The concept of “immunosurveillance” describes a homeostatic balance whereby cells that undergo transformation into cancer cells are normally eliminated or kept in check by the immune system. In 1985 an autopsy study found that 36% of “normal” thyroid glands showed…
Physiology Hormone activity, increased metabolic demands, the gravid uterus, and biochemical changes related to the fetoplacental unit result in significant alterations in maternal physiology, anatomy, and pharmacology during pregnancy, as shown in Fig. 37.1 . These physiologic changes have a…
Dysfunction of the complex physiologic processes of the endocrine systems can lead to significant and potentially life-threatening problems. Administration of exogenous hormones or drugs that mimic or antagonize hormonal effects to manipulate the metabolic milieu is important in many therapies.…
Endocrine physiology encompasses processes that range from master regulation by the pituitary gland to the much larger pancreas, which controls energy utilization processes of the body. This chapter reviews normal endocrine physiology and pathophysiology, as well as the basic anesthetic…
Historical Perspective In the first half of the 20th century, one of the most feared complications of general anesthesia was postoperative vomiting (POV), primarily because aspiration of gastric contents into the lungs could lead to death. Early prophylaxis sometimes consisted…
Macronutrients have traditionally been regarded as a means to satisfy basic energy needs for cellular homeostasis, while amino acids are considered necessary for anabolism and protein synthetic machinery of the cell. Surgical, traumatically injured, and critically ill patients, however, are…
One of the main functions of the liver is to protect against toxins. The endoplasmic reticulum of hepatocytes contains families of enzymes that protect the organism against an accumulation of lipid-soluble exogenous and endogenous compounds. This is done by transforming…
In perioperative management, the hepatic and gastrointestinal (GI) systems usually receive consideration after the cardiovascular and respiratory systems. However, potential perioperative problems such as aspiration, ileus, and nausea and vomiting are common and significant. Additionally, end-stage liver disease—often associated with…
The most widely used medications in pulmonary medicine are those delivered via inhalation for small airway diseases, such as asthma, chronic obstructive pulmonary disease, and cystic fibrosis. Using the lung as a vehicle for drug delivery is well known to…
This chapter describes the physiology of the respiratory system by detailing the control systems and mechanisms of air movement into and out of the lungs that allow oxygen and carbon dioxide to exchange with blood. Emphasis is placed on those…