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Oral surgery > 10. General anesthesia - general anesthesia stages. Intensive care in maxillofacial surgery. > Flashcards

10. General anesthesia - general anesthesia stages. Intensive care in maxillofacial surgery. Flashcards

1
Q

Four stages of general anesthesia

A
  1. Minimal Sedation (Anxiolysis):
    * Normal response to verbal stimulation
    * No impact on airway, ventilation, or cardiovascular function
  2. Moderate Sedation (Conscious Sedation):
    * Purposeful response to verbal or tactile stimulation
    * Airway and ventilation not compromised
    * Cardiovascular function maintained
  3. Deep Sedation/Analgesia:
    * Responce after repeated or painful stimulation
    * Possible need for assistance in maintaining airway and ventilation
    * Cardiovascular function is maintained
  4. General Anesthesia:
    * Unarousable even with painful stimulation.
    * Airway intervention is required
    * Possible support needed for ventilation and potential impairment of cardiovascular function.
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2
Q

Role of an Intensive Care Unit (ICU) in a hospital setting

A
  • Patients with severe and life-threatening illnesses and injuries
  • Constant, close monitoring and support from specialist equipment and medications
  • Staffed by highly trained doctors and nurses
  • Higher staff-to-patient ratio
  • Access to advanced medical resources and equipment
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3
Q

Types of conditions commonly treated in ICUs

A
  • Acute respiratory distress syndrome (ARDS),
  • Trauma, multiple organ failure, and sepsis
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4
Q

Different types of ICUs based on medical specialties

A
  • Neonatal Intensive Care Unit (NICU):
  • Pediatric Intensive Care Unit (PICU):
  • Psychiatric Intensive Care Unit (PICU):
  • Coronary Care Unit (CCU):
  • Neurological Intensive Care Unit (NeuroICU):
  • (Trauma ICU):
  • Post-Anesthesia Care Unit (PACU):
  • High Dependency Unit (HDU): A transitional unit for patients requiring close observation and care not critical enough for ICU.
  • Surgical Intensive Care Unit (SICU): Provides care for critically ill surgical patients, managed by surgeons trained in critical care
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5
Q

Mobile Intensive Care Unit (MICU) and how it functions

A
  • Specialized ambulance equipped to provide on-scene advanced life support=>
  • Resuscitation and intensive care during transport
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6
Q

Types of equipment and systems commonly found in an ICU

A
  • Mechanical ventilators
  • Cardiac monitors, equipment for constant monitoring of bodily functions
  • Intravenous lines, feeding tubes, nasogastric tubes
  • Suction pumps, drains, catheters
  • Wide array of drugs
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7
Q

What is covered in the personal history of a patient

A
  • Habits like chewing tobacco
  • Alcohol consumption
  • Smoking, drug abuse, and exposure to commercial sex workers
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8
Q

Purpose of routine haematological investigations in oral and maxillofacial surgery

A
  • Overall health status
  • Detect infections
  • Assess nutritional status
  • Identify bleeding disorders and evaluate the immune response to facilitate postoperative recovery
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9
Q

What haemoglobin (Hb) indicates in a blood test

A

Indicates the oxygen-carrying capacity of the blood

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10
Q

Normal haemoglobin values for males and females

A
  • Females: 12 to 16 g/dL
  • Males: 14 to 18 g/dL

g/dL- grams per decilitre

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11
Q

Decreased haemoglobin value suggests

A
  • Anaemia=>iron deficiency
  • Decreased absorption of vitamins and minerals
  • Bone marrow depression, increased blood loss
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12
Q

What should be done if a patient has low haemoglobin

A

Referred to specialists

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13
Q

What a complete blood count (CBC) includes

A
  • Red blood cell count
  • White blood cell count
  • Differential white blood cell count
  • Platelet number estimation, and a blood smear description
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14
Q

Benefits of performing a CBC

A
  • Helps to determine nutritional status
  • Detect infections
  • Identify bleeding disorders
  • Evaluate the patient’s immune response
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15
Q

Normal values for red blood cell count in males and females

A
  • Females: 4.5 to 5.5 million cells per cu mm
  • Males: 4.5 to 6.2 million cells per cu mm

cu= cubic millimetres (mm3)

