较强的刺激可引起心肌纤维性颤动,这一段时间就称为易损期。
第三章麻醉生理学Ⅰ名词解释1.肺泡表面活性物质:是一种脂蛋白复合物,由脂质、蛋白质和糖组成,主要成分是二棕榈腺磷脂酰胆碱,以单分子层排列于肺泡内衬液气界面具有降低肺泡表面张力作用的物质。
P422.无效腔:在肺和呼吸道中,虽有通气但不能进行气体交换的区域。
有生理无效腔(由解剖无效腔和肺泡无效腔组成)和机械无效腔之分P463.氧离曲线:它是表示血红蛋白与氧结合和解离的曲线,两者呈正相关。
当P a O2降低,氧解离增多,氧饱和度下降。
氧离曲线呈“S”形,当氧分压在60~100mmHg时,氧分压变化大,但氧饱和度变化很小。
P484.P50:表示pH为7.4,PaO2为40mmHg及体温37℃及氧饱和度是50%时的氧分压,是反映氧释放功能、Hb与O2亲和力的常用指标,正常人为26.5mmHg。
P48/P5045.心指数:指每平方米体表面积的心输出量,用来衡量心脏功能。
P576.前负荷:心肌收缩前所负载的负荷称前负荷,它决定心肌收缩前的长度。
P57 7.后负荷:心肌开始收缩时遇到的负荷或阻力称为后负荷。
通常以平均动脉压的高低反映后负荷的大小。
P588.脑缺血反应:当脑血流量减少时,心血管中枢的神经元可对脑缺血发生反应,引起交感缩血管紧张显著增强,外周血管强烈收缩,动脉血压升高,称为脑缺血反应。
P669.食物热价:1g某种食物氧化时释放的热量。
P9810.食物氧热价:某种食物氧化时消耗1L氧所产生的热量。
P9811.呼吸商:各种供能物质氧化时产生的CO2量与O2的消耗量的比值。
P98 12.基础代谢率:是基础状态(即清晨清醒进食前,排除食物的特殊动力作用;平卧,排除肌肉活动的影响;环境温度在20~25℃;安静)下单位时间内的能量代谢。
P9813.恶性高热:目前所知的唯一可由麻醉药引起围麻醉期死亡的遗传性疾病,是一种亚临床肌肉病,在全麻过程中接触挥发性吸入麻醉药(如氟烷)和去极化肌松药(琥珀胆碱)后出现骨骼肌强直性收缩,产生大量能量,导致体温持续快速升高,进而进行性循环衰竭,是一种代谢亢进危象。
绝对不应期absolute refractory periodThe time interval during which a cell is incapable of initiating a second action potential.动作电位action potentialAn action potential is a rapid change in the membrane potential. Each action potential begins with a sudden change from the normal resting negative potential to a positive membrane potential (depolarization) and then ends with an almost equally rapid change back to the negative potential (repolarization).主动转运active transportThe movement of substances across the membrane occurs against the electrochemical gradient with the necessity of consumption of metabolic energy后负荷afterloadAfterload is the load that is given to the muscle after the beginning of the contraction.自身调节autoregulationIn certain cases, a tissue or organ can respond directly to the environmental changes, depending neither on nervous nor on humoral control. This form of regulation is called auto-regulation.完全强直收缩complete tetanusWhen the frequency of stimulation reaches a critical level, the successive contractions are so rapid that they literally fused together, and the contraction appears to be completely smooth and continuous. This is called completely tetanus.去极化depolarizationThe change in membrane potential away from the resting potential and toward the sodium equilibrium.入胞endocytosisVery large particles enter the cell by a specialized function of the cell membrane called endocytosis. The principle forms of endocytosis are pinocytosis and phagocytosis.平衡电位equilibrium potentialElectrochemical equilibrium is a steady state, as in the resting membrane potential of a cell ,in which an electrical potential and chemical potential gradient are in balance and no net movement of charged particles occurs.兴奋性excitabilityExcitability is the ability of certain kinds of cells (excitable cell) to generate active changes in their membrane potential. Excitability is a fundamental property common to all tissues and cells.兴奋excitationExcitation signifies and increases in activity, such as contraction of a muscle, acceleration of the heart beat.出胞exocytosisA stimulus to secrete causes the intracellular vesicles to fuse with the plasma membrane and to release the vesicles contents is called exocytosis.易化扩散facilitated diffusionIn facilitated diffusion, transport proteins (carrier and channel proteins) hasten the movement of certain substances across a membrane down their concentration gradients.以通道为中介的转运facilitated diffusion via ion channelChannels are membrane proteins that contain small, highly selective aqueous pores. Channels usually allow specific ion, eg ,Na+,K+,Ca2+ or Cl- to move down their electrochemical gradients across the membrane.反馈feedbackFeedback is a flow of information along a closed loop. Usually, a constancy of physiological variable requires a feedback mechanism that feeds the output information back to the control system so as to modify the nature of control.稳态HomeostasisHomeostasis is the maintenance of a constant state with special reference to the internal medium.体内in vivoExperiments performed on the whole body.内环境internal environmentAll cells of the body live in the extracellular fluid, extracellular fluid is called the internal environment of the body.