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APEX > Formulas 2 > Flashcards

Formulas 2 Flashcards

1
Q

Axillary

A

Arm abduction (deltoid)

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2
Q

Musculocutaneous

A

Elbow flexion (biceps)

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3
Q

Median

A

Thumb opposition

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4
Q

Radial

A 
Elbow extension (triceps)
Wrist and finger extension
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5
Q

Ulnar

A

Pinky finger abduction

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6
Q

Femoral triangle borders

A

SAIL
Sartorious- medial
Adductor longus- lateral
Inguinal ligament- superior, b/w ASIS and pubic tubercle

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7
Q

Ankle block nerves clockwise

A 
(From achilles)
Tibial nerve
Saphenous nerve
Deep peroneal nerve
Superficial peroneal nerve
Sural nerve
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8
Q

Ankle pneumonic

A

TIPPED
Tibial inversion plantar flexion
Peroneal eversion dorsiflexion

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9
Q

Ulnar nerve injury

A

Ulnar- claw hand

most common intraop injury

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10
Q

Median nerve injury

A

Median- inability to oppose thumb

AC IV sticks and axillary blockade

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11
Q

Radial nerve injury

A

Radial- wrist drop

direct compression on spiral groove of humerus

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12
Q

DO2

A

1000 mL/min

normal oxygen extraction ration = 250mL/min (25% of CO)

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13
Q

normal CO

A

HR x SV

5-6L/min

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14
Q

CaO2

A

20 mL/dL

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15
Q

VO2

A

250 mL/min at rest

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16
Q

CvO2

A

15mL/dL

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17
Q

Ohms law

A

Flow= pressure gradient /resistance

MAP= (CO x SVR) /80) + CVP

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18
Q

Poiuselle’s law

A

(pie x R(to the 4th power) x change in pressure) / (8 x n x l)

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19
Q

Reynolds number

A

<2000= laminar
2000-4000= transitional
>4000=turbulent

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20
Q

CI

A

CO/BSA

2.4-4.2 L/min/m(squared)

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21
Q

SV

A

EDV-ESV
CO x (1000/HR)
50-110 mL/beat

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22
Q

SVI

A

SV/BSA

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23
Q

EF

A

((EDV-ESV)/EDV) x 100
(SV/EDV) x 100

60-70%
LV dysfunction when less than 40%

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24
Q

MAP

A

(1/3 x SBP) + (2/3 DBP)
((COxSVR) /80) + CVP
70-105 mmHg

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25
Q

Pulse pressure

A

SBP-DBP
stroke volume output/arterial tree compliance
40 mmHg

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26
Q

SVR

A

((MAP-CVP/CO) x 80
800-1500 dynes/sec/cm to the -5th

arteriolar resistance, doesn’t take viscosity or other factors of afterload into account

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27
Q

SVRI

A

((MAP-CVP/CI) x 80

1500-2400 dynes/sec/cm to the -5th/m squared

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28
Q

Ventricular output measurement

A

CO, SV, LVSW, RVSW

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29
Q

Filling pressure measurement

A

CVP, PAD, PAOP, LAP, LVEDP

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30
Q

End diastolic volume

A

RVEDV

LVEDV

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31
Q

% of CO in atrial kick

A

20-30%

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32
Q

PVR

A

((mPAP- PAOP)/CO) x 80

150-200 dynes/sec/cm to the -5th

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33
Q

Law of Laplace

A

wall stress= (intraventricular pressure x radius)/ wall thickness

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34
Q

SA node blood supply

A

RCA: 50-60% of people
CxA: 40-50% of people

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35
Q

Coronary artery dominance

A

RCA supplies PDA= right dominance
CxA supplies PDA= left dominance
RCA and CxA supply PDA= co dominance

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36
Q

myocardial oxygen extraction

A

70%
very efficient
coronary sinus saturation= 30%

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37
Q

coronary blood flow

A

coronary perfusion pressure/coronary vascular resistance

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38
Q

coronary perfusion pressure

A

Aortic DBP- LVEDP

or DVP-PAOP

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39
Q

coronary autoregulation

A

MAP 60-140 mmHg

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40
Q

coronary blood flow

A

225-250mL/min

4-7% of CO

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41
Q

myocardium O2 consumption

A

8-10 mL/min/100g

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42
Q

conditions that set SVR proximal to systemic circulation

A

aortic stenosis
hypertrophic cardiomyopathy
coarctation of the aorta

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43
Q

Ca-v difference

A

(1.34 x hgb x SpO2)- (1.34 x hgb x SvO2)
normal CaO2= 20 mLO2/ dL blood
normal CvO2=15 mLO2/ dL blood
normal Ca-v difference= 5 mLO2/ dL blood

