APIC Flashcards
(49 cards)
What receptor are neuromuscular blockade drugs specific for?
nicotinic acetylcholine receptor
Where does the trachea begin?
At the level of the thyroid cartilgae C6
What level dose the trachea bifrucate
T5
When to suspect difficult bag mask ventilation
BONES Beard Obesity/ Obstetrics No teeth Elderly Sleep Apnoea
Proper positioning for intubation
“sniffing position” : flexion of lower C spine (C5,6), i.e bow head forward and extension of upper C spine at atlanto (C1) - occipital joint, ie. nose in the air
aligns the 3 axes of mouth, pharynx and larynx to allow visualisation from the oral cavity to the glottis
proper position for laryngoscope tip to visualise cords is in the epiglottic vallecular
contraindicated in known/ suspected C spine fracture/ instability
Differential Diagnosis of Poor bilateral breath sounds after Intubation
DOPE Displaced ETT Obstruciton Pneumothorax Esophageal intubation
ASA Classfication
1: Normally healthy
2: Mild systemic disease, but with no limitation of activity
3: Severe Systemic disease that limits activity; not incapacitating
4: Incapacitating systemic disease which poses a threat to life
5: Moribund. Not expected to survive 24 hour even with operation
6: Braindead patient whose organs are being removed for donor purposes
State which stage of anesthesia each of the following descriptions refers to? Delirium; violent behavior; increased blood pressure; increased respiratory rate; irregular breathing
rate and volume; amnesia; retching and vomiting with stimulation; disconjugate gaze
Stage II (excitement)
State which stage of anesthesia each of the following descriptions refers to? Depression of vasomotor center; depression of respiratory center; death may occur
Stage IV (medullary depression)
State which stage of anesthesia each of the following descriptions refers to? Eye movements cease; fixed pupils; regular respiration; relaxation of skeletal muscles
Stage III (surgical anaesthesia)
State which stage of anesthesia each of the following descriptions refers to? Loss of pain sensation; patient is conscious; no amnesia in early part of this stage
Stage I (analgesia)
Give Examples of inhaled anaesthetics
sevoflurane; desflurane; nitrous oxide;
isoflurane; enflurane; methoxyflurane Halothane;
With regard to inhaled anesthetics, what does MAC stand for?
minimum alveolar concentration
What is MAC in regard to inhaled anesthetics?
The concentration of inhaled anesthetic required to stop movement in 50% of patients following a surgical stimulus; a measure of potency for inhaled anesthetics
Which inhaled anaesthetic has the largest MAC?
Nitrous oxide
Which inhaled anaesthetic has the smallest MAC
Halothane
As lipid solubility of an inhaled anesthetic increases, what happens to the concentration of inhaled anesthetic needed to produce anesthesia, that is, does it increase or decrease?
Decreases
What is the blood/gas partition coefficient?
The ratio of the total amount of gas in the blood relative to the gas equilibrium phase. It refers to an inhaled anesthetic’s solubility in the blood.
Are MAC values higher or lower in elderly patients
Lower
Are MAC values higher or lower when opioid analgesics and/or sedative hypnotics are used concomitantly?
Lower
What is the role of the periaqueductal gray matter?
Primary control centre for descending pain modulation
enkephalin?
endogenous opiod neurotransmitter
Substantia gelatinosa
where the first order neuron of the spinothalamic tract synapses n
Do inhaled anesthetics increase or decrease the response to Pco2 levels?
Decrease
