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931: Advanced Principles of Anesthesia I > Final exam Review > Flashcards

Final exam Review Flashcards

1
Q

Indications for cervical plexus block include

A

carotid endartectomy, clavicle fracture, superficial neck surgery

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2
Q

The major nerves of the cervical plexus include

A

greater auricle, lessor occipital, supraclavicular, transverse cervical nerve, phrenic nerve

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3
Q

If the patient is not able to “pull” this describes appropriate blocking of the

A

musculocutaneous nerve

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4
Q

The nerves of the brachial plexus are in the tightest bundle at the

A

supraclavicular level

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5
Q

Injury to the _____- & ____ can occur with interscalene block

A

dorsal scapular & long thoracic nerve

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6
Q

Lipid emulsion dosing is

A

1.5 mL/kg

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7
Q

The quadratus lumborum targets the

A

ilioninguinal & iliohypogastric nerves

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8
Q

The lumbar plexus supplies sensory & motor innervation to

A

the thigh, anterolateral knee, & sensory innervation to the medial aspect of the lower extremity below the knee

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9
Q

The femoral triangle includes:

A

medial aspect of sartorius, medial aspect of adductor longus, & inguinal ligament

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10
Q

Landmark technique for the sciatic (subgluteal block)

A

greater trochanter & ischial tuberosity

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11
Q

Landmark for the iPack block includes

A

the posterior capsule & the popliteal fossa

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12
Q

Labs for myomectomy include

A

T&C & H&H

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13
Q

A total hysterectomy involves removal of

A

uterus & cervix

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14
Q

Hemabate is contraindicated for

A

asthmatics

methergine should not be given for those with hypertension

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15
Q

Cervidil will

A

ripen the cervix

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16
Q

Normal GFR is

A

125 mL/min.

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17
Q

ADH works in the

A

distal tubule to reabsorb water

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18
Q

General anesthesia is associated with a decrease in

A

renal blood flow, GFR, urinary flow, electrolyte secretion, & impairs autoregulation

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19
Q

S/s of fluoride toxicity include

A

hypernatremia & increased creatinine

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20
Q

CKD exists when

A

GFR is less than 60 mL/min.

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21
Q

Risk factors for AKI include

A

age >50 years, cardiac comorbidities & AAA

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22
Q

Symptoms of CKD do not appear until

A

less than 40% of normal functioning nephrons remain `

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23
Q

The most common cause of death for patients with CKD is

A

ischemic heart disease

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24
Q

Treatment for hyperkalemia includes

A

25-50 grams of dextrose, 10-20 units of regular insulin, 50-100 mEq for sodium bicarbonate

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25
Q

The most reliable test for renal function is

A

creatine clearance

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26
Q

Glycine toxicity can cause

A

transient blindness

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27
Q

Complications of TURP are related to

A

water intoxication, fluid overload, & hyponatremia

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28
Q

Most important prevention for TURP is

A

to avoid Tendelenburg position

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29
Q

The spinal cord ends at

A

L1-L2 in adults & L3 in children

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30
Q

When added to a spinal, clonidine

A

is not a vasoconstrictor & has synergistic effects, can help with tourniquet pain

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31
Q

Fiber types include

A 
type b- preganglionic autonomic
type C- pain, warm, could, & touch
Type A- alpha- proprioception, motor
Type A beta- touch, pressure
Type A gamma- muscle tone
Type A delta- pain, cold, temperature & touch
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32
Q

33 bones of the spinal column include

A 
7 cervical
12 thoracic
5 lumbar
5 sacral
5 coccyx
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33
Q

Total CSF volume in an adults is

A

150 mL, produce 21 mL/hour, SAH holds 20-35 mL

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34
Q

The phrenic nerve is _____ the anterior scalene

A

anterior

35
Q

If both recurrent laryngeal nerve paralyzed then cords will be

A

paramedian

if vagus is paralyzed then cadaveric position

36
Q

Disadvantages to regional block include

A

hypotension & unpredictable success rate

37
Q

Uvulopalatopharyngoplasty enlarges airway through removal of

A

soft palate, palatine tonsils, & uvula

38
Q

____ is more soluble than air, helium, oxygen, or nitrous

A

CO2

39
Q

IAP

A

15 mmHg

40
Q

Physiologic changes of pneumoperitneum include

A

increased PaCO2, EtCO2, & decreased VR

41
Q

Sphincter of Oddi spasm can be treated with

A

glucagon

42
Q

Pickwickian syndrome is a

A

severe chronic OSA leading to cor pulmonale

43
Q

Describe how biventricular failure develops in obese patients.