44
Q

aortic valve orifice

A

norm: 2.5-3.5 cm2

severe stenosis: <0.8cm2

45
Q

triad of aortic stenosis

A

Syncope-3 years
Angina- 5 years
Dyspnea- 2 years

46
Q

mitral valve

A

normal orifice: 4-6 cm2
severe stenosis: <1cm2
LAP-LV gradient exceeds 10 mmHg
PASP >50mmHg

47
Q

greatest risk factor for cardiac probs with non cardiac surgery

A

unstable angina

48
Q

best EKG leads to monitor for ischemia

A

V3>V4>V5>III>aVF

49
Q

best EKG leads to assess for ST changes in patients with CAD

A

5 lead: V3, aVf, MCL5 or III

3 lead: aVf and MCL5

50
Q

best leading for monitoring arrhythmia

A

II

51
Q

ventricular compliance

A

ventricular volume/ventricular pressure

52
Q

most common cause of secondary hypertension

A

renal artery stenosis

53
Q

CCB impairing contractility

A

verapmail>nifedipine>dilt>nicardipine

54
Q

Beck’s triad

A

muffled heart tones- from fluid accumulation in pericardial sack
jugular vein distention- decreased venous return in R heart
decreased SV- hypotension

55
Q

Pulsus paradoxis

A

decreased SBP by >10mmHg during inspiration

56
Q

Kussmahl’s sign

A

increased JVD and and CVP during inspiration

57
Q

determinants of outflow through LVOT

A

systolic LV volume
force of LV contraction
transmural pressure

58
Q

duration after cardiac stents to wait for elective surgery

A

bare metal stent: 30 days

DES:first generation 12 months, second generation 6 months, 12 months minimum with acute coronary syndrome

59
Q

Becks syndrome

A 
From Artery of Adamkiewciz occlusion of anterior cord in T11-T12
Bowel and bladder dysfunction
Flaccid paralysis of lower extremeties
loss of temp/pain
Preserved touch and proprioception
60
Q

Gas vapor pressures

A

Sevo- 157
Iso- 238
Des- 669
Nitrous- 38770

61
Q

Gas blood gas solubility

A 
Sevo- 0.65
Iso- 1.45
Des-0.42
Nitrous- 0.46
Nitrogen- 0.014 (N2O enters space 34x more than nitrogen can exit)
62
Q

CO per tissue group

A

VRG- 75% CO, 10% body mass
Muscle and skin- 20% CO, 50% body mass
Far- 5% of CO, 20% body mass
Non VRG- <1% CO, 20% body mass

63
Q

MAC values

A

Sevo- 2
Iso- 1.2
Des- 6.6
Nitrous- 104

64
Q

Meyer overton hypothesis

A

lipid solubility is proportional to the potency of anesthetic agent

65
Q

Ficks law of diffusion

A

Directly proportional- partial pressure difference, solubility coefficient, membrane surface area

Inversely proportional- membrane thickness, molecular weight

66
Q

ideal gas law

A

PV=nrT
n= number of moles
r=0.0821 liter-atm/K/mole

conceptually P=T/V

67
Q

law of Laplace in L ventricle

A

(LV pressure x radius)/ (LV wall thickness x 2)

68
Q

Exposure to radiation

A

5 rem per yer

0.5 rem per year in pregnancy, 0.05 rem per month

69
Q

Distance from radiation

A

6 ft away= 9 inches of concrete of 2.5mm lead

intensity- 1/distance squared

70
Q

Critical temp of common gasses

A 
N2O- 36.5
CO2- 31
Oxygen- -119
Air= -140
N2= -147
71
Q

Celsius and Kelvin

A

Celsius= K - 273.15

72
Q

Celsius and Fahrenheit

A

F= (C x 1.8) +32

73
Q

Boiling point of H2O

A

100 degrees C

212 degrees F

74
Q

Freezing point of H2O

A

0 degrees C

32 degrees F

75
Q

Pressure

A

Force/area

76
Q

Pressure conversion

A

1 atm= 760 mmHg= 760 torr= 1 bar = 100kPa= 1033 cm H20 = 14.7 lb/inch squared
1mmHg= 1.36 cm H20

