A 39-year-old woman with embolic occlusion of an iliac artery is subject to an operating room delay before perfusion can be restored. The following is/are true:

b. Earliest ultrastructural changes of ischemia in muscle include mitochondrial swelling and loss of glycogen granules

c. Phosphocreatine mediated rephosphorylation of ADP occurs for about 3 hours after ischemia

Skeletal muscle can tolerate ischemia by anaerobic glycolysis for up to 6 hours. The earliest ultrastructural changes in ischemic muscle include mitochondrial swelling and loss of glycogen granules. During ischemia, ATP levels are maintained by phosphocreatine mediated rephosphorylation of ADP until phosphocreatine levels are exhausted after about 3 hours. Of the possible causes of the “no-reflow” phenomenon, capillary obstruction by leukocytes is more likely than capillary thrombosis.