等长收缩isometric contractionTension increases but the length of the muscle does not change when a muscle contracts.等张收缩isotonic contractionTension remains constant but the muscle shortens when a muscle contracts.负反馈negative feedbackA regulated variable is sensed, information is sent to a controller, and action is taken to oppose change from the desire value.神经肌肉接头neuromuscular junctionThe complex structure responsible for signal transmission from nerve to skeletal muscle.正反馈positive feedbackWith positive feedback, a variable is sensed and action is taken to reinforce change of the variable, so it promotes a change in one direction.前负荷preloadPreload is the load that is given to the muscle prior to its contraction.相对不应期relative refractory periodA period follows the end of the absolute refractory period, during which it is possible to elicit a second action potential, but the threshold stimulus intensity is higher than usual.复极化repolarizationShortly after depolarization, the sodium channels begin to close and the potassium channels open more than they normally do. Then, rapid diffusion of potassium ionsto the exterior re-establishes the normal resting potential. This is called repolarization of the membrane.静息电位resting potentialThe difference in electrical potential across the membrane of an undisturbed cell, having a positive sign on the outside surface and a negative sign in the interior.跳跃传导salutatory conductionConduction of a nerve impulse down a myelinated nerve fiber by skipping from node to node.单纯扩散simple diffusionDiffusion means simply movement through the membrane caused by random motion of the molecules of the substances, moving either through cell membrane pores or through the lipid matrix of the membrane.钠-钾泵sodium-potassium pumpThe sodium-potassium pump is responsible for the coupled active transport of Na せ out of cells and Kせ into cells. Sodium-potassium pump is also an adenosine triphosphatase, an enzyme that catalyzes the hydrolysis of ATP to adenosine diphosphate (ADP).凝集agglutinationDuring blood transfusion, the red blood cells aggregated together in clumps which were sufficiently large to block minor blood vessels. This clumping is known as agglutination.血液凝固blood coagulationThe coagulation system consists of cofactors and a series of zymogens which sequentially activate one another, leading to formation of fibrin at a site of vascular injury.血型blood groupBlood groups are system of genetically determined antigenic substances on the membrane of red blood cells.血压blood pressureBlood pressure means the force exerted by the blood against any unit area of the vessel wall.交叉配血cross-match testSerum from recipient is tested against the donor's cells, and serum from donor is tested against the recipient's cells, this test is called cross-matching test.红细胞沉降率erythrocyte sedimentation rateWhen blood to which an anticoagulant has been added stands in a narrow tube, the red cells gradually sediment, leaving a clear zone of plasma above. The erythrocyte sedimentation rate is measured as the length to column of clear plasma after one hour.红细胞生成素erythropoietinErythropoietin is a hormone secreted by the kidneys which stimulates hemoglobin synthesis and erythropoiesis.纤维蛋白溶解fibrinolysisIn many cases fibrin within blood vessels is rapidly dissolved to restore thefluidity of the blood, and in others the fibrin becomes hyalinized or is removed by phagocytes and replaced by connective tissue. The process of liquefaction of fibrin is known as fibrinolysis.血红蛋白hemoglobinHemoglobin is a chromoprotein found in the red blood cells and having a great affinity for oxygen.自动节律性autorhythmicityAutorhythmicity is the ability to initiate its own beat. Many cardiac tissues are found to have autorhythmicity, for example sinoatrial node, intraventricular tracts and Purkinje cells. In addition to the cardiac tissue, the smooth muscle of the gastrointestinal tract has also autorhythmicity.容量血管capacitance vesselsThe veins have wide lumen and contain a greater volume of blood than any other section of the circulation does, thus the veins are referred to as the capacitance vessels.