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16
Q

Conditions are associated with decrease in red blood cell count

A
  • Anaemia, pellagra
  • Haemorrhage, and liver disease
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17
Q

Conditions associated with an increase in red blood cell count

A
  • Polycythaemia and extreme dehydration
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18
Q

Normal values for white blood cell count in adults and children

A
  • Adults: 5000 to 10000 cells per cu mm
  • Children below 7 years: 6000 to 15000 cells per cu mm
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19
Q

Conditions that cause an increased white blood cell count (leucocytosis)

A
  • Acute infections
  • Uraemia, leukaemia, and steroid therapy
20
Q

Conditions that cause a decreased white blood cell count (leukopenia)

A
  • Aplastic anaemia, radiation therapy
  • Infectious mononucleosis, malaria, AIDS
21
Q

Physiological factors can cause an increase in WBC count

A
  • Pregnancy, exposure to heat and cold
  • Muscular exercise, and emotional stress
22
Q

Normal distribution of polymorphonuclear leukocytes (neutrophils) in a differential white blood cell count

A

Neutrophils: 50 to 70 percent

23
Q

Conditions that cause an increase in neutrophils

A
  • Infections, granulocytic leukaemia
  • Post-surgery, severe exercise
24
Q

Conditions that cause a decrease in neutrophils

A

Aplastic anaemia, viral infections, and patients undergoing radiation

25
Q

Normal distribution of lymphocytes

A

25 to 40 percent

26
Q

Conditions that cause an increase in lymphocytes

A

Viral infections, tuberculosis, mononucleosis

27
Q

Conditions that cause a decrease in lymphocytes

A

Stress, uraemia, and steroid therapy

28
Q

Normal value for platelet count

A

150,000 to 400,000 cells per cu mm

29
Q

Conditions that cause an increased platelet count

A
  • Malignancy, post-surgery
  • Iron deficiency anaemia, trauma
30
Q

Conditions that cause a decreased platelet count

A

Viral infections, and infectious mononucleosis

31
Q

Normal ESR values for males and females using Wintrobe’s method

A
  • Females: 0-20 mm/hour
  • Males: 0-10 mm/hour
32
Q

What an elevated ESR indicates

A

Chronic infections, infarctions, trauma

33
Q

Normal bleeding time by Duke’s method

A

3 to 5 minutes

34
Q

Conditions that cause an increased bleeding time

A
  • Thrombocytopenia
  • Capillary wall abnormalities (vitamin C deficiency)
  • Platelet abnormalities (drug-induced, e.g., aspirin, warfarin)
35
Q

Normal clotting time by Lee-White method

A

4 to 10 minutes

36
Q

Conditions that cause prolonged clotting time

A

Thrombocytopenia, clotting factor deficiency, and use of anticoagulants.

37
Q

Normal prothrombin time

A

12-14 seconds

38
Q

Sites bacterial cultures can be obtained from

A

Throat, sputum, draining pus,

39
Q

How cultures from the oral cavity can be obtained

A
  • Gathering exudative material=>by aspiration with a needle and syringe
  • or by using a swab
40
Q

Biopsy and why is it important

A
  • Removal of tissue from a living subject for histological evaluation
41
Q

Punch biopsy and when it is used

A
  • Small part of the lesion is obtained using a punch
  • Useful for mucosal lesions in inaccessible regions
  • May cause crushing or distortion of the tissues
42
Q

When an incisional biopsy performedand how it is done

A
  • Large diffuse lesion
  • Section of the lesion, along with normal tissue, is incised using a scalpel
43
Q

Excisional biopsy and when it is appropriate

A
  • Removal of the entire lesion
  • Appropriate for extremely small lesions (less than 1 cm)
44
Q

Normal range for fasting blood glucose values

A

Between 65 and 110 mg/100 ml of blood

45
Q

Normal postprandial (after eating) blood glucose level

A

Between 120 and 160 mg/100 ml of blood.

46
Q

Conditions associated with increased blood glucose levels

A

Diabetes mellitus, Cushing’s syndrome, pancreatitis

Oral surgery (106 decks)

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