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Advanced Principles I > Exam 2 > Flashcards

Exam 2 Flashcards

0
Q

Thoracic procedures may require what type of ventilation?

A

One-lung

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1
Q

What is a wake up test?

A

Wake pt in the middle of surgery and have them move to test motor function. Usually just for scoliosis repair.

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2
Q

ALIF

A

Anterior lumbar interbody fusion

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3
Q

Benefits of ALIF

A

Usually has less blood loss; muscle preservation

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4
Q

Type and cross for how many units for back surgery?

A

At least 2

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5
Q

Restrictions when using evoked potential monitoring

A

No muscle relaxant; 1 MAC; no N2O (narcotics and Propofol ok)

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6
Q

2 risks associated with cervical spine surgery

A
  1. Airway complication

2. Obstruction after extubation (at risk immediately and for several hours after)

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7
Q

Risks associated with cervical spine surgery are increased under what 3 conditions?

A
  1. Surgery lasting > 5 hours
  2. Blood loss > 300 mL
  3. Surgical exposure of > 3 levels
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8
Q

What is the sclera?

A

Continuous with the cornea at the corneoscleral junction; the posterior sclera is perforated by the optic nerve. It is protective and rigid and maintains the shape of the eye.

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9
Q

What is the cornea?

A

Transparent, permits light into internal ocular structures.

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10
Q

What is the uveal tract?

A

Middle layer, vascular, direct opposition to the sclera

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11
Q

What is the suprachoroidal space?

A

Potential space, separates sclera from uveal tract, can become filled with blood

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12
Q

What is the iris?

A

Includes pupil, controls the light entering the eye

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13
Q

What is a ciliary body?

A

Where aqueous humor is formed, contains muscles which adjust the shape of the lens to accommodate focusing at various distances

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14
Q

What is the retina?

A

Neuro-sensory membrane composed of 10 layers that convert light impulses to neural impulses, optic nerve brain

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15
Q

What is vitreous humor?

A

A gelatinous substance located in the center of the globe. Adherent to the anterior-most 3 mm of the retina as well as to large blood vessels and the optic nerve

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16
Q

What is a complication associated with vitreous humor?

A

May pull on retina causing retinal tears and/or detachment

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17
Q

Normal intraocular pressure

A

12-20 mmHg

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18
Q

Intraocular pressure reflects the balance between:

A

Aqueous humor formation in the ciliary body and it’s elimination

19
Q

Aqueous humor is eliminated via:

A

The canal of Schlemm

20
Q

Glaucoma can cause obstruction of the canal of Schlemm leading to:

A

Increased IOP

21
Q

The most important influence on the formation of aqueous humor is:

A

The difference in osmotic pressure between aqueous humor and plasma

22
Q

Hypertonic solutions (such as mannitol) will decrease both:

A

Aqueous humor production and IOP

23
Q

Increasing venous pressure has what effect on IOP?

A

Increases IOP by decreasing aqueous humor drainage and increasing choroidal blood volume

24
Q

Activities that increase IOP via a rise in venous pressure:

A

Laryngoscopy, intubation, airway obstruction, coughing, trendelenburg position

25
Q

An IOP of __________ could cause permanent vision loss

26
Q

Hypotension of choroid causes:

A

Decreased cerebral blood flow and decreased IOP

27
Q

Hypertension of the choroid causes:

A

Swelling of CBV - a temporary outflow adjusts IOP toward normal (auto regulated)

28
Q

Increased PaCO2 levels cause __________ IOP

29
Q

Hypocarbia decreases IOP by:

A

Vasoconstriction and reduced carbonic anhydrase activity

30
Q

____________ increases choroidal vasodilation and increases IOP

31
Q

Hypothermia ___________ formation of aqueous humor

32
Q

Effect of succinylcholine on IOP

A

Increases 6-8 mmHg by prolonged contracture of the extra ocular muscles. Returns to pre-drug levels in 5-7 min.

33
Q

Effect of NDMRs on IOP

A

Reduce IOP by relaxing extra ocular muscles

34
Q

Effect of volatile agents on IOP

A

Reduces choroidal volume by reducing BP

35
Q

Effect of Etomidate on the eye

36
Q

Potential effects of ketamine on the eye

A

Blepharospasm and nystagmus

37
Q

Effect of ketamine on IOP

38
Q

Timolol

A

B antagonist used to treat chronic glaucoma

39
Q

Possible side effects of timolol

A

Bradycardia and bronchospasm

40
Q

Echothiophate

A

Irreversible cholinesterase inhibitor used for treatment of glaucoma. Causes miosis which decreases IOP

41
Q

DOA of echothiophate

A

4-6 weeks (long acting anti-cholinesterase)

42
Q

Length of time required for 50% return of cholinesterase activity after echothiophate

43
Q

Effect of echothiophate on succinylcholine activity

A

PROLONGS it!!!

44
Q

Goal of ophthalmic surgery is to avoid:

A

Increases in IOP

Advanced Principles I (1 decks)

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