A

increased total blood volume, increased CO, increased RAAS, increased left-side heart pressures & LVH

44
Q

Anesthetic considerations for spinal surgeries include

A

visual loss, bleeding, VAE

45
Q

BCIS symptoms include

A

hypotension & hypoxemia & heart block

46
Q

Pneumatic tourniquet should not be used for more than

A

2 hours

47
Q

Fat embolism s/s include

A

petechia, hypoxemia, & pulmonary edema

48
Q

The two branches of the vertebral artery include

A

the anterior spinal artery & posterior spinal arteries

49
Q

6 extraocular muscles of the eye include:

A

superior rectus- supraduction- CN III
inferior rectus- infraduction- CN III
medial rectus- adduction- CN III
lateral rectus- abduction- CN VI
superior oblique- intorsion, depression-CN IV
inferior oblique- extorsion, elevation- CN III

50
Q

Describe the oculocardiac reflex.

A

the nerve that carries signal to the brain for the reflex is the trigeminal nerve
the vagus sends back out to cause bradycardia–> stop pulling on the muscle, give atropine or glycopyrrolate

51
Q

What’s unique about the optic nerve?

A

part of the CNS- outgrowth of the brain

it is not a cranial nerve & so the meninges surround it

52
Q

Intraocular pressure measures

A

measures the pressure of the eye & is formed by aqueous humor
normal pressure is 12-20 mmHg
someone with glaucoma will have higher intraocular pressure

53
Q

The following medications can be administered to bring intraocular pressure down:

A

diamox- contraindications include sulfa allergy & liver/kidney dysfunction
mannitol

54
Q

The branches of the trigeminal nerve include

A

ophthalmic, maxillary, & mandibular

55
Q

The facial nerve includes

A

the zebra bit my cousin paul

anterior: temporal, zygomatic, buccal & mandibular
inferior: cervical
posterior: posterior auricular

56
Q

Fire triad includes

A

oxidizer
fuel source
ignition source

57
Q

TTJV is

A

rapid, small volume ventilation
be mindful of expiratory time
pressure you’re ventilating at is 60 psi

58
Q

Most common complication of plastics is

A

DVT & PE

59
Q

______ presents the highest risk for morbidity & mortality in plastic surgery

A

liposuction

60
Q

The FDA max dose of lidocaine is

A

35 mg/kg

61
Q

Considerations for burns include:

A

concern for airway edema- check cuff leak
may have to suture ETT
keep the room warm
aseptic
paralytic dosages- don’t use succinylcholine, requires higher doses of NMDRs
very painful so give opioids

62
Q

Endpoints for burn surgeries include

A

> 3 hours, >10 units of blood, <35 degrees

63
Q

Nerves most often monitored in ENT surgery include

A

facial, vagus, recurrent & superior laryngeal nerve, & spinal accessory nerve

64
Q

Tonsil surgery considerations include:

A

rebleeding into the stomach, RSI, bad PONV, want an H&H if they rebleed

65
Q

Endoscopic sinus surgery considerations include

A

controlled hypotension
dural puncture
positioning-rotated away with arm tucked

66
Q

With sentinel lymph node biopsy,

A

axillary nerve monitoring is being performed so you can’t paralyze

67
Q

When dye is injected for masectomy

A

pulse ox can drop

allergic reaction to dyes

68
Q

If a patient is having a DIEP flap

A

avoid vasopressors specifically pheylephrine b/c microvasculature

69
Q

For ambulatory surgery

A

6 months for labs if no change
no routine preop testing
cheaper to do surgery here

70
Q

Disadvantages of ambulatory surgery include

A

less time monitoring for complications
have to transfer for higher level care
have to coordinate PT/OT
don’t have set preop-decreased privacy

71
Q

Perioperative complications most commonly occur in

A

20-49 year olds

72
Q

Appropriate patients for ambulatory surgery include

A

ASA 1 or 2, no known difficult airway, should be at baseline health status

73
Q

Need ____ bottles of dantrolene

A

36 vials

dose 2.5 mg/kg

74
Q

Damage to dorsal scapular produces

A

atrophy & weakness of the rhomboid

75
Q

Spinal cord specific gravity is

A

1.003-1.009

76
Q

Hyperbaric will

A

settle in the thoracic if you lay them flat

77
Q

For epidural anesthesia, ____ determines block density

A

concentration determines density and volume determines spread

78
Q

Bupivacaine is cardiotoxic because

A

it is highly protein bound & it sticks around

79
Q

Benefits for laparoscopic surgery include

A

early mobilization
less pain
less blood loss

80
Q

Disadvantages for laparoscopic surgery include

A 
decreased visualization 
PONV
retained gas with shoulder pain- Toradol
crepitus
subcutaneous emphysema
81
Q

Obesity types include gynecoid & android

A

android is worse because it is around the heart

82
Q

In obese patients, lung volumes are

A

decreased & all capacities are decreased as well

83
Q

Fat emboli will present as

A

SOB
petechiae
fat globules in urine

931: Advanced Principles of Anesthesia I (22 decks)

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