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APEX > Formulas > Flashcards

Formulas Flashcards

1
Q

maximum allowable blood loss

A

(EBV x (Hct starting- Hct target))/ Hct starting

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2
Q

Law of Laplace

A

pressure= (2 x tension) / radius

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3
Q

PVR

A

((mPAP-PAOP)/CO) x 80

Norm= 150-200

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4
Q

SVR

A

((MAP-CVP)/CO) x 80

Norm= 800-1500

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5
Q

metabolic equivalent

A

metabolic rate of specific physical activity/metabolic rate at rest

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6
Q

trans pulmonary pressure

A

alveolar pressure-intraplural pressure

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7
Q

Alveolar ventilation

A

(TV- dead space) x RR or CO2 production/PaCO2

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8
Q

minute ventilation (VE)

A

TV x RR or Vt x RR

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9
Q

dead space to tidal volume ration (Vd/Vt)

A

0.33 in SV patient, 0.5 in mechanical ventilation

PaCO2-PeCO2)/PaCO2 (PeCo2=partial pressure of CO2 in exhaled gas, not the same as ETCO2

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10
Q

Law of Laplace cylinder

A

tension=pressure x radius

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11
Q

Law of Laplace sphere

A

tension = (pressure x radius)/2

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12
Q

Alveolar oxygen (PAO2)

A 
FiO2 x (Pb - PH2O) - (PaCO2 / RQ)
PH2O= humidity of inhaled gas, assumed to be 47 mmHg
RQ= respiratory quotient, assumed to be 0.8
Normal 105.98 mmHg

Can estimate FiO2 x 6

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13
Q

Respiratory quotient

A

Co2 production/O2 consuption= 200 mL/min / 250 mL/min =0.8
>1= lipogenesis (overfeeding)
<1= lipolysis (Starvation)

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14
Q

Estimation of shunt %

A

Shunt increases 1% for every 20 mmHg A-a gradient

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15
Q

TV
FRC
VC

A

TV= 6-8 mL/kg
FRC= 35 mL/kg
VC= 65-75 mL/kg
calculated with ideal body weight

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16
Q

CaO2

A

O2 carrying capacity
(1.34 x SaO2 x Hgb) + (PaO2 x 0.003)
Normally 20 ml O2/dL

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17
Q

DO2

A

O2 delivery
CaO2 x CO x 10
Normally about 1000 mL O2/min

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18
Q

Normal H and H values

A

women 13 and 39

men 15 and 45

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19
Q

VO2

A 
O2 consumption
CO x (CaO2-CvO2) x 10

3.5 mL/kg/min
250 mL/min in 70 kg patient

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20
Q

Normal P50 O2

A

Where hgb 50% saturated by O2
26.5 mmHg
Lower= L
Higher= R

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21
Q

Bicarb reaction in blood

A

70%
H2O + CO2 H2CO3(carbonic acid) H+ + HCO3-
Need carbonic anhydrase for first reaction
H+ buffered by Hmg
HCO3 transported in plasma, Cl- goes into cell

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22
Q

Co2 bound to hemoglobin

A

23%

R-NH2 + CO2 RNH-CO2- + H+

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23
Q

Co2 dissolved in plasma

A

7%

solubility coefficient 0.067 mL/dL/mmHg

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24
Q

Vd/Vt

A

2ml/kg / 6mL/kg (normally 0.33)

increases to 0.5 in mechanical ventilation

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25
Q

FiO2

A

((Air flow rate x 21) + (O2 flow rate x 100)) / Total flow rate

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26
Q

Tidal volume with fresh gas coupling

A

Vt on ventilator - FGF during inspiration - vol lost to compliance

  1. Convert fresh gas flow from L/min to mL/min
  2. Multiple by FGF by the percentage of time in inspiration (1:2 IE= 33.33%)
  3. Divide 2 by RR.
  4. Add set Vt to 3.

