Organ Systems

Detailed Discussion of Organ Systems for the Anesthesia Written Boards

Central and Peripheral Nervous Systems

  • Brain: Cerebral Cortex, Functional Organization, Subcortical Areas (Basal Ganglia, Hippocampus, Internal Capsule, Cerebellum, Brain Stem, Reticular Activating System), Cerebral Blood Flow (Effect of Perfusion Pressure, Ph, PaCO2, PaO2, and Cerebral Metabolic Rate for O2 (CMRO2), Inverse Steal, Gray vs. White Matter, Autoregulation (Normal, Altered, and Abolished), Pathophysiology of Ischemia/Hypoxia (Global vs. Focal, Glucose Effects), Effects of Brain Trauma or Tumors, Cerebrospinal Fluid (Formation, Volume, Composition, Flow and Pressure), Blood-Brain Barrier (Active and Passive Molecular Transport Across, Causes of Disruption, Relation to Blood Chemistry and Acid-Base Balance), Cerebral Protection (Hypothermia, Anesthetic and Adjuvant Drugs)
  • Spinal Cord: General Organization, Spinal Reflexes, Spinal Cord Tracts, Evoked Potentials
  • Neuromuscular and Synaptic Transmission: Morphology, Receptors, Receptor Density, Membrane Potential, Mechanism, Action Potential (Characteristics, Ion Flux), Synapse, Transmitters, Precursors, Ions, Termination of Action, Transmission Characteristics, Presynaptic and Postsynaptic Functions
  • Skeletal Muscle Contractions: Depolarization, Role of Calcium, Actin/Myosin; Energy Source
    and Release
  • Pain Mechanisms and Pathways: Nociceptors and Nociceptive Afferent Neurons, Wind-Up Phenomenon, Dorsal Horn Transmission and Modulation, Spinal and Supraspinal Neurotransmission and Modulation, Opioid Receptors, Autonomic Contributions to Pain; Visceral Pain Perception and Transmission, Social/Vocational/Psychological Influences on Pain Perception, Gender and Age Differences in Pain Perception
  • Autonomic Nervous System: Sympathetic and Parasympathetic (Receptors, Transmitters, Synthesis, Storage, Release, Responses), Ganglionic Transmission Reflexes (Afferent and Efferent Limb)
  • Temperature Regulation: Temperature Sensing (Central, Peripheral), Regulating Centers (Set Point), Heat Production and Conservation, Heat Loss Mechanisms, Body Temperature Measurement (Sites, Gradients), Effect of Drugs/Anesthesia on Temperature Regulation, Special Pediatric Considerations
  • Anatomy: Brain, Cerebral Cortex (Cerebellum, Basal Ganglia, Major Nuclei and Pathways), Brain Stem (Respiratory Centers, Reticular Activating System), Cerebral Circulation: Circle of Willis, Venous Sinuses and Drainage
  • Spinal Cord and Spine: Variations in Vertebral Configuration, Spinal Nerves (Level of Exit, Covering, Sensory Distribution), Blood Supply, Sacral Nerves: Innervation of Pelvic Structures, Meninges (Epidural, Subdural and Subarachnoid Spaces), Parasympathetic Nervous System (Location of Ganglia, Vagal Reflex Pathways, Sympathetic Nervous System (Ganglia, Rami Communicantes, Sympathetic Chain), Cranial Nerves, Carotid and Aortic Bodies, Carotid Sinus, Ganglia, Rami Communicantes, Sympathetic Chain, Nociception (Peripheral Nociceptors, Transduction, Afferent Pathways: Neurons, Dorsal Horn, CNS Pathways)

