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CVSOH BVSc3 > AH Anaesthesia > Flashcards

AH Anaesthesia Flashcards

1
Q

What is ASA I classification?

A

Normal healthy animal

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2
Q

What is ASA II classification?

A

Mild systemic disease

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3
Q

What is ASA III classification?

A

systemic disease, well compensated or controlled by treatment

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4
Q

What is ASA IV classification?

A

Severe uncompensated systemic disease

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5
Q

What is ASA V classification?

A

Unlikely to survive 24 hours

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6
Q

How long should cats fast for?

A

6-8 hours

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7
Q

How long should dogs fast for?

A

8-10 hours

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8
Q

How long should you fast rabbits for?

A

Dont need to - maybe 30 mins before

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9
Q

What is anaesthesia?

A

Reversible production of a state of unconsciousness

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10
Q

What is regional anaesthesia?

A

Lack of sensation caused by interruption of sensory nerve conduction in any region of the body

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11
Q

What is sedation?

A

Allaying of irritability or excitement

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12
Q

What is analgesia?

A

Reduced sensibility to pain

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13
Q

What is narcosis/hypnosis?

A

Sleep like state

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14
Q

What is the sequence of events of anaesthesia?

A 
Owner conversation/consent
Pre-op exam
Check list/ASA classification
Premedication
Induction
Maintenance
Recovery and post-op care
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15
Q

What is the anaesthesia triad?

A

Narcosis
Analgesia
Muscle relaxation

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16
Q

What breed specific problem do boxers have relating to anaesthesia?

A

Cant have ACP (acepromazine)

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17
Q

What breed specific problem do collies have relating to anaesthesia?

A

Multiple drug resistance gene - drugs build up in brain
Ivermectin
Butorphanol
Acepromazine

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18
Q

What breed specific problems do greyhounds have relating to anaesthesia?

A

Low body fat and lack cytochrome P450 so need to use low dose

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19
Q

What breed specific problem do dobermanns have relating to anaesthesia?

A

Von Willebrand factor

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20
Q

What drugs are in schedule 2 of the misuse of drugs act?

A

Full mu agonists

eg. morphine, ketamine

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21
Q

What drugs are in schedule 4 of the misuse of drugs act?

A

Benzodiazepines

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22
Q

What are the two options for induction of anaesthesia?

A

Injectable anaesthesia

Inhalant anaesthesia

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23
Q

What is are the two main IV injectable induction agents?

A

Propofol

Alfaxalone

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24
Q

What is the murphy’s eye?

A

Safety hole in an endotracheal tube

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25
Q

What are the two different types of cuffs?

A

Low volume high pressure

High volume low pressure

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26
Q

Which type of cuff is the best?

A

High volume low pressure - square, pressure spread over a larger SA

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27
Q

What is a V GEL used for?

A

Rabbits

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28
Q

What is the pilot balloon?

A

Small tube that allows us to inflate and deflate the cuff inside

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29
Q

What is the cuff for?

A

Prevents gas leaking - tight seal in trachea

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30
Q

How long should an endotracheal tube be?

A

Incisors to shoulder tip - not too long as increases deadspace

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31
Q

What is a species consideration in endotracheal intubation?

A

Local anaesthetic in cats - laryngospasm

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32
Q

Best way to confirm correct endotracheal tube placement?

A

Capnograph trace

Then condensation in tube

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33
Q

What is the cylinder yolk?

A

Supports the cylinder, prevents wrong cylinder being attached

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34
Q

What system is used to prevent the cylinder being attached to the wrong inlet?

A

Pin index safety system - two protruding pins

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35
Q

What is the name of the seal in the cylinder yolk?

A

Bodok seal

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36
Q

What colour pipe signifies oxygen?

A

White

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37
Q

What colour pipe signifies nitrous?

A

Blue

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38
Q

What colour pipe signifies medical air?

A

Black with white collar

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39
Q

What is the name of the connection which prevent the wrong pipeline being attached?

A

Schrader sockets and schrader probe - wall

Non-interchangeable screw thread (NIST) - machine

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40
Q

What stops hypoxia happening with nitrous oxide?

A

Hypoxic guard

O2 failure alarm

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41
Q

What is the check valve?

A

Prevents backflow of gas to the machine - protects the machine from too much pressure

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42
Q

What measures the flow of gas?

A

Flowmeter

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43
Q

What is the minimum flow of O2?

A

200-300mL/min

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44
Q

What are the three parts of the flowmeter?

A

Flow control valve
Transparent tube
Floating bobbin/ball

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45
Q

What contains the volatile liquid anaesthetic agent?

A

Vaporiser

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46
Q

Where is the vaporiser located?

A

Downstream of the flowmeter

On the back bar of the machine

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47
Q

Where do the two streams of gas go in the vaporiser?

