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NCERT ECC IMPROVE INTERNATIONAL > Anaesthesia and Analgesia > Flashcards

Anaesthesia and Analgesia Flashcards

1
Q

What are 5 things you should consider when making an GA plan

A

Signalment
Brief History
Current medication
Procedure

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2
Q

What should be done for a clinical exam of a patient before a GA

A 
Temperature 
pulse rate and quality 
heart ausc 
chest ausc 
MM 
CRT 
Weight
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3
Q

What are Dobermanns prone too

A

DCM

Vonn Willebrans disease - coagulation issues

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4
Q

What can ACP cause in boxers

A

vasovagal syncope, hypotension and collapse

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5
Q

What are some complications that can arise for a patient during induction

A

Apnoea
Collapse
Hypoventilation
Regurgitation and aspiration

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6
Q

What are some complications that can arise for a patient during a GA

A 
Hypotension 
Hypoxia 
Hypoventilation 
Regurgitation and aspiration 
Hypothermia 
Hypercapnia
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7
Q

What is the definition of SAP ( Systolic arterial pressure )

A

the pressure during cardiac contraction

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8
Q

What is the definition of MAP (Mean arterial pressure)

A

average pressure in the vessels during one cardiac cycle

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9
Q

What is the definition of DAP (dilated arterial pressure)

A

the pressure during cardiac relaxation

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10
Q

What is Cardiac output (CO)

A

The amount of blood pumped from the left ventricle per minute

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11
Q

What is Stroke Volume (SV)

A

The amount of blood pumped from the left ventricle per beat

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12
Q

What is SVR (systemic vascular resistance

A

The resistance that must be over come to push blood through the circulation and create flow.

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13
Q

What is preload

A

The initial stretching of the cardiac muscle cells prior to contraction

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14
Q

What is afterload

A

The force against which the heart has to contract to eject blood

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15
Q

What is cardiac contractility

A

Myocardial contractility is the ability of the heart muscle

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16
Q

How do you treat hypotension

A
  1. Determine underlying cause (bleed)
  2. Reduce volatile agents
  3. Restore any deficits (bolus?)
  4. Ensure other parameters are normal
  5. vasopressors ( noradrenaline, ephedrine)
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17
Q

When is hypoventilation likely?

A

Due to reduced ventilatory drive (drugs hypothermia CNS depression)
Inability to ventilate properly (open thorax, muscle failure, incorrect tube placement)

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18
Q

What does a normal breathing pattern entail

A

Ribs moving in and out

Negative pressure is produced

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19
Q

What are 5 factors effecting respiration

A

Overweight
Tumours
Environment factors
Species variation (brachy)

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20
Q

What are some abnormalities with a dog with BOAS

A 
Stenotic nares 
Nasal turbulence 
Elongated/thickened soft palate 
Laryngeal collapse 
Fibrotic lungs
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21
Q

What should be avoided in a patient with BOAS

A

Stress
Heat
High doses of sedation

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22
Q

What are some examples of procedures that have respiratory comprised patients under GA

A

BOAS
Bronchoscopy (e.g BAL)
Thoracotomy

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23
Q

What is oxygenation

A

The process of delivering oxygen from the alveoli to the cells of the body.