心动周期cardiac cycleThe cardiac events that occur from the beginning of one heart beat to the beginning of the next are called a cardiac cycle . Cardiac cycle is composed of two periods: systole and diastole.心指数cardiac indexCardiac index is the cardiac output per square meter of body surface area.心输出量cardiac outputThe product of the frequency of pumping (heart rate) and the stroke volume is the cardiac output; it is also called minute volume.心力储备cardiac reserveThe ability of the heart to adapt need of organism for expelling a larger quantity of blood above the basal level.心血管中枢cardiovascular centerThe cardiovascular centers are responsible for integration of sensory information and subsequent modification of efferent autonomic nerve activity to the heart and blood vessels.中心静脉压central venous pressureThe venous pressure as measured at the right atrium.代偿间歇compensatory pauseThe pause between the extra beat and the next normal beat is slightly longer than the usual beat interval, which is called compensatory pause.舒张压diastolic pressureDiastolic pressure is the lowest blood pressure in an artery during the diastole of the heart.有效不应期effective refractory periodThe duration from the beginning of phase 0 to -60mV of repolarization fails to produce action potential to any stimulus, no matter how strong. This duration is called ERP. In the ERP, the excitability is almost zero.射血分数ejection fractionThe proportion of the end-diastolic volume that is ejected . stroke volume/end diastolic volume).心电图electrocardiogramThe synchronized depolarizations spreading through the heart cause currents that establish field potential, whose differences can be amplified and detected by electrodes placed on the body surface. The record produced is called electrocardiogram.交换血管exchange vesselThe capillaries are tubes formed by a single layer of endothelial cells,. They create a very large area where the material exchanges between blood and the tissue cells take place.心音heart soundWhen the valves close, the vanes of the valves and the surrounding fluids vibrate under the influence of the sudden pressure differentials that develop, giving off sound that travels in all directions through the chest. These sounds are called heart sounds.异常自身调节heterometric autoregulationRegulation of cardiac output as a result of changes in cardiac muscle fiber length is called heterometric regulation.平均动脉压mean arterial pressureThe mean arterial blood pressure is the pressure in the arteries, average over time.微循环microcirculationMicrocirculation is the circulation between arterioles and venules. In the microcirculation, the most purposeful function of the circulation occurs: transport of nutrients to the tissues and removal of cellular excreta.起搏点pacemakerThe automatic cells that ordinarily fire at the highest frequency which are located in the sinoatrial node, excitation of the heart normally begins in the sinoatrial (SA) node.期前收缩premature systoleWhen a second action potential is triggered at the very start of the relative refractory period, the second contraction is superimposed on the semirelaxed phase of the first contraction. This phenomenon is called premature systole.脉压pulse pressureThe pulse pressure is the difference between the systolic pressure and diastolic pressure.每搏输出量stroke volumeStroke volume is referred to the volume ejected at each contraction by one side of the heart.每搏功stroke workThe stroke work of the heart is the amount of energy that the heart converts to work during each heart beat while pumping blood into arteries.收缩压systolic pressureThe pressure rises during cardiac systole and falls during diastole. The peakpressure value reached during systole is termed the systole pressure. Usually, at rest systolic pressure of the healthy young adult is 100~120mmHg.肺泡通气量alveolar ventilationThe amount of air reaching the alveoli per minute, at rest it generally amounts to 4.2L/min.解剖无效腔anatomic dead spaceThe space in the conducing zone of the airways occupied by gas that does not exchange with blood in the pulmonary vessels, such as in the nose, pharynx, and trachea since these area is not useful the gas exchange process but instead goes to fill respiratory passages.