CE04 Flashcards by Taylor Mastin

What is the preservative in succinylcholine and lidocaine?

Methylparabyns

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How does the number of lumens in a CVP correlate with risk of infection?

More lumens=greater risk

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What is the shortest acting NDMB?

Rocuronium

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Whats the shortest acting neuromuscular blocker?

Sux

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What is the RSI intubating dose for sux?

1.5mg/kg

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What is the RSI intubating dose for roc?

0.6-1.2mg/kg (Hall uses 1mg/kg)

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What is the RSI intubating dose for vec?

0.1mg/kg

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What’s the easiest way to assess heart rate, rhythm, and pulse pressure during preop?

Palpate radial pulse

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Which membrane is pierced by the SLN?

Thyrohyoid membrane

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Which branch of the SLN is sensory?

Internal

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Which branch of the SLN is motor?

External

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What muscle does the external branch of the SLN innervate?

Cricothyroid muscles

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What area does the internal branch of the SLN innervate?

Supraglottic region

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What is the action of the muscles innervated by the SLN?

Tensing

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What is the action of the muscles innervated by the RLN?

Adducting, abducting, shortening

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What is the only muscle innervated by the SLN?

Cricothyroid

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What 3 intrinsic muscles adduct the vocal cords?

LOT - lateral cricoarytenoid, oblique arytenoid, transverse arytenoid

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What muscle abducts the vocal cords?

Posterior cricoarytenoid

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What muscle tenses the VCs?

Cricothyroid

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What 2 muscles shorten the VCs?

Vocalis, thyroarytenoid

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What 2 muscles close the glottis?

Aryepiglottic and thyroepiglottic

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Which vein is most at risk for an occult hemorrhage?

Subclavian - most likely to bleed without us knowing

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Given an 80kg patient with an FRC of 30cc/kg, a tidal volume of 660cc, and a RR of 10/min - calculate time to preoxygenation

Time constant=volume/flow
aka FRC/alveolar ventilation

Time constant=(80kg30cc/kg)/[(660-176)10]=0.5

Multiply by 3 for 90% EtO2
=~1.5min

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Which cranial nerves innervate the extra-ocular muscles of the eye?

3, 4, 6

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Which nerves provide sensory and motor innervation to the soft palate?

Sensory - V2 | Motor - X, V3

How much neuromuscular blockade could still remain with 1/4 apparent twitches?

90-95% block

How much neuromuscular blockade could still remain with 4/4 apparent twitches?

60-80% block

How much neuromuscular blockage could still remain with 4/4 full twitches?

5-10%

What does PTT measure? What factors are excluded?

Intrinsic pathway; excludes factors 7 and 13

What does PT measure? What factor is included?

Extrinisic pathway; includes factor 7

What are the normal values for PTT

25-35 seconds

What are the normal values for PT

11-14 seconds

What are the normal values for INR

0.8-1.2

What is the risk of IV catheterization in the basilic and cephalic veins

Kinking

What is the risk of IV catheterization in the EJV

Infiltration, airway obstruction

How do you calculate MAP

Pulse pressure/3 + diastolic

What are the normal NMB monitoring values for sensory thresholds

4-5mAMPS

What are the normal NMB monitoring values for motor thresholds

12-15mAMPS

Which vein has the risk of thrombophlebitis

Cephalic

What is the purpose of the drip chamber on IV fluid tubing

Monitor flow and function

What is the supplied concentration of etomidate

2mg/ml

What is the induction drug with garlic taste

Thiopental

When was the ASA classification system established

1941

How many tubes should you prepare to be safe and cost efficient

What should you not use to inject drugs into an IV port

Hypodermic needle

What does RAE stand for, as in oral and nasal RAE tubes

The creators - Ring, Adair, Elwyn

Under what lighting do you examine a patient for peripheral catheterization

Tangential task lighting

If a venous valve is encountered when approximately half of an IV catheter has been introduced, what action should be taken?

Provide fluid flow and advance the catheter

To obtain good IVF flow, what is a practical, safe height for the IVF bag to be above the patient?

90cm

What is the most numerous cation in human cells?

K+

Which IVFs are appropriate for dilution of PRBCs or contiguous administration with PRBCs? Which are contraindicated and why?

NS. LR is contraindicated because of the presence of calcium

Which IV fluids are relatively contraindicated in patients with ESRD?

Which IV fluids provide realistic supplementation of potassium for potassium-depleted patients?

None

What is the unit of measure for a NMB monitor?

milliamps

What is the induction drug that causes hallucinations?

Ketamine

What is the induction drug that causes tonic-clonic activity?

Etomidate

What is the definition of leukocytosis

Elevated number of white blood cells (normal ~4300-10800)

What is the supplied concentration of ondansetron?

4mg/2ml (2mg/ml)

What is an indication to employ bacterial endocarditis antibiotic prophylaxis?

Patients with a prosthetic valve

How do you calculate PiO2

(Pbar-Ph2o) x FiO2

What value tells us the AMOUNT of oxygen in the blood

CaO2

What is cyanosis

Bluish coloration of skin and mucous membranes that occurs when two or more grams/liter of deoxyhemoglobin are present

What is the name of the clinical exam finding where the finger tips and nail beds appear enlarged

Clubbing

What are the 5 pathophysiologic causes of hypoxemia

1) Alveolar hypoventilation 2) V/Q mismatch 3) Frank shunt 4) Decrease PiO2 5) Diffusion defect

What drug undergoes Hofmann elimination

Cisatricurium

What is the empiric setting for NMB monitoring

40mAMPS

Which NMB causes tachycardia

Pancuronium

Which NMB can cause bradycardia

Sux

Which NMB should you use for patients with ESRD

Cis

Which phase of the capnogram is the alveolar phase

Phase III

What are the attachments of the sternocleidomastoid muscle

Clavicle and manubrium

What physiological lung volume change is associated with steep reverse trendelenberg position

Increased FRC

What is the standard VCo2 levels at rest

200ml/min

What are the 3 patient variables that most often alter the stimulation threshold for NMB monitoring in the OR

1) Temperature38.3 2) Peripheral edema 3) Electrolytes

What tests are done to assess function of the vagus nerve?

Valsalva and Mueller manuevers

What preop test should you perform in women with child bearing potential

Beta-hCG

What determines the inspired partial pressure of isoflurane

Temperature

What oral temperature is defined as a fever

Usually between 37.9-38.3 celsius