Most new ventilators decouple so this does not apply

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27
Q

Reynold’s number

A

(Density x diameter x velocity)/viscosity

Re<2000= laminar flow (dependent on gas viscosity)
Re > 4000= turbulent flow (depending on gas density)
2000-4000= transitional flow

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28
Q

Volume lost to circuit

A

Circuit compliance x peak pressure

Some of Vt used to expand circuit

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29
Q

mL of liquid anesthetic agent used per hour

A

Vol% x FGF in L/min x 3

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30
Q

calculating vaporizer output at elevation

A

Required dial setting= (normal dial setting x 760)/ambient pressure (mmHg)

Higher altitude= higher setting
Lower altitude= lower setting

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31
Q

reaction of CO2 with sodalime

A

CO2 + H2O = H2CO3 (carbonic acid)
H2CO3 + 2 NaOH = Na2CO3 + 2 H2O + heat
Na2CO3 + Ca(OH)2 = CaCO3 (calcium carbonate) + 2 NaOH (sodium hydroxide)

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32
Q

Absorbent capacities

A

Soda lime 26L of CO2 per 100 g

Calcium hydroxide lime 10.6 L per 100g

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33
Q

reaction of CO2 with calcium hydroxide lime

A

CO2 + H2O= H2CO3
H2CO3 + Ca(OH)2 = CaCO3 + 2H2O + energy(heat)

No CO and very title compound A
Lower fire risk
Less absorbent capacity

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34
Q

Hydration of sodalime

A

13-20% by weight

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35
Q

Mapleson for SV and controlled ventilation

A

SV- A > DFE > CB

CV- DFE> BC> A

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36
Q

Plateau pressure

A

Pressure in smal airways and alveoli after tital volume is delivered
During inspiratory pause
Barotrauma risk increased with pressure > 35 cm/H2O
Static compliance= tidal volume/ (plateau pressure- PEEP)

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37
Q

Peak inspiratory pressure

A

Maximum pressure during inspiration

Dynamic compliance= tidal volume/ (PIP-PEEP)

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38
Q

Dysfunctional hemoglobin

A

Carboxyhemoglobin- absorbs 660 at same rate as oxyhemoglobin, Overestimates SpO2
Methemoglobin- absorbs 660 and 990 equally, Underestimates if > 85%
Overestimates if < 85%

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39
Q

SPO2

A

Oxygenated hgb/ (oxygenated hgb + deoxygenated hgb) X 100%

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40
Q

BP cuff sizing

A

length- long enough to wrap around 80% of arm

width- 40% circumference of patients arm

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41
Q

Arm position and NIBP reading

A

10 cm= 7.4 mmHg change

1 inch= 2 mmHg

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42
Q

Mixed venous O2 saturation

A 
SvO2= SaO2- (VO2/(Q x 1.34 x Hgb x 10))
Normal= 65-75%
VO2= oxygen consumption
SaO2= loading of hemoglobin in arterial blood

Need a PA cath to get blood from SVC, IVC, and coronary sinus together

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43
Q

Bipolar leads

A

I- lateral, CxA
II- inferior, RCA
III- inferior, RCA

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44
Q

Limb leads

A

AVR

AVL
Lateral
CxA

aVF
Inferior
RCA

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45
Q

Precordial

A 
V1- septum, LAD
V2- septum, LAD
V3- anterior, LAD
V4- anterior, LAD
V5- lateral, CxA
V6- lateral, CxA
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46
Q

Axis deviation

A

Use lead 1 and aVF
+ and += normal (between -30 and +90)
- and -= extreme R

Leads are Reaching towards each other(I down and aVF up)= R (greater than 90)
Leads are Leaving each other (I up and aVF down)= L (less than -30)

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47
Q

Class 1 antiarrhythmic

A

Na+ channel blockers
1A- quinidine, procainamide, disopyramide
Phase 0 dep, prolonged phase 3 repol

1B- lidocaine, phenytoin
Phase 0 dep, shortened phase 3 repol

1C- flea indie, propafenone
Strong phase 0 dep

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48
Q

Class 2 anti arrhythmic

A

Beta blockers

Slows phase 4 depol in SA node

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49
Q

Class 3 antiarrhythmic

A

K+ channel blockers
Amiodarone, bretylium
Prolongs phase 3 repolarization
Increased effective refractory period

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50
Q

Class 4 antiarrhythmic

A

Ca Channel blockers
Verapamil, dilt
Decreased conduction velocity through AV node

