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Comprehensive exam Spring 21 (retake) > Extra Basic exam 1 material (could be important?) > Flashcards

Extra Basic exam 1 material (could be important?) Flashcards

1
Q

what nerves provide general sensation to the anterior 2/3 and posterior 1/3 of the tongue?

A

lingual nerve and glossopharyngeal nerve

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2
Q

What nerve provides sensation to the airway below the epiglottis?

A

Vagus nerve

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3
Q

The superior laryngeal branch of the Vagus nerve divides into what two parts?

A

external (motor) LN

internal (sensory) LN

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4
Q

What nerve provides sensory supply to the larynx between the epiglottis and the vocal cords? (which is another way of saying above the vocal cords)

A

Internal Laryngeal Nerve

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5
Q

What nerve innervates the larynx below the vocal cords and trachea?

A

Recurrent laryngeal nerve

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6
Q

What laryngeal muscle increases vocal cord tension (tenses the cords)?

A

cricothyroid

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7
Q

What laryngeal muscle reduces cord tension (relaxes the cords)?

A

Thyroarytenoids

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8
Q

What laryngeal muscle abducts the vocal cords (dilates)?

A

Posterior cricoarytenoids

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9
Q

You WANT a TMD of?

A

3 FB or more (equal to 3 or more)

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10
Q

What neck circumference in inches is suggestive of difficulties?

A

GREATER than 17 in

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11
Q

Mask ventilation for long periods may result in pressure injury to branches of what two nerves?

A

trigeminal or facial nerves

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12
Q

What three axis must be lined up to have sniffing position?

A

oral
pharyngeal
laryngeal

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13
Q

What degree upward ramp should morbid obesity patient be positioned on?

A

30 degree

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14
Q

What is the cut length for normal males and females?

A

24 cm

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15
Q

When talking about high pressure or low pressure ETT cuffs, which one has a lower incidence of mucosal damage and thus are generally employed?

A

LOW pressure cuffs

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16
Q

Where is the MILLER blade placed?

A

Epiglottis (lifts it up from underneath it)

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17
Q

Over inflation of the bulb of an ETT beyond WHAT may inhibit capillary blood flow, injuring the trachea?

A

30 mm Hg

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18
Q

After you intubate someone what do you do to confirm placement?

A

Listen to the lungs, stomach, and capnograph tracing monitoring.

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19
Q

What is the BEST confirmation/definitive test of tracheal placement?

A

The persistent detection of CO2 by capnograph.

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20
Q

What is typically the earliest evidence of bronchial intubation?

A

increase in peak inspiratory pressure

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21
Q

What type of nose drops and what % vasoconstricts the vessels in the nose and shrink mucous membranes?

A

Phenylephrine nose drops 0.25%-0.5%

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22
Q

If someone has trauma or rheumatoid arthritis then what type of intubation technique should take place?

A

minimal cervical spine movement (fiber optic intubation would be ideal)

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23
Q

What type of patient would you Awake FOI?

A

predicted inability to ventilate by mask

upper airway obstruction

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24
Q

When do you employ an invasive airway technique?

A

can’t intubate, can’t ventilate situations

25
Q

End tidal CO2 declines suddenly, what should be considered?

A

pulmonary (thrombus) or venous air embolism should be considered.

other causes could be sudden decline in cardiac output or a leak in the circuit

26
Q

What can cause a rise in the CO2 while monitoring your patient?

A

hypoventilation

increased CO2 production as occurs with MH, Sepsis, depleted CO2 absorber, or breathing circuit malfunction.

27
Q

extubating during what plane of anesthesia increases the risk of laryngospasm?

A

LIGHT

28
Q

What can you do to the patient in order to tell if they are in a light or deep plane of anesthesia?

A

pharyngeal suctioning and watch for a reaction - any reaction to it indicates light plane and no reaction shows a deep plane

29
Q

If ventricular bigeminy occurs during intubation what might this indicate?

A

light anesthesia

30
Q

What are some things you can do prior to DL to decrease the change in hemodynamics?

A

IV lidocaine, opioids, B blockers, or deepen the plane of inhalation anesthesia minutes before laryngoscopy

31
Q

Define laryngospasm?

A

forceful involuntary spasm of the laryngeal musculature caused by sensory stimulation of the superior laryngeal nerve.

32
Q

What kind of spasm is common in asthmatic patients?

A

Bronchospasm

33
Q

Bronchospasm can sometimes be a clue to?

A

bronchial intubation

34
Q

What type of anesthetic would you choose if you want to maintain consciousness during surgery?

A

spinal, epidural, or caudal (also peripheral nerve blocks)

35
Q

What is the only absolute contraindication to spinal or epidural anesthesia?

A

when the patient wishes another from of anesthesia (refuses the regional)

obviously if there is an abscess of any kind at the site of injection you would not do it

36
Q

Lidocaine 5% plain duration?

A

60-75 min.

37
Q

Lidocaine 5% with added vasoconstrictor duration?

A

60-90 min.

38
Q

Bupivacaine 0.75% plane duration?

A

90-120 min.

39
Q

Bupivacaine 0.75% with added vasoconstrictor duration?

A

100-150 min.

40
Q

Which LA is the most cardio toxic?

A

Bupivacaine

41
Q

Which LA class is prolonged in patients with atypical pseudocholinesterase?

A

Esters

42
Q

Which class of LA do not accumulate in the blood? Which class is more likely to accumulate in the blood?

A

Esters do NOT accumulate in the blood because they are metabolized by pseudocholinesterase. Amides would be more likely to accumulate.

43
Q

Which class of LA may cause hypersensitivity and why?

A

Ester may cause hypersenitivity: The Para-aminobenzoic acid is metabolic end-product of ester metabolism is the culprit

44
Q

Most used spinal interspace?

A

L3-L4

45
Q

Largest interspace?

A

L5-S1

46
Q

Spinal cord ends where in adults? Where in pediatrics?

A

L1-L2 adults

L3 pediatrics

47
Q

Dura sac ends where in adults?

Where in pediatrics?

A

S2 in adults

S4 in pediatrics

48
Q

PDPH, when does it start and where does the patient feel it?

A

24-48 hours after the puncture, localized at the occipital region and neck

49
Q

What position helps a PDPH?

A

Supine position will help the PDPH

50
Q

If someone has a PDPH that requires a blood patch, the injection should be made where?

A

preferably below the site of initial puncture because there is preferential cephalad spread.

51
Q

Tell me the major differences between an epidural and spinal?

A

Spinal is a small amount of LA, where an epidural requires tenfold increase in dose.

Spinal produces an intense, rapid, predictable block, an epidural has a slower onset.

52
Q

What are the s/s of an epidural hematoma?

A

back pain and leg weakness

53
Q

How do you diagnose an epidural hematoma and what must be done if a patient has one?

A

Diagnosed by CT or MRI. It must be surgically decompressed in 6 – 8 hours, otherwise there is irreversible neurological damage.

54
Q

A normal healthy patient would be an ASA what?

A

I

55
Q

A patient with mild systemic disease but no functional limitations would be an ASA what?

A

II

56
Q

A patient with severe systemic dz that is a constant threat to life?

A

ASA 4 (IV)

57
Q

A patient with severe systemic dz that results in functional limitations?

A

ASA III

58
Q

Moribund patient?

A

ASA V

59
Q

Brain dead patient would be an ASA what?

A

VI

Comprehensive exam Spring 21 (retake) (5 decks)

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