Anesthesia Clerkship

Question 1

What nerve innervates the posterior tongue, pharynx,tonsils, soft palate, and the anterior surface of the epiglottis?

Answer 1

Glossopharyngeal nerve (CN IX)

Question 2

What nerve innervates the posterior surface of the epiglottis and the glottis?

Answer 2

Superior Laryngeal nerve (CN X)

Question 3

What nerve innervates the larynx below the level of the glottis and the trachea?

Answer 3

Recurrent laryngeal nerve (CN X)

Question 4

Typical induction sequence

Answer 4

Preoxygenation (5 minutes or 4 vital capacity breaths), IV opioid (decrease sympathetic response to laryngoscopy/intubation), induction agent, mask ventilation (peak pressure of 20), muscle relaxant, intubation

Question 5

Meyer-Overton Rule:

Answer 5

the potency of inhalation agents directly correlates with their lipid solubility

Question 6

List the inhalational anesthetics in order of solubility in blood (high to low).

Answer 6

Halothane > Isoflurane > Sevoflurane > NO/Desflurane

Question 7

MAC NO

Answer 7

105

Question 8

MAC Halothane

Answer 8

0.75

Question 9

MAC Isoflurane

Answer 9

1.2

Question 10

MAC Desflurane

Answer 10

6.0

Question 11

MAC Sevoflurane

Answer 11

2.0

Question 12

List things that decrease the MAC:

Answer 12

Hypo/hyperthermia, age (6% per decade), acute EtOH, anemia, hypoxia, hypercarbia, hypotension, hypercalcemia, hyponatremia, pregnancy

Question 13

List things that increase the MAC

Answer 13

Youth, chronic EtOH, hypernatremia, acute amphetamines, cocaine, ephedrine

Question 14

Stages of Anethesia

Answer 14

1) Analgesia, 2) Excitement, 3) Surgical Anesthesia, 4) Medullary Paralysis

Question 15

This inhalational agent irreversibly oxidizes vitamin B12, thus inhibiting the enzymes which require it.

Answer 15

Nitrous oxide

Question 16

These inhalational agents have trifluoroacetic acid as a metabolite

Answer 16

Halothane and isoflurane

Question 17

With this inhalational agent, you should check for carboxyhemoglobin

Answer 17

Desflurane

Question 18

This inhalational agent can increase compound A producton, leading to theoretical nephrotoxicity.

Answer 18

Sevoflurane