Final quick hits

Question 1

Where does the anterior lateral system cross over?

Answer 1

Decussates at the dorsal horn

Question 2

What does ipsilateral stand for?

Answer 2

Same side

Question 3

What is the dorsal column responsible for?

Answer 3

Fine touch
Two touch
Vibration
Proprioception

Question 4

What is the Antero-lateral system responsible for?

Answer 4

Pain
Temp
Crude touch
Pressure

Question 5

Which cranial nerve is most likely to be compressed by a pituitary tumor?

Answer 5

Optic - CN 2

Question 6

At a PaCO2 of 40 what is the CBF?

Answer 6

50mL/100g brain tissue

(10 points higher)

Question 7

What does compression on the medulla cause?

Answer 7

Irregular respirations

Question 8

What level of PaCO2 is recommended for hyperventilation?

Answer 8

30-35

<30 can cause cerebral ischemia

Question 9

Most common symptom of SAH? (sub-arachnoid hemorrhage)

Answer 9

Headache

About 50% lose consciousness

Question 10

What is the most significant source of morbidity and mortality in the patient with SAH?

Answer 10

Cerebral vasospasm - Delayed contraction of the cerebral arteries which may lead to infarction

Question 11

How does free Hgb and the amount of blood observed on CT correlate to a cerebral vasospasm?

Answer 11

Increases the incidence

Question 12

Incidence of a cerebral vasospasm?

Answer 12

About 25% of patients a week later

Question 13

What is an additional treatment for a cerebral vasospasm outside of HHH therapy?

Answer 13

Nimodipine - doesn’t break spasm but increases collateral flow

Question 14

Best treatment if the aneurysm ruptures during the procedure?

Answer 14

Reverse with protamine -1mg per 100 units of heparin

Question 15

Two common ways of reducing ICP that should be avoided in TBI’s?

Answer 15

Hyperventilation

Steroids

Question 16

What drugs are patients with Alzheimer’s disease on? How does this affect our anesthetic plan?

Answer 16

Cholinesterase inhibitors are given such as tacrine, donepezil, rivastigmine, and galantamine

These increase the duration of Succ

Question 17

What is affected by Parkinson’s?

Answer 17

Dopaminergic neurons in the basal ganglia

This increases AcH (shaking from constant stimulation)

Question 18

What drugs should be avoided in Parkinsons?

Answer 18

-Metoclopramide
-Butyrophenones (Haldol+Droperidol)
-Phenothiazines (promethazine)

Question 19

How is ocular perfusion pressure calculated?

Answer 19

MAP - intraocular pressure

Question 20

Where is the most common site of arterial bleed in the brain?

Answer 20

Arachnoid and pia matter

Question 21

What are the three layers of the brain?

Answer 21

DAP

Dura
Arachnoid
Pia

Question 22

Most common site for venous bleed in the brain?

Answer 22

Dura and arachnoid

Question 23

What CN is responsible for pupil constriction ?

Answer 23

CN3

Question 24

Order the path for posterior circulation

Answer 24

Subclavian

Vertebral

Basilar

Posterior cerebral artery

Question 25

What part of the cerebellum maintains equilibrium?

Answer 25

Archicerebelleum

Question 26

What part of the cerebellum maintains muscle tone?

Answer 26

Paleocerebellum

Question 27

What part of the cerebellum coordinates voluntary muscle movement?

Answer 27

Neocerebellum

Question 28

What part of the brainstem controls auditory and visual tracts?

Answer 28

Midbrain

Question 29

What part of the brainstem controls autonomic integration?

Answer 29

Medulla and Pons

Question 30

What part of the brainstem controls consciousness and sleep?

Answer 30

RAS

Question 31

What part of the brain controls memory and learning?

Answer 31

Hippocampus

Question 32

What part of the brain controls emotion, appetite, pain, and stress

Answer 32

Amygdala

Question 33

What part of the brain controls cognition, movement, and sensation?

Answer 33

Cerebral cortex

Question 34

What part of the brain has fine control of movement?

Answer 34

Basal ganglia

Question 35

Cranial nerves photo

Answer 35

Question 36

Seizure photo

Answer 36

Question 37

Blood flow of brain photo

Answer 37

Question 38

What nerves carry parasympathetic output?

Answer 38

3,7,9,10

Question 39

What percent of all parasympathetic activity is the vagus nerve responsible for?

Answer 39

75%

Question 40

Anterior or Posterior; What is the sensory pathway?

Answer 40

Posterior SSEPS posterior 1/3 of spinal cord

Question 41

Anterior or Posterior; What is the motor pathway?

Answer 41

MEPs anterior 2/3 of spinal cord

Question 42

Which channelopathy is associated with hypokalemic periodic paralysis?

Answer 42

Calcium

Question 43

What two drugs should be avoided in Guilian Barre?

Answer 43

Ephedrine Exageratted response) Succ

Question 44

Two common signs of a cerebral spasm?

Answer 44

New neurologic deficit Altered LOC

Question 45

Gold standard for diagnosing cerebral vasospasm?

Answer 45

Cerebral angiography

Question 46

Treatment for TBI for patient on aspirin?

Answer 46

Hypertonic solution Platelets to reverse aspirin

Question 47

For a TBI, what should CPP be maintained above?

Answer 47

70

Question 48

What three drugs are helpful in mapping seizures?

Answer 48

Etomidate Methohexital Alfentanil

Question 49

How do locals affect the seizure threshold?

Answer 49

They reduce it but properly executed block does not increase the risk

Question 50

Which anticonvulsant is excreted unchanged by the kidneys?

Answer 50

Gabapentin

Question 51

What two changes are seen in Parkinsons?

Answer 51

Decreased dopamine in the basal ganglia Increased GABA in the thalamus

Question 52

Anterior Spinal Artery Syndrome - S&S?

Answer 52

Flaccid paralysis Bowel and Bladder dysfunction Low of temp and pain

Question 53

What is preserved during Beck's syndrome? (Anterior Spinal Artery syndrome) Why?

Answer 53

Preserved touch and proprioception The dorsal column is perfused by the posterior (not anterior) which is why

Question 54

What is supplied by the anterior artery?

Answer 54

Corticospinal tract (motor) Autonomic function (Bowel and Bladder) Spinothalamic tract - pain and temperature