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Principles semester 2 > Cardiovascular anesthesia > Flashcards

Cardiovascular anesthesia Flashcards

Denise

1
Q

retrograde autologus priming uses

A

pt blood to displace crystalloid primed pump tubing

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2
Q

when full flow on pump is confirmed, you should

A

turn vent to bag and monitor to bypass mode. Sevo off

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3
Q

Most difficult crawford aneurysms to remair

A

1 and 2

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4
Q

Crawford 2 aneurysm has significant risk for

A

paraplegia and renal failure

artery of adamkiewicz

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5
Q

Which dissection is a surgical emergency

A

acute dissection of ascending aorta

often includes aortic valve

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6
Q

which dissection is usually medically manaanged

A

descending aorta (unless ruptured or leaking)

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7
Q

Classic AAA triad

A
  1. hypotension
  2. back pain
  3. Pulsatile abdominal mass
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8
Q

higher clamp generally means

A

greater insult

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9
Q

how many posterior spinal arteries are there and what is perfused

A

2 posterior spinal arteries perfuse posterior 1/3 of the spinal cord

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10
Q

How many anterior spinal arteries are there and what is perfuse

A

1 anterior spinal artery
perfuses anterior 2/3 of spinal cord

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11
Q

Most important of paired radicular arteries

A

artery of adamkiewcz

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12
Q

What does the artery of adamkiewicz perfuse and where does it originate

A

anterior cord in thorocolumabr region

usually originates on left between T11 and T12

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13
Q

watershed areas

A

regions of spinal cord that have single blood supply

particularly vulnerable to ischemia

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14
Q

Which region of cord is highly dependent on artery supply and result

A

Thoracolumbar region of anterior spinal cord

interruption of radicular flow can cause ischemia/infarction

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15
Q

Cross clamping avove artery of adamkiewicz can cause

A

anterior spinal syndrom

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16
Q

s/sx anterior spinal syndrome

A

aka beck’s syndrome
1. flaccid paralysis of lowers
2. bowel/bladder dyfuction
3. loss temp and pain sensation

touch and proprioception is preserved!

17
Q

corticospinal tract is perfused by

A

anterior blood supply

(flaccid paralysis)

18
Q

Autonomic motor fibers are perfused by

A

anterior blood supply

(bowel/bladder)

19
Q

Spinothalmic perfushed by

A

anterior blood supply

loss of temp/pain sensation

20
Q

Dorsal column perfused by

A

posterior blood supply

touch/propreoception preserved

21
Q

Perfused by anterior blood supply (3)

and what is each responsible for?

A
  1. corticospinal tract (r/t flaccid paralysis)
  2. autonomic motor fibers (r/t bowel/bladder)
  3. spinothalmic (r/t loss of temp/pain sensation)
22
Q

perfused by posterior blood supply

A

Dorsal column (touch/proprioception)

23
Q

Amaurosis Fugax

A

blindness in one eye

sign of impending stroke

emboli from ICA to opthalmic artery

24
Q

Best neuro monitoring

A

an awake patient

25
Q

CPP =

A

MAP - ICP (or CVP, whichever is higher)

26
Q

What increases EEG frequency

A
  1. mild hypercarbia
  2. early hypoxemia
  3. seizure
  4. ketamine
  5. N2O
  6. light anesthesia
27
Q

What decreases EEG frequency

A
  1. very hypercarbic
  2. hypoxic
  3. cerebral ischemia
  4. hypothermia
  5. OD of anesthetic
  6. opioids
28
Q

carotid stump pressure that indicates possible cerebral hypoperfucsion

A

<50 mmHg

carotid stump measurement is taken distal to clamp

29
Q

Surgical stimulation of carotid endardectomy can activate

A

baroreceptor relfex

30
Q

baroreceptor relfex management

A
  1. glycopyrrolate (possibly pre medicate)
  2. ask surgeon to stop
  3. infiltrate carotid body with local anesthetic
31
Q

Hypercarbia can create a (carotid endardectomy)

A

steal phenomenon and shunt blood away from hypoperfused cerebral tissue

32
Q

Carotid endardectomy hematoma considerations

A

can cause compromised airway

may not see it at site but can cause tracheal deviation

may need trach

33
Q

balloon inflation in carotid artery stenting

A

Balloon inflation–>baroreceptors–>bradycardia–>hypotension

pretreat with glycopyrrolate or atropine

34
Q

most common complication of carotid artery stenting

A

thromboembolic stroke d/t debris

35
Q

TransCarotid Artery Revascularization

A

blood flow is reversed in area of blockage

reducesrisk of stroke during balloon inflation

36
Q

reversal of blood flow in TCAR reduces risk of

A

stroke during balloon inflation

clot gets caught in machine

Principles semester 2 (17 decks)

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