Respiratory System

  • Lung Volumes: Definitions, Methods of Measurement, Normal Values, Time Constants
    b) Spirometry, Static and Dynamic Volumes, Deadspace, Nitrogen Washout, O2 Uptake,
    CO2 Production, Exercise Testing
  • Static and Dynamic Compliance, Pleural Pressure Gradient, Flow-Volume Loops and
    Hysteresis, Surfactant, Laplace Law
  • Lung Mechanics: Resistances, Principles of Gas Flow Measurement, Methods of Measurement, Work of Breathing, Regulation of Airway Caliber
  • Ventilation-Perfusion: Distribution of Ventilation, Distribution of Perfusion, Zones, Hypoxic Pulmonary Vasoconstriction
  • Diffusion: Definition, Pulmonary Diffusion Capacity, Apneic Oxygenation, Diffusion Hypoxia
  • Blood Gases: O2 Transport, O2 Physical Solubility, Oxyhemoglobin (Hb-O2) Saturation, Hb-O2
    Dissociation Curve, 2,3-Diphosphoglycerate (2,3-DPG), P50, Respiratory Enzymes,
    Hemoglobin (Hb) As A Buffer, CO2 Transport, Blood CO2 Content, Carbonic Anhydrase, CO2 Dissociation Curve,
    Bohr Effect, Haldane Effect, Systemic Effects of Hypercarbia, Hypocarbia, Hyperoxia, Hypoxemia
  • Control of Ventilation: Respiratory Center, Central and Peripheral Chemoreceptors, Proprioceptive Receptors, Respiratory, Muscles and Reflexes; Innervation, CO2 and O2 Response Curves
  • Non-Respiratory Functions of Lungs: Metabolic, Immune
  • Anatomy: Nose, Pharynx (Subdivisions, Innervation, Larynx (Innervation; Muscles, Blood Supply, Cartilages, Vocal Cords, Positions with Paralysis, Differences Between Infant and Adult); Trachea: Structure and Relationships in Neck and Chest
  • Muscles of Respiration, Accessory Muscles
  • Pharmacology: Bronchodilators, β-agonists, Anticholinergics, Antiinflammatory medications, Steroids, Leukotriene modifier drugs, Mast cell stabilizers, Immunoglobulin E (IgE) blockers

Cardiovascular System

  • Physiology: Cardiac Cycle, Control of Heart Rate, Synchronicity of Pressure, Flow, ECG, Sounds, Valve Action, Impulse Propagation, Normal ECG, Electrophysiology; Ion Channels and Currents
  • Ventricular Function: Frank-Starling Law, Preload and Afterload, Intracardiac Pressure, Force, Velocity, Length, Rate of Shortening, Myocardial Contractility, Measurement Limitations, Cardiac Output (Determinants and Regulation), Myocardial Oxygen Utilization, Systolic and Diastolic Function
  • Venous Return: Vascular Compliance/Venous Capacitance, Controlling Factors, Muscle Action (Intrathoracic Pressure, Body Position), Blood Volume and Distribution
  • Blood Pressure: Systolic, Diastolic, Mean, and Perfusion Pressures, Intracardiac, Pulmonary, Venous, Systemic and Pulmonary Vascular Resistance, Viscosity, Baroreceptor Function
  • Microcirculation: Capillary Diffusion, Osmotic Pressure, Starling’s Law, Pre-Post Capillary Sphincter Control, Viscosity, Rheology
  • Regional Blood Flow and Its Regulation: Cerebral and Spinal Cord, Coronary, Pulmonary, Renal, Splanchnic–Hepatic, Muscle and Skin, Uterine and Placental
  • Regulation of Circulation and Blood Volume: Central (Vasomotor Center, Hypothalamic-Pituitary-Adrenal Axis), Peripheral: Receptors and Reflexes, Hormonal Control, Mixed Venous Oxygen Tension and Saturation
  • Anatomy: Normal Anatomy of Heart and Major Vessels, Coronary Circulation, Heart Conduction System; Innervation, Blood Supply of Other Major Organs
  • Pharmacology: Digitalis (Actions and Toxicity), Inotropes, Phosphodiesterase III Inhibitors (Inodilators Milrinone, Others), Antiarrhythmics, Antianginal Drugs, Vasodilators (Nitroprusside, Nitroglycerin, Hydralazine, Nesiratide, Calcium Channel Blockers, Others), Angiotensin Converting Enzyme Inhibitors and Angiotensin Blockers, Electrolytes (Potassium, Magnesium, Phosphorus, Calcium), Cardiovascular Effects, Non-Adrenergic Vasoconstrictors: Vasopressin and Congeners