波尔效应Bohr effectThe increased oxygen release by hemoglobin in the presence of elevated carbon dioxide levels (the effects shift the oxygen hemoglobin dissociation curve to the left and upward). By forming hydrogen ions, carbon dioxide loading facilitates oxygen unloading, ., the decrease in O2 affinity of hemoglobin when the pH of blood falls, which is closely related to the fact that deoxygenated hemoglobin (deoxyhemoglobin) binds H+ more actively than does oxyhemoglobin.顺应性complianceDistensibility, the ability of the lungs to tolerate changes in volume, a property that reflects the presence of elastic fibers. It is defined as the change in volume per unit change in pressure (△V/△P), the reciprocal of the compliance.弹性阻力elastic resistanceA term used to describe the elastic properties of the lung and chest wall; the resistance or elastance (△V/△P),the reciprocal of the compliance.机能余气量functional residual capacityIt equals to the expiratory reserve volume plus the residual volume. This is the amount of air that remains in the lungs at the end of normal expiration (about 2300ml).何尔登效应Haldane effectThe increase in carbon dioxide unloading from hemoglobin in response to the combination of oxygen with hemoglobin, ., when oxygen binds with hemoglobin, carbon dioxide is released.补吸气量inspiratoy reserve volumeThe air inspired with a maximal inspiratoy effort in excess of the volume. ., the maximum extra volume of air that be inspired over and above the normal tidal volume, it is usually equal to about 3000ml.胸内压intrapleural pressureThe pressure within the pleural cavity is called intrapleural pressure.肺内压intrapulmonary pressureThe pressure within the alveoli of the lungs, also called intrapulmonary pressure.氧含量oxygen contentThe oxygen content is used to indicate how much O2 per liter of blood is attached to the hemoglobin in normal arterial blood, described as percent saturated.氧离曲线oxygen dissociation curveThe graph of the relationship between the partial pressure of oxygen and the degree of hemoglobin saturation with oxygen, which has a characteristic sigmoid shape表面活性物质pulmonary surfactantA detergent-like mixture of phospholipids and lipoproteins that lowers the surface tension of water, produced by surfactant-secreting (Type-II) cells. It is a mixture of dipalmitoyl phosphatidyl choline (DPPC), other lipids, and proteins.肺通气pulmonary ventilationThe total amount of new air moved into the respiratory passages each minute; equal to the tidal volume times the respiratory rate. The minute respiratory volume generally amounts to 6L/min.余气量residual volumeThe air left in the lungs after a maximal expiratory effort. This volume averages about 1200 milliliters.潮气量tidal volumeThe amount of air that moves into the lungs with each inspiration (or the amount that moves out with each expiration) ., the volume of air inspired or expired with each normal breath; it amounts to about 500ml.肺总容量total lung capacityThe maximum volume to which the lungs can be expanded with the greatest possible effort (about 5800ml); it is equal to the vital capacity plus the residual volume.通气-血流比ventilation /perfusion ratioThe ratio of pulmonary ventilation to pulmonary blood flow for the whole lung, at rest about (4.2 L/min ventilation divided by 5.5 L/min blood flow).吸收absorptionAbsorption is the process of transporting small molecules from the lumen of the gut into blood stream.基础代谢率basal metabolic rateThe basal metabolic rate is the metabolic rate determined under basal conditions which includes complete mental and physical relaxation in a room or a comfortable temperature and 12~14 hours after the last meal.体温body temperatureThe body temperature is often referred to core temperature. The core refers to the central area of the body, including the brain and viscera, which are maintained at a constant temperature.消化digestionDigestion is a process essential for the conversion of food into a small and simple form.能量代谢energy metabolismThe energy metabolism means the liberation, transformation and utilization of energy produced by the material metabolism in the body.胃排空gastric emptyingGastric emptying is promoted by the intense peristaltic contractions in the stomach antrum. At the same time, emptying is opposed by varying degrees of resistance tothe passage of chyme at the pylorus.胃泌素gastrinGastrin is a gut hormone secreted by the endocrine G cells in the gastric pyloric mucosa and duodenum mucosa. Gastrin is secreted in two forms, a large form called G-34, and a smaller form, G-17.调定点set pointAt a critical body core temperature, drastic changes occur in the rate of both heat loss and heat production. That is, all the temperature control mechanisms continually attempt to bring the body temperature back to this set-point level.慢波slow waveIf an electrode is inserted into a smooth muscle, it records a recurring depolarization, they are called slow waves or basic electrical rhythm (BER). Slow waves are not action potential, but show undulating changes in the resting membrane potential.出汗sweatingSweating is an active secretory process from eccrine sweat glands which are widely distributed over the surface of body.醛固酮aldosteroneAldosterone is a sodium-retaining hormone of the adrenal cortex. Aldosterone reduces sodium excretion and increases potassium excretion by the kidneys, this increasing sodium and decreasing potassium in the body.抗利尿激素antidiuretic hormoneA product of neurohypophyseal which, through its action on kidneys, promotes the conservation of body water.皮质肾单位cortical nephronThe nephrons have their glomerular located in the outer and middle portion of the renal cortex are called cortical nephrons.肾小球有效滤过压 glomerular effective filtration pressureThe effective filtration pressure of glomerular represents the sum of the hydrostatic and colloid osmotic forces that either favor or oppose filtration across the glomerular capillaries.肾小球滤过分数glomerular filtration fractionThe glomerular filtration fraction is the filtration rate as percentage of the total renal plasma flow that passes through both kidneys.球管平衡glomerulotubular balanceOne of the most basic mechanisms for controlling tubular reabsorption is the intrinsic ability of the tubules to increase their reabsorption rate in response to increased tubular inflow. This phenomenon is referred to as glomerular-tubular balance.渗透性利尿osmotic diuresisAn increase in urine flow due to excretion of an osmotic active solute.肾糖阈renal glucose thresholdWhen the plasma glucose concentration increases up to a value about 180 to 200 mg per deciliter, glucose can first be detected in the urine, this value is called therenal glucose threshold.肾素reninAn enzyme of renal origin that catalyzes the conversion of angiotensinogen to angiotensin I.水利尿water diuresisThe volume of urine increases when water intake exceeds body needs, it is resulted from suppression of ADH secretion适应adaptationWhen a maintained stimulus of constant strength is applied to a receptor, the frequency of the action potential in its sensory nerve deadens over time. This phenomenon is known as adaptation.适宜刺激adequate stimulusThe stimulus that a receptor is specialized to receive and transduce. In the case of the eye, the adequate stimulus would be visible light, in the ear it would be sound waves, and so on.暗适应dark adaptationOn going from a light environment into a darker one, there is a gradual increase in sensitivity allowing dimmer lights to be seen, a mechanism known as dark adaptation.简化眼reduced eyeIf all the refractive surfaces of the eye are algebraically added together and then considered to be one single lens, the optics of the normal eye may be simplified and represented schematically as a "reduced eye".视敏度visual acuityVisual acuity is defined as the ratio of the distance of the individual from the chart to the distance at which the details of the correctly read line subtend 1'of arc.视野visual fieldThe field of vision is the area seen by an eye at a given instant. The area seen to nasal side is called the nasal field of vision, and the area seen to lateral side is called the temporal field of vision.胆碱能神经纤维cholinergic fiberA kind of neuron that liberates acetylcholine at its synaptic knobs with activity.