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Anatomy physiology and responses to vascular surgery 

Anatomy physiology and responses to vascular surgery
Chapter:
Anatomy physiology and responses to vascular surgery
Author(s):

Dr Jonathan P. Thompson

, Dr Simon J. Howell

, and Dr Richard J. Telford

DOI:
10.1093/med/9780199594429.003.0002
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date: 14 October 2019

Best management of the vascular surgical patient requires a good working knowledge of relevant anatomy and physiology. This chapter includes the essential background anatomical and physiology needed by the competent vascular anaesthetist. The most important areas: cardiovascular, respiratory, renal, nervous systems, and blood coagulation, are covered in succinct detail. In health, external stimuli provoke biological responses which act to maintain physiological homeostasis. These are often altered in vascular surgical patients by the effects of ageing, cardiovascular or other associated diseases, or by concurrent drug treatments. Vascular surgery, anaesthesia and radiological interventions may also have profound effects on these systems. They can also impair the normal autoregulatory responses which maintain physiological balance. These are especially relevant within the cardiovascular renal and respiratory systems, and in patients undergoing major arterial, aortic or carotid interventions. Topics include cardiac anatomy and physiology, regulation of the circulation and cardiac output, and the responses to aortic cross clamping and unclamping. Cerebral blood flow, the effects of vascular surgery on renal and function, pain pathways, normal coagulation and the responses to major haemorrhage are covered. A separate section describes the effects of regional and general anaesthesia , and vascular surgery on the respiratory system. Sections on important anatomy relevant to regional anaesthesia and the tracheobronchial tree act as essential background to practical procedures detailed later in the book. In addition to the vascular anaesthetist, this chapter will be useful background information for all professionals involved in the care of the vascular surgical patient.

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