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24
Q

How is oxygenation monitored

A

Pulse oximetry

Arterial blood gas

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25
What is Ventilation
The process of delivery air to the alveoli within the lungs. 'The act of breathing'
26
What is capnography
A measurement of inspired and expired carbon dioxide
27
What is end tidal CO2
The partial pressure of cO2 at the end of exhaled breath
28
What can a decreased CO2 mean
reduced cardiac output reduced metabolic rate hypothermia
29
what is myocardial oxygenation
the balance between myocardial oxygen delivery and myocardial oxygen demand
30
What will happen if the myocardium becomes hypoxic
it will throw arrhythmias and wont contract efficiently
31
What are 5 things that cardiac disease may influence on anaesthesia
1. the cardiovascular functional reserve may be eroded 2. Drugs used may impair the cardio function. 3. Cardio disease effect organ systems 4. Cardiac disease alters drug disposition and distribution 5. Treatment of cardio disease including medication can interact with GA
32
What are 5 anaesthetic considerations when dealing with a cardiac patient
``` Keep giving cardiac meds up until GA Avoid stress Pre and post oxygenation Avoid fluid overload ensure adequate analgesia ```
33
What is an opioid
A drug that acts on opioid receptors to produce morphine like effects
34
Where are opioid receptors found
central and peripheral nervous system | GI tract
35
What is an agonist
a chemical that binds to and activates the receptor to produce a biological response
36
What is an antagonist
A chemical that binds to a receptor and blocks the receptor but does not activate
37
Full agonist
Bind to a activates the receptors with maximum response
38
Partial agonist
drug that binds to and activates a given receptor but only has partial efficacy compared to a full agonist
39
What are the 3 classes of opioids
Mu Kappa Delta
40
What is fentanyl
a full mu agonist
41
what is morphine
a full mu receptor agonist
42
what is methadone
a full mu receptor agonist | NDMA receptor
43
What is buprenorphine
partial mu receptor agonist
44
What is butorphanol
mu opioid antagonist and kappa opioid agonist
45
What is an NSAID
Non steroidal anti inflammatory drug
46
How to NSAIDS work
by the inhibition of COX1/COX2 enzyme which make certain mediators (prostaglandins)
47
What is prostaglandins in terms of NSAIDs
prostaglandins are involved in the inflammatory response and coagulation
48
What is the COX 1 enzyme responsible for
house keeping - GI protection coagulation renal blood regulation
49
what is COX2 enzyme responsible for?
Producing prostanoids mediating inflammation
50
What does a local anaesthetic do?
It decreased transduction or transmission of a noxious stimulus to the spinal chord or the brain
51
What will a local agent do that an analgesic agent wont
a local agent will completely get rid of pain
52
What affect with an alpha 2 have on the body
vasoconstriction and increase in afterload decrease in heart rate and increase in stroke volume reduced cardiac output
53
What is the transduction pain path way and an example
A nociceptive stimulus that turns a noxious stimulus into a transmissible signal example - skin bone tissues
54
What is the transmission pain path way
The message from the transduction pain is transmitted via peripheral nerves to the spinal chord/dorsal horn
55
What is the modulation pain path way
The modulation of pain involves changing or inhibiting transmission of the pain impulses in the spinal chord
56
What is the perception pain path way and an example
TRANSDUCTION TRANSMISSION MODULATION PERCEPTION The cerebral cortex knows exactly where the pain is from (or where it will hurt). e.g pain, fear or pleasure
57
What are the 4 pain pathways
Transduction Transmission Modulation Perception
58
Define pain
An unpleasant sensory and emotional experience that associated with actual or potential tissue damage
59
Define acute pain
Pain that lasts less than 3 months
60
Define chronic pain
pain that lasts more than 3 months
61
Define Allodynia
central pain sensation following a normal non painful stimuli
62
Define hyperalgesia
Increased sensitivity to stimuli that would normally be painful
63
Somatic pain
Occurs when pain receptors in tissue are activiated (skin,muscle, joint, connective)
64
Visceral pain
Pain that results from the activation or nociceptors of the thoracic pelvis or abdominal viscera.
65
What is a recumbent patient
a patient that cannot rise and involuntarily lies down
66
What is a critical patient
a patient that requires a highly level of nursing intervention and anything can change at any moment
67
what is Kirbys rule of 20
``` veterinary nursing check list for critical patients fluid balance o2 and ventilation heart rate and rhythm Glucose Temp Albumin electrolytes Mentation RBC haematology GI mobility nutrition renal function coags infection control and immune systems drug dose metabolism wound care nursing TLC ```
68
What is the suggested formula for calculating RER
(70xBTW)^0.75
69
What are some types of nutritional feeding tubes
naso-oesophageal oesophageal Gastrotomy enerostomy/jejunostomy
70
What is a HAI
Hospital acquired infection
71
What are 4 causes of HAI
animal person contact indirect contact droplets (airborne)

NCERT ECC IMPROVE INTERNATIONAL (8 decks)

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