A

The chamber above the liquid anaesthetic
The bypass channel
The ratio of gas can be adjusted

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48
Q

Where does the breathing system attach to on the machine?

A

The common gas outlet

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49
Q

What is scavenging?

A

Removal of environmental contaminants eg. anaesthetic gases

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50
Q

What are the two types of scavenging?

A

Active and passive

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51
Q

What is active scavenging?

A

Waste gases etc. are drawn outside of building by a fan and vent system

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52
Q

What is required for active scavenging?

A

An air break to prevent negative pressure to patients breathing system

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53
Q

What is passive scavenging?

A

Patients expiratory effort pushes gases out into tube going outside building or into a activated charcoal canister

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54
Q

How is oxygen supplied?

A

Liquid oxygen from a vacuum insulated evaporator - very cold

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55
Q

What are the two main maintenance inhalational agents?

A

Isoflurane

Sevoflurane

56
Q

What is the minimum alveolar concentration?

A

The effective dose that 50% of the population needs to prevent movement in response to pain
Helps determine potency of drugs

57
Q

What does a high minimum alveolar concentration mean?

A

Low potency of volatile agent

58
Q

What has an affect on the minimum alveolar concentration?

A 
Hypothermia
Drugs
Pregnancy
Old age 
Hypotension - low blood pressure
59
Q

What has a higher blood solubility - iso or sevoflurane?

A

Isoflurane - longer to have effect and longer recovery as goes round in blood more but still good

60
Q

What has a lower minimum alveolar concentration?

A

Isoflurane

61
Q

Which is an irritant to mucous membranes - iso or sevo?

A

Isoflurane

Sevo is non irritant so good for chamber induction of smallies

62
Q

Do iso and sevo provide analgesia?

A

No

63
Q

What effect does nitrous have on the body?

A

Good analgesic

64
Q

What is the second gas effect from nitrous?

A

When the concentration gradient increases when there is more than one gas in the alveoli

65
Q

What is diffusion hypoxia from nitrous?

A

Nitrous is very insoluble in blood rapidly diffuses back into the alveoli displacing O2 after nitrous is stopped

66
Q

When are IM injections used for maintenance?

A

Quick procedures as they are difficult to control the depth, unpredictable and slow onset

67
Q

What are the different types of IV maintenance?

A

Repeat IV injections - boluses

TIVA - total intravenous anaesthesia - infusion

68
Q

What does TIVA require?

A

Syringe drive/pump

Technical skill - difficult calculations

69
Q

How can heat be lost?

A

Convection
Conduction
Radiation
Evaporation

70
Q

What stage of anaesthesia has 3 different planes?

A

Stage 3

71
Q

What is the position of the eye in plane 1 and 2 of stage 3 of anaesthesia?

A

Ventromedial

72
Q

What are the cranial nerve reflexes like in stage 2 of anaesthesia?

A

Present, may be hyperactive

73
Q

What is stage 2 of anaesthesia?

A

Between onset of unconsciousness until rhythmic breathing

74
Q

What is plane 1 of anaesthesia suitable for?

A

Minor procedures eg. skin suturing, lancing abcesses

75
Q

What is present in plane 1 of anaesthesia?

A

Pinch reflex

Palpebral reflex

76
Q

What reflexes are present in plane 2 of anaesthesia?

A

Palpebral reflex barely

Corneal reflex

77
Q

What is the position of the eyeball in plane 3 of anaesthesia?

A

Central

78
Q

What is the HR and BP like in plane 3 of anaesthesia?

A

Low

79
Q

What procedures are plane 2 and 3 of anaesthesia suitable for?

A

All procedures

80
Q

What is stage 4 of anaesthesia?

A

Overdose

81
Q

What are the characteristics of stage 4 of anaesthesia?

A 
Eye central swit hno palpebral reflex
Rapid/very slow weak pulse
Resp failure
Long capillary refill time 
Twitching in the throat
82
Q

What are some methods of monitoring anaesthesia without equipment?

A 
Peripheral pulse 
Resp rate
Eye position
Temperature
MM and CRT
83
Q

What can be used to listen to the heart from inside the animal?

A

Oesophageal stethoscope

84
Q

What does a palpebral reflex mean?

A

Anaesthesia is light

85
Q

What do ventromedial eyes mean?

A

Adequate anaesthesia

86
Q

What do central eyes mean?

A

If palpebral reflex present - light

If no palpebral reflex present - deep

87
Q

What is an arterial blood pressure measurement indicating?

A

Is an indirect indicator of blood flow

88
Q

How do you measure blood pressure indirectly?

A

Doppler/oscillometric (cuff)

89
Q

How do you measure blood pressure directly?

A

Catheter in artery

90
Q

What is the best type of indirect arterial BP measurement?

A

Doppler

91
Q

How is doppler different to oscillometric?

A

Only measures systolic, rather than both systolic and diastolic

92
Q

What artery do you use for direct blood pressure monitoring?

A

Metatarsal/dorsal pedal artery

93
Q

What does the doppler system use to detect blood pressure?

A

Ultrasonic signal which converts to an auditory signal depending on freq of RBCs

94
Q

What does the direct blood pressure monitoring system use to detect BP?

A

Pressure waves in fluid filled tubing system

95
Q

What drugs can affect blood pressure?

A

ACP

Volatile gases - iso and sevo

96
Q

What is the ideal blood pressure?

A

90mmhg systolic

97
Q

How do you treat low blood pressure?

A

Reduce volatile agent and increase local blocks/analgesia

Maybe fluids

98
Q

What information does a capnograph give you?

A

Inspired CO2
Expired CO2
Respiratory rate
Capnograph - wave form

99
Q

What should inspired CO2 be?

A

0

100
Q

What are the two types of capnography?

A

Side stream

Main stream

101
Q

How does a side stream capnograph work?

A

Takes sample of expired air to analyse

102
Q

What are the main advantages of side stream capnograph?

A

Cheaper, less likely to break

103
Q

How does a main stream capnograph work?

A

Gas is analysed inside the connector using a infrared light source and a sensor

104
Q

What are the pros and cons of main stream capnography?

A

Real time results

Very expensive, easily damaged

105
Q

What does the baseline of the capnograph trace represent?

A

The inspired gas - should be 0 CO2

106
Q

What does the first angle in the capnograph trace represent?

A

Ventilation perfusion of the lungs

107
Q

What does it mean if the first angle of the capnograph trace is greater than 90 degrees?

A

Ventilation perfusion mismath

108
Q

What does the second angle of the capnograph trace assess?

A

Rebreathing

109
Q

What does the flattening of the capnograph mean?

A

Alveolar plateau - last bit of the alveolar gas sample

110
Q

What is the end tidal CO2 in dogs?

A

35-45mmhg

111
Q

What could cause low end tidal CO2?

A

Hyperventilation - less CO2 build up
Low cardiac output
Hypothermia
Leak

112
Q

What can cause a patient to rebreathe CO2 using a non-rebreathing system?

A

Too low fresh gas flow - CO2 not being pushed out of system

Too much dead space

113
Q

What can cause a patient to rebreathe CO2 using a rebreathing system?

A

Exhausted absorbent - soda lime

Faulty/sticky valves

114
Q

What info does ECG give you?

A

Heart rate - not CO tho

ECG trace

115
Q

Where are the ECG adhesive pads placed?

A

On paws

116
Q

What are the colours of the ECG leads?

A

Red, yellow, green - traffic light

117
Q

Where does each colour of ECG lead go on the animal?

A

Red - right fore
Yellow - left fore
Green/black - left hind

118
Q

What does the P wave represent on an ECG?

A

Atrial depolarisation

119
Q

What does the QRS complex represent on the ECG?

A

Ventricular depolarisation

120
Q

What does the T wave represent on the ECG?

A

Ventricular repolarisation

121
Q

What is a first degree block on an ECG?

A

Prolonged distance between P and R waves

Signal is struggling to get through but does eventually

122
Q

What is a second degree block on an ECG?

A 
Beat stops (either randomly or progressively gets longer)
Intermittent passage through the AV node
123
Q

What is a third degree block on an ECG?

A

Complete heart block, signal wont pass to AVN at all

124
Q

What is different about a horse ECG?

A

QRS complex is negative - leads different places

125
Q

What info does a pulse oximeter monitor?

A

Haemoglobin O2 saturation levels

Pulse rate

126
Q

Where does a pulse ox fit on the animal?

A

Tongue

127
Q

How does a pulse ox monitor the oxyhaemoglobin?

A

Light emission/detector

Oxyhaemoglobin absorbs more infrared light/less red light

128
Q

What is not a good reading on a pulse ox?

A

95-90% - not great

less than 90% - bad

129
Q

What can be an issue with pulse ox?

A

Can give false readings
Pigmentation bad
Poor perfusion/anaemia

130
Q

When should you deflate the cuff during recovery?

A

When close to extubation, not when you turn volatile agent off

131
Q

When do you extubate dogs/rabbits?

A

When laryngeal reflexes return (swallowing)

132
Q

When do you extubate cats?

A

Before laryngeal reflexes return - danger of laryngospasm

Ear flick and blink reflexes

133
Q

When do you do late extubation?

A

Brachycephalic

134
Q

What should you monitor during recovery?

A

Temperature
Pulse
Respiration

135
Q

What is a common issue in recovery?

A

Hypothermia

136
Q

How do you monitor discomfort in recovery?

A

Composite pain scales
Grimace scales
Behavioural assessment

CVSOH BVSc3 (60 decks)

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