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51
Q

Torsades pneumonic

A 
POINTES
Phenothiazines
Other meds- methadone, droperidol, haldol, zofran, halogenated agents, amiodarone, quinidine
Intracranial bleed
No known cause
Type I antiarhythmics
Electrolyte disturbances- low K, low Ca, low Mg
Syndromes- Romano ward, Timothy
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52
Q

EEG waveforms

A

Beta- high frequency, low voltage, awake or light anesthesia
Alpha- medium frequency, awake but restful with eyes closed
Theta- general anesthesia and children sleeping
Delta- low frequency, GA, deep sleep, and brain injury

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53
Q

Definition of pulmonary hypertension

A

PAP > 25 mmHg

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54
Q

PVR

A

((mean PAP - PAOP) X 80) / CO

Norm= 150-250 dynes/sec/cm to the -5th power

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55
Q

Drugs you can give in ETT

A

NAVEL

Narcan, atropine, vasopressin, epi, lidocaine

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56
Q

Objective measures of respiratory distress

A

Vital capacity (mL/kg)- <15
Inspiratory force (cm/H2O)- <25
Oxygenation at 21%- PaO2 <55, A-a gradient >55
Oxygenation at 100%- PaO2 < 200, A-a gradient >450
PaCO2 >60
RR >40 or <6

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57
Q

Indicators of postoperative pulmonary complications in patients undergoing pulmonary surgery

A

Airflow: FEV1<40% of predicted
Gas exchange: DLCO < 40% of predicted
Cardiopulmonary reserve: VO2 max < 15 mL/kg/min (normal male=35-40, normal female=27-31) (if can’t climb 2 flights of stairs, this patient is at risk)

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58
Q

Double lumen tube placement

A

Male: size 39-41 fr, depth 29cm
Female: size 37-29 fr, depth 27cm
Children 8-9: 26 size
Childre >10 : 28 or 32 size

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59
Q

Lateral decubitus and V/Q

A

Nondependent- better ventilated

Dependent- better perfused

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60
Q

Mallampati pneumonic

A

PUSH

Pillars, uvula, soft palate, hard palate

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61
Q

Atlantoocciptal joint mobility

A

Normal flexion and extension: 90-165 degrees

Normal extension: 35 degrees (difficult DL if less than 23 degrees)

62
Q

Risk factors for difficult mask

A 
BONES
Beard
Obesity- BMI>26
No teeth
Elderly- age>55
Snoring
63
Q

NPO guidelines

A

2 hours- clear liquids
4hours- breast milk
6 hours- non human milk, solids, infant formula
8 hours- fatty food

64
Q

Mendelson syndrome

A

risk factors- Gastric pH <2.5, gastric volume>25mL (0.4 mL/kg)
Risk reduced by clear liquids 2 hours before

65
Q

Pressure for cricoid

A

Before LOC- 20 newtons or 2kg

After LOC- 40 newtons or 4kg

66
Q

large tongue pneumonic

A

Big Tongue
Beckwith syndrome
Trisomy 21

67
Q

small chin pneumonic

A 
Please Get That Chin
Pierre robin
Goldenhar
Treacher collins
Cru di chat
68
Q

cervical spine anomaly pneumonic

A

Kids TRY Gold
Klippel-feil
Trisomy 21
Goldenhar

69
Q

ETT size in peds

A

ETT without cuff- (Age/4) +4

Depth- ID x 3

70
Q

Total body water

A 
42L in 70 kg adult male (60% of total body weight)
ICV 40% of total body weight or 28 L
ECV 20% of total body weight or 14 L
16% interstitial fluid 11L
4%plasma fluid (3L)
71
Q

Plasma osmolarity

A

(Na x 2) + (glucose/18) + (BUN/2.8)

normal= 280-290 mOsm/L

72
Q

Solutions

A

Hypotonic 255 mOsm/L
Ex: NaCl 0.45%, D5W

Isotonic 285 mOsm/L
Ex: NaCl 0.9%, 5% albumin, LR, plasmalyte A, Voluten 6%, Vespan 6%

