Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

surgery class > anesthesia > Flashcards

anesthesia Flashcards

1
Q
  • general anesthesia via vaporizer and carrier gas
  • when inhaled partial pressure of gas = blood and goes through body
  • dose is percent end-tidal agent and MAC is end-tidal level of gas needed to prevent movment to noxious stimulate in 50% of patients
A

inhaled anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

3 cardiac effects of inhaled agents

A

decreases 3 things: contractility, SVR and MAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  • ischemia in pt with fixed stenotic lesions
  • valvular heart disease
  • cardiomyopathy
  • congenital defects

these are implications of cardiac effects of what type of anesthesia?

A

inhaled agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what MET level are you concerned about with a patient going into surgery?

A

less than 4 METs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

3 signs of CHF

A

JVD
L.E edema
crackles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

4 pulm effects of inhaled agents

A
  • bronchodilation
  • decreased respiratory drive
  • increased respiratory rate with decreased tidal volume
  • atelectasis
  • increased CO2 threshold to breathe– issue for OSA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

decreased breath sounds suggests what 4 conditions might be at play?

A

atelectasis
infection– could also have crackles or rhonchi
COPD
pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

2 CNS effects of inhaled agents

A
  • increased cerebral blood flow & ICP
  • decreased cerebral metabolic demand
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

4 neuro labs/imaging to get

A

CT/MRI for mass effect
plasma levels of anticonvulsant meds
carotid US for detection of carotid dz
MRI for ischemic changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

fam h.o prolonged medication reactions is indicative of …

A

pseudocholinesterase deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

fam h.o high fevers, unexplained cardiac arrest is indicative of …

A

malignant hyperthermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is this condition? what 3 things can happen as it progresses?

  • autosomal dom defect in ryanodine receptor that releases calclium
  • hypersensitive to releasing stimuli & hyposensitive to inactivating signals
A

malignant hyperthermia
- acidosis, hyperK, arrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

2 triggering agents of MH

A
  • volatile anesthetic gasses– sevo-, iso-, des-flurane
  • succinylcholine (nondepolarizing muscle relaxant)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

2 things you see with MH

A
  • increased: RR, CO2, HR, temp
  • myoglobinuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how is MH tx

A
  • stop agent, give DANTROLENE 2.5mg/kg
  • support: decrease temp, manage hyperK
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3 components of general anesthesia

A

analgesia
hypnosis
muscle relaxant

17
Q

2 muscle relaxants

A

succinylcholine
NDMR

18
Q

propofol is what type of GA

A

IV hypnotics

19
Q

phases of GA (9)

A
  1. pretreatment
  2. monitoring
  3. time out
  4. pre-oxygenation
  5. induction
  6. airway mangement
  7. maintenance
  8. emergence
  9. recovery
20
Q

what phase of GA is this

  • goal is to reduce complications
  • meds commonly given prior to patient arriving in the OR
A

pretreatment

21
Q
  • anxiolytics (midazolam)
  • olanzapine, meclizine, scopolamine
  • Na bicitrate, famotidine– aspiration risk reduction
  • metoclopramide
  • albuterol
A

pretx meds

22
Q

Every patient shall have arterial blood pressure and heart rate determined every __ minutes

A

5

23
Q

goal pre-ox

A

90%

24
Q

What is the gas agent used in mask inductions?

A

Sevoflurane

25
Q

most common supraglottic airway

A

Laryngeal mask airmway (LMA)
- they are placed in posterior oropharynx above the glottis

26
Q
  • less secure than ETT & doesn’t protect from laryngospasm and aspiration
  • no need for muscle relaxant
  • doesn’t irritate the trachea
  • less coughing and bucking
A

supraglottic airways

27
Q
  • can cause HTN and tachy on placement/removal & can be hard to place
  • irritating to the trachea causing coughing, bronchospasm
  • can still move air if patient laryngospasms
A

ETT

28
Q
  • spinal/subarachnoid block
  • epidural block
  • combined spinal-epidural (CSE)
A

neuraxial regional anesthesia

29
Q

which spinal anesthetic lasts longest? shortest?

A

longest: tetracaine
shortest: chloroprocaine

30
Q

used in:
- c section
- knee & hip replacement surgery
- foot & ankle surgery
- urology surg
- below umbilicus if not candidate for GA

A

spinal anesthesia

31
Q
  • rapid onset w/ very low dose with no CNS effect
  • can cause rapid drop in BP
  • if high can cause bradycardia & profound hypotension (T1-4), paralyze the diaphragm (C3-5)
A

spinal anesthesia pros and cons

32
Q
  • used in lumbar or thoracic space
  • higher concentration for surgical anesthesia; lower for analgesia
  • can be enhanced by adding narcotic or epi
A

epidural

33
Q

uses:
- labor & post op analgesia
- csection if in place for labor
- L.E or urology w/ uncertain duration
- thoracic and abdominal procedures intra and post op

A

epidural uses

34
Q
  • can be used for indeterminate op. length
  • used intraop and postop
  • sympathectomy more controlled
  • slower onset & less dense block; more finicky
  • larger dose of LA needed ; potential for dural puncture or epidural hematoma d/t larger needle
A

epidual pros and cons

35
Q
  • avoid general anesthesia if used as primary anesthetic
  • better post-op pain control
  • less narcotic need while blocking; faster discharger
  • increased blood flow to surgical site
  • Cannot be used for breast surg or paravertebral blocks
  • potential for permanane nerve injury and local anesthetic systemic toxicity (LAST), bleding, infection
A

peripheral regional

36
Q
  • combo of IV agents for deep sedation used to make patient comfy for procedures
  • risks: awareness & unprotected airway
  • agents: BZD, narcotics, hypnotics, ketamine
A

MAC (monitored anesthesia care)

surgery class (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions