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Anesthesiolgy > Anesthetic Depth and Monitoring > Flashcards

Anesthetic Depth and Monitoring Flashcards

1
Q

What is the use of EEG?

A
  • gives information about cortical, but not subcortical activities
  • correlates with anesthetic depth, but does not predict arousal
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2
Q

What is BIS?

A
  • bispectral index monitor
  • provides number between 0 and 100
  • easier to interpret than EEG
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3
Q

Describe Stage 1 of anesthesia

A
  • voluntary movement
  • from drug administration to loss of consciousness
  • excitement and struggle may occur
  • epinephrine release, tachycardia, irregular breathing, coughing
  • pupillary dilation
  • ataxia, recumbency
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4
Q

Describe Stage 2 of anesthesia

A
  • involuntary movement
  • from loss of consciousness until onset of regular breathing
  • state of delirium, struggling and exaggerated reaction to stimuli
  • epinephrine release, tachycardia, irregular breathing
  • pupillary dilation, strong palpebral reflex
  • strong jaw tone, intubation not possible
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5
Q

Describe Stage 3 of anesthesia

A
  • general anesthesia
  • from onset of regular breathing until cessation of effective breathing
  • no movement in response to stimuli
  • progressive muscle relaxation, loss or reflexes, and respiratory depression
  • 3 planes
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6
Q

Describe Plane 1 of Stage 3 of anesthesia

A
  • light anesthesia
  • weakening palpebral and corneal reflexes
  • no swallowing reflex
  • pupils constricted
  • no involuntary movement
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7
Q

Describe Plane 2 of Stage 3 of anesthesia

A
  • medium anesthesia
  • progressive intercostal paralysis
  • stable respiration and pulse
  • loss of laryngeal reflexes
  • weak palpebral, strong corneal reflexes
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8
Q

Describe Plane 3 of Stage 3 of anesthesia

A
  • deep anesthesia
  • diaphragmatic breathing
  • pupils dilate, eyes central
  • no palpebral/corneal reflexes
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9
Q

Describe Stage 4 of anesthesia

A
  • overdose
  • respiratory failure
  • cardiac arrest
  • death
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10
Q

What depth of anesthesia is indicated by rotated eyes?

Central eye + dilated pupil?

A

rotated: stage 3, plane 2
central: both too light or too deep

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11
Q

What depth of anesthesia is indicated by spontaneous eye movement?

A

too light anesthesia

arousal may be imminent

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12
Q

What depth of anesthesia is indicated by spontaneous blinking?

A

too light anesthesia

slow blinking may be seen in horses

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13
Q

What depth of anesthesia is indicated by lacrimation?

A

light but appropriate depth

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14
Q

What is occurring during the P wave of an ECG?

A

atrial depolarization: contraction

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15
Q

What is occurring during the QRS complex of an ECG?

A

ventricular depolarization

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16
Q

What is occurring during the T wave of an ECG?

A

ventricular repolarization

17
Q

Describe the mammalian type A conduction system

A
  • purkinje fibers excite the endocardium only
  • excitation spreads via muscle fibers
  • generates base-to-apex current flow
  • humans and small animals
18
Q

Describe the mammalian type B conduction system

A
  • purkinje fibers penetrate the myocardium
  • most of the myocardium is excited simultaneously
  • generates apex-to-base current flow
  • negative R wave
  • horses, ruminants, pigs
19
Q

What is the set up of B-type leads?

A

white: right jugular furrow or withers (RA)
black: cardiac apex region (LA)
red: anywhere else (LL)

20
Q

Which is the highest point of the BP curve?

Which is the lowest point?

A

systolic pressure is the highest point

diastolic pressure is the lowest point

21
Q

What is the equation for BP?

A

BP = (HR x SV) x SVR
HR x SV = CO
SV - stroke volume
SVR - systemic vascular resistance

22
Q

Where do you position the transducer to measure blood pressure?

A

at the level of the base of the heart

  • point of shoulder in sternal recumbency
  • point of sternum in lateral recumbency
23
Q

What values of PaO2 and SaO2 indicate hypoxemia?

A

PaO2 < 60 mmHg

SaO2 < 90%

24
Q

What affects the results of a pulse ox reading?

A
  • tissue thickness
  • hypoperfusion (vasoconstriction)
  • anemia
  • pigmentation
  • movement
  • presence of abnormal Hb species
25
Q

When should a pulse ox be used?

A
  • if patient is breathing room air
  • if there is a V/Q mismatch
  • if there is a respiratory disease
26
Q

What are the normal PaCO2 values?

A

35-45 mmHg

27
Q

Effects of hypothermia

A
  • < 96F
  • decreases MAC of anesthetics
  • CV system may be depressed
  • recovery prolonged
28
Q

Effects of hyperthermia

A
  • > 102F
  • increases MAC of anesthetics
  • may damage CNS

Anesthesiolgy (10 decks)

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