条件反射conditioned reflexA conditioned reflex is a reflex response to a stimulus that previously elicited little or no response, acquired by repeatedly pairing to stimulate with another stimulus that normally does produce the response.去大脑僵直decerebrate rigidityWhen the brain stem is sectioned below the midlevel of the mesencephalon, the rigidity occurs in the antigravity muscles. This phenomenon is called decerebrate rigidity.脑电图electroencephalogramThe minute electrical currents spontaneously generated by neuronal activity which recorded from the scalp or directly from the cortical surface.诱发电位evoked potentialThe various discrete electrical changes in the encephalon or the spinal cord which can be produced by stimulation of sense organs or of some point along the ascending pathways to it.兴奋性突触后电位. excitatory postsynaptic potentialThe excitatory postsynaptic potential is the local postsynaptic depolarization due to release of excitatory transmitter from presynaptic terminals. EPSP brings the membrane closer to threshold and makes it more likely that an action potential will be triggered.抑制性突触后电位 inhibitory postsynaptic potentialA hyperpolarizing potential at a synapse that reduced the excitability of the postsynaptic cell.运动单位motor unitA motor axon, together with all of the skeletal muscle fibers it innervates.非特异性传导系统 nonspecific projection systemDiffuse projections from the nonspecific thalamic nuclei connecting the ascending reticular activating system to widespread areas of cortex have a role in modifying the states of consciousness which is called nonspecific projection system.突触后抑制postsynaptic inhibitionThe presynaptic neuron liberates an inhibitory transmitter increasing the permeability of the postsynaptic membrane to potassium ions and /or chloride ions thereby increasing the negativity of the postsynaptic membrane potential. In this hyperpolarized state it is difficult to stimulate.突触前抑制presynaptic inhibitionA process which reduces the amount of synaptic transmitter liberated by action potentials arriving at excitatory synaptic knobs. The neuron producing presynaptic inhibition ends on an excitatory synaptic knob.牵涉痛referred painDamage to an internal organ is commonly associated with pain or tenderness not in the organ but in some skin region sharing the same segmental innervation. This phenomenon is called referred pain.第二信使second messengerA small, diffusible molecule produced when a hormone combines with a cell membrane receptor and which carries the message to the inside of the cell.特异性传导系统specific projection systemThe specific sensory projection system uses relatively direct pathways through specific thalamic nuclei to restricted cortical regions.脊休克spinal shockComplete transection of the spinal cord results in the immediate paralysis and loss of sensation in all body regions innervated by spinal cord segments below the lesion, this phenomenon is called spinal shock.牵张反射stretch reflexWhen a skeletal muscle with an intact nerve supply is stretched, the muscle being stretched contracts. This is a monosynaptic reflex called the stretch reflex.非条件反射unconditioned reflexA fixed reflex whose mechanism may be supposed to be inherited as its functioning does not depend on previous experience.激素hormoneA hormone can be defined as a chemical substance (a compound), which is synthesized and secreted by a specific cell type. It is generally transported in the circulation and at very low concentrations elicits a specific response in target tissues affecting the activities of cells in another portion of the body.胰岛素insulinA hormone secreted by the beta cells of the pancreatic islets; causes a reduction in plasma glucose concentrations. Insulin lowers blood glucose mainly by facilitating glucose uptake in muscle and adipose tissue and by inhibiting hepatic glucose output.甲状腺激素thyroid hormoneThe thyroid hormone is referred to thyroxine and triiodothyronine which increase the rate of chemical reactions in almost all cells of the body, thus increasing the general level of body metabolism.。
一、名词解释MAC肺泡最小有效浓度(the minimum alveolar concentration, MAC):指在一个大气压下,使50%受试对象对伤害性刺激无体动反应的肺泡内麻醉药的浓度。
