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Sem 3 > case 10 > Flashcards

case 10 Flashcards

1
Q

What does the Glasgow Coma Scale look at?

A

eye
speech
motor

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2
Q

What is the reticular activating system formed by?

A
  • midbrain reticular formation
  • mesencephalic nucleus
  • thalamic intralaminar nucleus
  • dorsal hypothalamus
  • tegmentum
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3
Q

How can be define consciousness (in relation to neuronal activity)?

A

-neural activity of reticular activating system:

auditory, visual and ascending sensory tracts

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4
Q

What are the three phases of anaesthesia?

A
  • induction
  • maintenance
  • recovery
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5
Q

What is the triad of general anaesthesia?

A

hypnosis
analgesia
muscle relaxation

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6
Q

What hypnotics are there?

A
  • propofol
  • barbituates
  • benzodiazepines
  • isoflurane (trichloethylone, halothane, enflurane)
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7
Q

What analgesics are there?

A

opiates ie fentanyl

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8
Q

What muscle relaxants are there?

A

-depolarising
suxamethonium

-non-depolarising
atracium

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9
Q

Which type of muscle relaxant do you need to give for intubation?

A

non depolarising

ie atracium

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10
Q

What is solubility and potency of drug? (inhalant gas)

A
  • solubility = how it dilutes in the blood (you want it to have low solubility to be faster acting)
  • potency = lipid solubility: enter membrane faster
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11
Q

What do you use to measure blood gas solubility (coefficient)?

A

Oswald coefficient

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12
Q

How do hypnotics work?

A

-disrupt synaptic transmission
(pure-synaptic membrane, altering reuptake, altering binding, altering activation/ionic conduction of postsynaptic membrane)

-direct action on neuronal plasma membrane

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13
Q

What do you use to measure lipid solubility and anaesthetic potency?

A

Meyer-Overton theory

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14
Q

What are the different mu receptors and what do they do?

A

Mu1: analgesia
Mu2: respiratory depression
Mu3: vasodilation
+ dependence, constipation, nausea, vomitting, confusion, dysphoria, meiosis

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15
Q

What do you use in opiate over dose?

A

naloxone (bids to receptor without being potent: dislodges opiate)

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16
Q

How does suxamethonium work?

What are the adverse effects?

A
  • depolarising blocker: binds to ACh receptors and blocks them (very profound relaxation)
  • but short acting (broken down by AChE)

AE: muscle pain, hyperkalaemia, malignant hyperthermia, anaphylaxis

17
Q

How does curare/atracium work?

What are the adverse effects?

A
  • non depolarising blocker; structurally similar to ACh –> dipoles ACh but doesn’t cause depolarisation
  • long acting: competitive inhibitor, effect is concentration dependent (if increase ACh concentration, will no longer have inhibition because it will be displaced)

AE: hypotension, histamine release, wheeze, tachycardia or bradycardia, anaphylaxis, complete reversal)

18
Q

How does neostigmine work? when is it given? With what is it given?

A
  • reverse muscle relaxation: anti cholinesterase: stops breakdown of ACh: ACh builds up and start to displace the other drugs
  • given with glycopyrrolate: prevents neostigmine muscarinic effects
19
Q

How does propofol work?

A

binds oto beta subunit on GABA-A receptor

20
Q

When do you use a neuropsychological assessment?

A

test people with known/possible neurologic or neuropsychiatric conditions

21
Q

What do you test in a neuropsychological assessment?

A
  • range of cognitive abilities/deficits that ate known to be linked to brain structures/pathways
  • personal/interpersonal and contextual factors: psychological function
22
Q

Why do you do a neuropsychological assessment?

A
  • measuring cognitive defects/strength
  • differential diagnosis
  • guide rehab strategy
  • monitor changes over time
  • scientific investigation
  • medico-legal evaluation
23
Q

How is neuropsychological assessment carried out?

A

(imaging, spinal fluid, evoked potentials, vestibular functioning etc)

  1. basic neurological exam
  2. interviews, observation behavioural rating
  3. full measurement using standardised measures (cognitive functions including perception, memory, language and intellectual abilities)

–> rehab plan

24
Q

Which cognitive functions are measured?

A
  • perception
  • memory
  • language
  • intellectual ability

Sem 3 (20 decks)

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