Gastrointestinal / Hepatic Systems

  • Physiology: Hepatic Function (Dual Blood Supply and Its Regulation)
  • Metabolic and Synthetic Functions
  • Excretory Functions
  • Mechanisms of Drug Metabolism and Excretion, Cytochrome P450

Renal and Urinary Systems/Electrolyte Balance

  • Physiology: Blood Flow, Glomerular Filtration, Tubular Reabsorption and Secretion, Renal Function Tests, Hormonal Regulation of Extracellular Fluid, Hormonal Regulation of Osmolality, Regulation of Acid-Base Balance, Drug Excretion, Water and Electrolytes: Distribution and Balance, Compartments
  • Pharmacology: Diuretics (Mechanism of Action, Comparison of Drugs, Effect on Electrolytes and Acid-Base Balance, Adverse Effects), Dopaminergic Drugs

Hematologic System

  • Pharmacology Anticoagulants, Antithrombotics, and Anti-Platelet Drugs (Mechanism of Action, Comparison of Drugs, Drug Interaction, Monitoring of Effects, Side Effects and Toxicity)
  • Alternatives to Transfusion: Hemodilution, Sequestration, Autotransfusion, Blood
    Substitutes, Erythropoietin
  • Immunosuppressive and Anti-Rejection Drugs
  • Transfusions: Indications, Blood Preservation, Storage, Blood Filters and Pumps, Effects of Cooling and Heating, Blood Warmers, Blood Components, Volume Expanders, Preparation for Transfusion (Type and Cross, Type and Screen, Uncrossmatched Blood), Autologous Blood, Designated Donors, Synthetic and Recombinant Hemoglobins
  • Transfusion Reactions: Febrile, Allergic, Hemolytic (Acute and Delayed), Complications of Transfusions, Infections (Hepatitis, Human Immunodeficiency Virus [HIV], Cytomegalovirus [CMV], Others), Citrate Intoxication, Electrolyte and Acid Base Abnormalities, Massive Transfusion: Coagulopathies, Hypothermia, Pulmonary (Transfusion-Related Acute Lung Injury [TRALI], Transfusion-Related Circulatory Overload [TACO], Immunosuppression

Endocrine and Metabolic Systems

  • Physiology: Hypothalamus, Pituitary, Thyroid, Parathyroid, Adrenal Medulla, Adrenal Cortex and
  • Biochemistry of Normal Body Metabolism: Carbohydrates, Aerobic and Anaerobic Utilization, Chemical Processes, Enzymes, Relationship to Hormones, Insulin, Human Growth Hormone, Glucocorticoids,
    Glucagon, Epinephrine, Effect of Stress
  • Proteins: Functions, Hormones, Antibodies, Cyclic Adenosine Monophosphate (CAMP); Cyclic Guanosine Monophosphate (CGMP)
  • Lipids: Triglycerides, Lipoproteins, Cholesterol (Specific Organ Metabolism (Brain, Heart, Liver, Muscle)

Neuromuscular Diseases and Disorders

  • Physiology of Neuromuscular Transmission: Prejunctional Events (Acetylcholine Synthesis and Release, Modulation By Nicotinic and Muscarinic Prejunctional Receptors), Postjunctional Events (Acetylcholine Binding to Acetylcholine Receptors, Ion Flow Through Acetylcholine Receptor)
  • Anatomy of the Neuromuscular Junction: Prejunctional Components (Motor Neurons, Neuronal Transport System, Synaptic Vesicles), Postjunctional Components (Muscle Cell, Acetylcholine Receptor), Perijunctional voltage-gated channels
Organ Systems
Course Information
Dr. Michael Ho
Skip to toolbar