ARDS急性呼吸窘迫综合症(acute respiratory distress syndrome,ARDS):是指原先并无心肺疾患的患者因急性弥漫性肺泡毛细血管损伤以至外呼吸功能严重障碍而发生的以急性呼吸功能衰竭为主要特征的症候群,其临床表现为进行性呼吸困难和低氧血症。
PCA病人自控镇痛(Patient Controlled Analgesia, PCA):指病人感觉疼痛时,主动通过计算机控制的微量泵按压按钮向体内注射医生事先设定的药物剂量进行镇痛。
屏气试验先让病人作数次深呼吸,然后让病人在深吸气后屏住呼吸,记录其能屏住呼吸的时间。
一般以屏气时间在30秒以上为正常。
如屏气时间短于20秒,可认为肺功能属显著不全TIVA全凭静脉麻醉(total intravenous anesthesia,TIVA):静脉全身麻醉将药物经静脉注入,通过血液循环作用于中枢神经系统而产生全身麻醉的方法称为静脉全身麻醉。
HPV缺氧性肺血管收缩(hypoxic pulmonary vasoconstriction,HPV):肺泡缺氧刺激产生多种血管活性物质,如肽类内皮素(ET),血栓素A(TXA),血小板激活因子(PAF),白三烯(LTS),内皮细胞依赖收缩因子(EDCF)等,它们都有很强的血管收缩作用,即形成所谓的缺氧性肺血管收缩(HPV),从而使病侧肺血流减少,低氧血症有所缓解静脉快速诱导:(rapid sequence induction)这是目前最常用的诱导方法,是病人经过充分吸氧后,先用镇静催眠或静脉麻醉药使病人意识消失,随即经面罩加压给氧,再用麻醉性镇痛药,接着静脉注射琥珀胆碱或非去极化类肌松药后进行气管插管的一种麻醉诱导方法。
大学《麻醉学》期末复习重点及习题解析(名词解释、选择、填空、简答、病例分析)目录《麻醉学》各章核心知识点 (1)《麻醉学》名词解释及简答题汇总 (22)名词解释: (22)简答题 (25)《麻醉学》习题集及答案解析 (29)一、名词解释 (29)二、单项选择题 (29)三、填空题 (39)四、简答题 (41)五、病案分析题 (42)答案 (43)《麻醉学》各章核心知识点第一章绪论1.临床麻醉学的5大组成部分:(考题)对病人的术前评估与准备;麻醉的实施与处理;专科病人的麻醉处理;为重疑难病人的麻醉处理;麻醉并发症的预防与诊治。
2.复合麻醉/平衡麻醉(balanced anesthesia):同时使用两种或两种以上麻醉药/或辅助药物以达到麻醉的基本要求,以能减少单个药物的用量及副作用。
3.联合麻醉(combined anesthesia):同时使用两种或两种以上方法以达到麻醉的基本要求,以能取长补短综合发挥各种方法的优越性。
4.临床麻醉工作包括:麻醉科门诊、临床麻醉、RR、ICU、疼痛诊疗。
5.麻醉:用药物或非药理性方法使人体局部或全身暂时失去知觉,麻醉的目的是为解除患者手术的痛苦。
第二章麻醉前病情评估与准备1.麻醉前访视的步骤:复习病历(史)→分析各项术前检查和化验结果→访视病人和系统检诊→进行麻醉和手术风险判断→知情同意2.麻醉前准备:1) 心血管系统:控制血压小于180/100mmHg,术前当天停用洋地黄、降压药;2) 呼吸系统:术前停止吸烟2周,进行呼吸功能锻炼,雾化吸入,有效抗生素治疗3-5天;3) 糖尿病:择期手术,控制血糖≤8.3mmol/L,尿糖低于(++),尿酮体阴性;4) 胃肠道准备:成人禁食12h,禁饮8h;小儿小于36个月者,禁食6h,禁饮2-3h;大于36个月者禁食8h,禁饮2-3h。
(考题)3.麻醉前用药的目的:1) 镇静2) 镇痛3) 抑制呼吸道腺体分泌,预防局麻药的毒性反应4) 调整自主神经功能,消除或减弱一些不利的神经反射活动4.麻醉前用药的常用药物:1) 镇痛药:吗啡、哌替啶、芬太尼2) 苯二氮卓类:地西泮、咪达唑仑3) 巴比妥类药物:苯巴比妥4) 抗胆碱药:阿托品、东莨菪碱5) H2受体阻断剂:西咪替丁、雷尼替丁5.术前需要停用的药物主要是某些抗抑郁药和抗凝药,阿司匹林术前需停药1-3周,华法林术前停药3-5天。
各大学麻醉专业考博试题协和医科大学,博士入学考试,麻醉试题一、名词解释及简答题(3分)FRC(功能余气量):在平静呼气末,吸气肌处于松弛状态时肺内存留的一部分气量称为功能余气量,约占肺总容量的40%。
功能余气量产生与正常量的维持,对机体具有重要的生理学意义2005年华中科技大学同济医学院攻读博士学位入学考试试题麻醉学一:名词解释(20分)ICP、 SIMV、 MAC、 POCD2004年华中科技大学同济医学院攻读博士学位入学考试麻醉学试题一:名词解释(20分)呼吸性酸中毒 meyer-overton法则 PCA 癌性镇痛三级用药阶梯 TOF FRC ETCO2 CO2排除综合症禁闭麻醉一度房室传导综合症2003年华中科技大学同济医学院攻读博士学位入学考试试题麻醉学一、名词解释(每体5分,共25分)1、POCD 2.ischemia preconditioning 3.intraoperative awareness 4. preemptive analgesia 5. CSEA徐州医学院麻醉药理学部分考题:名词解释:药代动力学,药效动力学,ED50,ED95,一室模型,二室模型,Ke0, 安全指数,副作用,后遗效应,效应室,t1/2α,t1/2β,hoffoman消除,MAC,静脉即时输注半衰期山大医学院2003年麻醉考研部分试题:脊髓前动脉综合症,PCVA,VAS,常见麻醉肌松药,全麻并发症,常见吸入麻醉药,PCA需要医生设置的参数,控制性降压2003年中南大学湘雅医学院附二院麻醉博士专业基础病生试题1.选择题(略)20分2.名词解释:pump-leak mechanism;general adaption syndrome;myocardial depressant复旦医学院和首医的麻醉题:简答、问答、病例分析、名解术中低血压、低氧血症的原因,麻醉机漏气的检查方法,画出麻醉机的呼吸回路并指出机械死腔的位置,呼吸囊向上、向下运动的优缺点,控制性降压的并发症,局麻药的机理和药理首医2004年考博题:名解(英文):diffused anoxia、MAC、TOF、BIS简答:深静脉穿刺并发症老年胸科手术麻醉注意事项单侧通气适应症首医99年硕士麻醉题(名解+问答)1硬膜外麻醉2突触3缺氧4双盲药物实验5吸入麻醉6PCA1何谓血浆胶体渗透压和血浆晶体渗透压,各有何作用?2气管插管后判断导管是否位于气管内的常用方法有哪些?3、应用呼吸机正压通气的相对禁忌症有哪些?4、局麻药的主要不良反应?5、全麻后呼吸系统的并发症有哪些?北医1997麻醉硕士1低血钾的常见原因和临床表现?2、输血的并发症?3、休克的常见继发性内脏器官损害?4、什麽是MAC?例举三种常用药的MAC值?5、气管插管的优点及并发症?北医1999硕士麻醉1何谓低氧血症?麻醉中低氧血症的原因?2、MAC定义?与何分配系数有关?举例说明。
麻醉常考的名词解释麻醉术语随着医学的发展而日益丰富和复杂,对于医学生和医务人员来说,熟悉和理解这些麻醉常考的名词至关重要。
然而,这些名词的解释可能并不总是那么简单和直接。
在本文中,我们将深入解释一些常见的麻醉学术语,帮助读者更好地理解它们的含义和应用。
1. 麻醉(Anesthesia)麻醉是指通过使用药物或其他技术手段,使人或动物失去疼痛感和意识,从而使他们无感觉和无意识状态下进行手术或其他医疗操作的一种方法。
麻醉的主要目标是确保患者的安全和舒适。
麻醉的三个主要组成部分包括麻醉诱导(induction)、麻醉维持(maintenance)和麻醉恢复(recovery)。
2. 麻醉师(Anesthesiologist)麻醉师是专门从事麻醉工作的医学专业人员。
他们具有深厚的医学知识和临床经验,负责评估患者的麻醉需求和安全风险,并进行个性化的麻醉方案制定和实施。
麻醉师还负责监测患者的生理状况和麻醉深度,并及时调整麻醉药物的用量和种类。
3. 全身麻醉(General Anesthesia)全身麻醉是一种通过让患者进入无意识状态,并抑制疼痛感知的麻醉技术。
这种麻醉方法通过全身给药途径,将麻醉药物输送到患者的血液循环中,从而达到全身范围的麻醉效果。
全身麻醉除了使患者不再感受到疼痛之外,还可以促使肌肉松弛、抑制自主反射、降低新陈代谢率以及维持生命体征的稳定。
4. 局部麻醉(Local Anesthesia)局部麻醉是一种通过将麻醉药物直接应用于感兴趣区域,以阻滞感觉神经传导而实现的麻醉方法。
局部麻醉可以用于局部手术以及其他特定区域的疼痛控制。
与全身麻醉相比,局部麻醉对全身生理系统的影响较小,并且更少产生副作用。
5. 麻醉深度(Depth of Anesthesia)麻醉深度是指患者在手术过程中的意识状态和对疼痛的感知程度。
麻醉深度的监测对于确保麻醉效果的安全和有效非常重要。
麻醉师通常通过监测患者的生理指标,如血压、心率、呼吸等变化以及脑电图等指标,来评估麻醉深度,并根据需要调整麻醉药物的用量和浓度。
第一章绪论1.internal environment(内环境)指机体内围绕在各细胞周围的细胞外液2.homeostasis(内环境稳态)内环境的各种物理,化学性质保持相对恒定的状态3.anesthesia(麻醉)指使用药物或其他方法使患者整体或局部暂时时期感觉,以达到无痛目的为进一步手术或其他治疗创造条件4.perioperative period(围术期)从确定手术治疗时起,至与本次手术有关的治疗基本结束为止的一段时间5.stress(应激反应)人体对一系列有害刺激做出的保护自己的综合反应第二章麻醉与神经系统1.resting potential(静息电位)指静息状态下神经元膜两侧外正内负的电位差。
2.action potential(动作电位)指神经元在静息电位基础上接受有效刺激后发生可迅速传导的膜电位波动。
3.electroencephalogram EEG (脑电图)在无明显刺激情况下,在头皮表面记录到的自发性生物电活动。