77
Q

Avogadros number

A

6.023 x 10 to the 23rd atoms

78
Q

Molecular weights

A

helium= 4 g

oxygen=16 g, 1 mole=32 g

79
Q

Mechanisms of heat transfer

A

Radiation (60%) >convection (15-30%) > evaporation (20%) > conduction (<5%)

80
Q

ingredients to produce fire

A

ignitor
fuel
oxidizer

81
Q

Burn body % adult

A 
Head 10%
Trunk 36%
Leg 18%
Arm 9%
Perineum 1%
82
Q

Burn body % kid

A 
Head 19%
Trunk 32%
Leg 15%
Arm 9.5%
for every year >1 year up to 10 years, head BSA decreases by 1% and leg increases by 0.5%
83
Q

Fluid replacement in burns

A

24 hours: 2 ml x % TBSA burned x kg
or 4 mL, use crystalloid (1/2 in first 8 hours, rest in 16 hours)
2nd 24 hours: D5W maintenance rate, 0.5mL x % TBSA burned x kg

84
Q

TAP block districution

A

T9-L1

85
Q

Barrier pressure

A

lower esophageal sphincter pressure - intragastric pressure

Reduced barrier pressure= increased reflux

86
Q

Samter’s triad

A

Aspirin exacerbated respiratory disease

nasal polyps, allerigic rhinitis, and asthma

87
Q

BMI

A

kg/m2

1 inch= 2.54cm

88
Q

IBW

A

men (kg)= height in cm- 100

women (kg)= height in cm -105

89
Q

CO increase per kg of fat

A

100 mL/min

90
Q

Drug dosage calc in obesity

A

Water soluble drugs calculated to IBW
Fat soluble drugs calculated to TBW
Vd for lipid soluble drugs&raquo_space; Vd for water soluble drugs (but both increase)

91
Q

TBW drugs

A 
Prop induction
Midazolam
Succ
Fent
Cis
92
Q

LBW drugs

A 
Prop maintenance
Remi
Roc
Vec
Fent maintenance
93
Q

Apnea/hypopnea index

A 
mild= 5-15 episodes/hr
moderate= 15-30
severe= >30
94
Q

STOPBANG

A 
Snore?
Tired?
Observed apnea?
Pressure?
BMI >35?
Age>50?
Neck circum >45cm?
Male gender?

high risk= >3 questions answered yes

95
Q

6 elements of informed consent

A 
competence
decision making capacity
disclosure of information
understanding of disclosed info
voluntary consent
documentation
96
Q

4 pieces of malpractice

A
  1. duty
  2. breech of duty
  3. causation
  4. damages
97
Q

res ipsa loquitur

A

“the thing speaks for itself”
injury would not have occurred without negligence
injury causes by something under the complete control of the provider
pt did not contribute in any way to injury
evidence for explanation of event solely under control of provider

98
Q

Causes of anesthesia related lawsuit

A
  1. death
  2. nerve damange
  3. permanent brain damage
  4. awareness
99
Q

increased risks of dying within 7 days of surgery

A
  1. physical status
  2. emergency vs. elective surgery
  3. major vs. minor surgery
  4. patient age (80 vs 60)
100
Q

airway management claims

A

most common for cause of death

  1. inadequate ventilation
  2. unrecognized esophageal intubation
  3. difficult airway
101
Q

paren patriae

A

father of the country

government serves as legal protector of citizens who can’t protect themselves

102
Q

% of anesthesia mistakes related to human error

A

70%

103
Q

Lifetime rem

A

(N-18) x 5

n=age in years

104
Q

Noise limits

A

8 hour exposure= 90dB

single noise= 115dB

105
Q

Triple aim

A

improving patient experience
improving population health
reduced per capita costs

106
Q

6 domains of high quality health care

A 
patient centered- dignity, respect, informed sharing, collaboration 
safe
effective
timely
efficient
equitable
107
Q

BP changes with cuff height

A

10 cm= 7.4 mmHg

1in= 2cm Hg

APEX (6 decks)

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