Diabetes mellitus Normal glucose physiology requires a balance between glucose utilization and endogenous production or dietary delivery ( Fig. 22.1 ). The liver is the primary source of endogenous glucose production via glycogenolysis and gluconeogenesis. Approximately 70% to 80% of…
Introduction The kidney plays a key homeostatic role in the tight regulation of extracellular fluid volume, blood pressure, solute transport and electrolyte concentrations, pH, and excretion of drug metabolites. Knowledge of how the kidneys perform these important functions aids in…
Alterations of water, osmolal, and electrolyte content and distribution as well as acid-base disturbances are common in the perioperative period and rarely happen in isolation because they are inherently interrelated. They both affect and are affected by the function and…
Malnutrition can be caused by either an insufficient consumption of essential nutrients or an overconsumption of poor nutrients. Currently the most prevalent nutritional disease worldwide is obesity. About two-thirds of the world’s population live in countries where being overweight and…
Inborn errors of metabolism manifest as a variety of metabolic defects that may complicate the management of anesthesia ( Table 18.1 ). In some instances, these defects are clinically asymptomatic and become manifest only in response to specific triggering events,…
The principal function of the gastrointestinal (GI) tract is to provide the body with a supply of water, nutrients, and electrolytes. Each division of the GI tract—esophagus, stomach, small and large intestines—is adapted for specific functions such as passage, storage,…
Epidemiology Nearly 4.5 million people in the United States are living with chronic liver disease, while more than 40,000 deaths annually are attributed to chronic liver disease. Liver dysfunction affects multiple organ systems and increases the risk of perioperative morbidity…
Introduction The peripheral nervous system consists of nerve elements outside the brain and spinal cord. It contains both peripheral nerves and elements of the autonomic nervous system. Disorders of the autonomic nervous system can result in significant hemodynamic changes as…
Anatomy of the vertebral column and spinal cord The vertebral column consists of 24 individual vertebrae (7 cervical, 12 thoracic, and 5 lumbar), in addition to the sacrum and coccyx. Basic anatomy of individual vertebrae and the vertebral column is…
Cerebral physiology Cerebral blood flow, blood volume, and metabolism Cerebral blood flow (CBF) is modulated by cerebral metabolic rate, cerebral perfusion pressure (CPP, the difference between the mean arterial pressure [MAP] and intracranial pressure [ICP]), and arterial blood carbon dioxide…