4.inhibitory postsynaptic potential IPSP (抑制性突触后电位)抑制性递质作用受体后,导致负离子通道开放,以Cl-内流为主,产生突触后膜的超极化。
5.consciousness(意识)机体对周围环境,自身生理和心理活动的觉知或体验。
a(昏迷)最严重的意识障碍,患者意识持续中断或完全丧失,各种强刺激均不能唤醒,随意运动消失,按严重程度可将昏迷分为三级,浅昏迷,中昏迷,深昏迷。
7.分离麻醉氯胺酮能引起脑部特定部位兴奋和其他部位抑制的状态,导致EEG-BIS始终处于清醒状态,并有梦境等表现,但意识,对外界刺激的相关反应和记忆均消失,即所谓分离麻醉,属明确的顺行性遗忘作用。
8.intraoperative awareness(术中知晓)指全麻下的患者在手术过程中出现了有意识的状态,并且在术后可以回忆起术中发生的与手术相关联的事件。
9.pain(疼痛)一种与组织损伤或潜在的损伤相关的不愉快的主观感觉和情感体验,是大多数疾病的共有症状,为人类共有且差异很大的一种不愉快的感觉。
10.visceral pain(内脏痛)指内脏组织受到各种伤害性刺激如牵拉,缺血,炎症,平滑肌痉挛或化学刺激等引起的疼痛。
11.referred pain(牵涉痛)内脏疾患往往引起与疼痛起源部位不同位置的体表部位发生疼痛或痛觉过敏的现象。
12.visual analogue scale VAS (视觉模拟评分表)具体方法是用一根长10cm的直线,两端分别标为无疼痛(0)和剧痛(10),患者根据自己所感受的疼痛程度在线上某一点作记号,表示疼痛的程度和心理上的冲击,医生记录数值后进行评分,从起点到记号处的距离长度反应疼痛的量。
13.stretch reflex (牵张反射)指有完整神经支配的骨骼肌在受到牵拉时引起同一肌肉发生收缩的反射。
14.muscle tone (肌紧张)指缓慢持续牵拉肌腱引起肌肉持续收缩的牵张反射。
15.myasthenia gravis (重症肌无力)一种骨骼肌的神经-肌接头兴奋传递障碍,进而影响收缩功能的获得性自身免疫疾病。
16.motor unit(运动单位)由一个∝运动神经元及其支配的全部肌纤维所组成的功能单位。
17.sympathetico -adreno-medullary system(交感-肾上腺髓质系统)指交感神经系统增强时伴有肾上腺髓质分泌的增加的功能调节系统。
可以动员机体许多器官的潜在功能以适应环境的急变。
18.enteric nervous system ENS(肠道神经系统)是胃肠道壁内的神经元和神经纤维所构成的神经网络。
19.脑-心综合征又称脑-心卒中,是指急性脑血管意外引起的继发性冠状动脉疾患,广义上指各种颅内疾患引起的继发性心脏损伤。
20.眼心反射即压迫,刺激眼球或眼眶,或牵拉眼外肌引起的由迷走神经介导的心动过缓甚至停搏。
21.cerebral spinal fluid CSF(脑脊液)是充满于脑室和蛛网膜下腔内的无色透明液体,产生于脑室内的脉络丛,由蛛网膜颗粒或绒毛引流至硬脑膜静脉窦,脑脊液主要对脑和脊髓起缓冲,保护,营养,运输代谢以及维持正常颅内压的作用。
22.blood brain barrier BBB(血脑屏障)血液和脑之间存在一种保护性屏障,即血脑屏障,其可限制脑内液体和其他物质流动,以维持脑内环境稳定,保证神经元的正常活动,血脑屏障由毛细血管内皮细胞,基膜及星形胶质细胞突组成。
第三章麻醉与呼吸1.functional residual capacity FRC(功能余气量)指平静呼气末存留于肺内的气量,功能余气量=补吸气量+余气量,其意义是缓冲呼吸过程中肺泡气氧分压和二氧化碳分压的过度变化。
2.ventilation/perfusion ratio(通气/血流比值)每分钟肺泡通气量和每分肺血流量之间的比值。
3.oxygen saturation of Hb(血红蛋白氧饱和度)血红蛋白氧含量占血红蛋白氧容量的百分比,表示血液实际携带的氧量占血液科携带氧量的比例。
4.forced vital capacity FVC(用力肺活量)尽力吸气后再尽力尽快呼气所能呼出的最大气量。
正常时略小于肺活量。
不仅可反映肺一次通气的最大能力,而且能反映肺组织的弹性状态和气道的通畅程度。
5.alveolar ventilation (肺泡通气量)每分钟吸入肺泡的新鲜空气量。
肺泡通气量=(潮气量-无效腔气量)X呼吸频率,由于去除了未参与肺泡与血液之间气体交换的通气量,能真实反映进行气体交换的有效通气量。
6.intermittent positive pressure ventilation IPPV(间歇正压通气)经呼吸道内施行间歇性的压力降外界气体送人肺内,使肺泡节律性张缩形成通气。
7.patient-ventilator asynchrony(人机对抗)实质上是呼吸机与自主呼吸泵节奏不同引起的异常人机关系,是机械通气最常见问题之一,也是机械通气最基本和最重要的问题之一。
8.hypoxic pulmonary vasoconstriction HPV(缺氧性肺血管收缩)单肺通气麻醉使手术侧肺不通气,局部缺氧看诱导局部肺血管收缩,即缺氧性肺血管收缩。
HPV是机体针对无通气局部减少功能性动静脉分流的自身适应性调节反应。
9.二氧化碳排出综合征通过急速排出二氧化碳可导致低二氧化碳血症的表现,并较一般的低二氧化碳血症所致者更严重,表现为血压骤降、脉搏减弱、呼吸抑制、或呼吸恢复延迟、意识障碍等征象,即为二氧化碳排出综合征,严重者可出现心律失常,甚至心脏停搏。
10.oxygen poisoning (氧中毒)不恰当的氧疗对机体也会有害,长时间昔日高浓度氧气会发生氧中毒,造成机体组织和功能上的损害。
第四章麻醉与循环1.stroke volume(每搏输出量)一侧心室一次心脏搏动所射出的血液量,称为每搏输出量,简称搏出量。
2.ejection fraction(射血分数)搏出量占心室舒张末期容积的百分比,健康成年人的射血分数为55%-65%3.cardiac output(心输出量)一侧心室每分钟射出的血液量,称为每分输出量。
4.cardiac reserve(心力贮备)心输出量随机体代谢需要而增加的能力称心力贮备或泵功能贮备,可法宁心脏泵血功能对代谢的适应能力。
5.cardiac index(心指数)以每平方米体表面积计算心输出量,用于不同个体间心脏功能的分析比较。
6.ventricular function curve(心室功能曲线)以心室舒张末期容积或压力作为横坐标,每搏输出量或每搏功作纵坐标所画出的曲线,又称Frank-Starling曲线,反映前负荷对心室泵血功能的影响。
7.heterometric autoregulation(异长自身调节)至通过心肌细胞本身初长的改变而引起心肌收缩强度的变化。
8.Cardiac output curves(心输出量曲线)以右心房压为横坐标,相应心输出量为纵坐标所画出的曲线,反映心房压对心输出量的影响。
9.venous return curve(静脉回流曲线)以右心房压为横坐标,以相应静脉回心血量为纵坐标所画出的曲线,反映右心房压对静脉回心血量的影响。
10.Hemodynamics(血流动力学)是研究血液在心血管系统内流动的力学,主要研究血压、血流阻力、血流量与血流速度以及他们之间的相互关系。
11.Hemorheology(血液流变学)是研究血液及其成分的流变性质及其变化规律的科学。
12.Fahraeus-Lindquist effect(法-林效应)当血液在直径小于0.2-0.3cm的微动脉内流动时,只要切变速率足够高,则随着血管口径的进一步变小,血液的黏性也变低,该现象称为法-林效应。
13.critical closing pressure(临界闭合压)当动脉血压降到某一临界水平时即使动静脉压差仍然存在,血管将完全关闭,血流停止。
这一玲姐压力值称临界闭合压。
14.oculocardiac reflex(眼心反射)指压迫眼球,激惹或牵拉眼外肌,经由三叉神经眼睫支传入到脑干心血管中枢,再由迷走神经传出,使心动过缓甚至停搏。
15.blood pressure(血压)指血管内的血液对于单位面积血管壁的侧压力,即压强。
16.central venous pressure(中心静脉压)右心房和胸腔内大静脉的血压称为中心静脉压。
17.baroreceptor reflex ( baroreflex )(降压反射)血压升高时,反射性引起心率减慢、心输出量降低、血管舒张和血压下降。
血压突然降低时,该反射减弱,血压回升。
18.coronary flow reserve(冠状动脉储备)冠状动脉血流为满足心肌氧需求量的增加所能增长的最大能力。
19.external counterpulsation(体外反搏)通过加在四肢远端及臀部的特质气囊管在心室舒张时充气加压四肢和臀部,以提高外周阻力和舒张压,增加冠状动脉血流量,在心室收缩前解除气囊加压以降低外周阻力,有利于增加心搏出量。
20. cerebral blood flow autoregulation(脑血流自身调节)当平均动脉压在60-140mmHg的范围内变动时,随着平均动脉压的升高或降低,分别引起脑内微动脉收缩或舒张,是脑血管阻力增加或减小,从而使脑血流量不至于随血压的升降而增减,这种灌注压发生变化时仍保持脑流量相对恒定的现象,称为脑血流的自身调节。
21.hypertensive encephalopathy(高血压脑病)指当血压突然升高超过脑血流自动调节的阈值时,脑血流出现高灌注,毛细血管压力过高,渗透性增强,导致脑水肿和颅内压增高,甚至形成脑疝,引起的一系列暂时性脑循环功能障碍的临床表现。