Hypertonic 315 mOsm/L
Ex: NaCl 3%, D5 NaCl 0.45% and 0.9%, D5 LR, Dextran 10%

73
Q

Coagulopathy with synthetic colloids

A

Dextran > hetastartch> hextend
don’t exceed 20mL/kg
not a problem with Voluten

74
Q

PaCo2 impact on pH

A

Acute respiratory acidosis
PaCO2 increases 10mmHg= pH decrease 0.08

Chronic respiratory alkalosis
PaCO2 increases 10mmHg= pH decrease 0.03

75
Q

anion ion gap

A

Major cations - major anions
Na - (Cl + HCO3)= 8-12 mEq/L
accumulation of acid= gap acidosis (Anion gap >14)
loss of bicarb or ECF dilution= non gap acidosis (anion gap <14)

76
Q

anion gap acidosis pneumonic

A 
MUDPILES
Methanol
Uremia
Diabetic ketoacids
Pareldehyde
Isoniazid
Lactate
Ethanol, ethylene glycol
Salicylates
77
Q

non anion gap acidosis pneumonic

A 
HARDUP
Hypoaldosteronism
Acetazolamide
Renal tubular acidosis
Diarrhea
Ureterosigmoid fistula
Pancreatic fistula
78
Q

Net filtration pressure

A

(Capillary hydrostatic pressure- interstitial hydrostatic pressure) - (plasma oncotic pressure- interstitial oncotic pressure)

79
Q

Na concentration in fluids

A

any solution with NaCl (including 5% albumin)= 154mEq/L
any solution with LR= 130 mEq/L
plasmalyte= 140 mEq/L

80
Q

Clotting factors pneumonic

A 
Foolish people try climbing long slopes after Christmas, some people have fallen
1- fibrinogen 
2- prothrombin
3- tissue factor
4-calcium
5-  labile factor
7- stable factor
8- anti hemophilic factor
9- Christmas factor
10- Stuart prower factor
11- plasma antithrombin antecedent
12- Hageman factor
13- fibrin stabilizing factor
81
Q

Extrinsic pathway

A

For 37 cents, you can purchase the extrinsic pathway

very fast

82
Q

Intrinsic pathway

A

If you can’t buy the intrinsic pathway for $12, you can buy it for $11.98

slower, can take up to 6 min

83
Q

final common pathway

A

The final common pathway can be purchased at the 5 and dime(X) for 1 or 2 dollars on the 13th of the month

84
Q

volume of distribution

A

amount of drug/desired plasma concentration

85
Q

loading dose

A

vd x desired plasma concentration/bioavailability

bioavailabiity=1 with IV drug

86
Q

extraction ratio

A

(arterial concentration- venous concentration)/arterial concentration

flow limited >0.7- increased blood flow increases clearance
capacity limited <0.3- changes in enzymes impact clearance, not impacted by blood flow

87
Q

low hepatic ratio drugs

A

roc, diazepam, lorazepam, methadone, thiopental, theophylline, phenytoin

88
Q

aPTT

A

norm 25-32 sec
measures intrinsic and common
Factors reduced by 30% for changes in #
response to unfractionized heparin, NOT LMWH

89
Q

PT/INR

A

norm 12-14 sec
measures extrinsic and common
Factors reduced by 30% for changes in #
response to warfarin

norm 1
standardized form of PT

90
Q

Bleeding time

A

norm 2-10min

prolonged by aspirin and NSAIDs

91
Q

ACT

A

norm 90-120 sec
heparin dosing
>400 for bypass

92
Q

Cranial nerve pneumonic

A

Oh Oh Oh To Touch And Feel Virgin Girls Vagina and Hymen

Some Say Marry Money But Brother Says Bad Business to Marry Money

93
Q

CSF flow pneumonic

A

Love My 3 Silly 4 Lorn Magpies

Laternal 
Monroe
3rd ventricle
Sylvius
4th ventricle
Luschka 
Magendie
94
Q

Cerebral blood flow

A

cerebral perfusion pressure/ cerebral vascular resistance

95
Q

CMRO2

A

3-3.8 mL/O2/100g brain tissue/min

Decreases by 7% for every 1 degree celsius

96
Q

CPP

A

MAP - ICP or CVP (whichever is higher)

autoregulation 50-150

97
Q

PaCO2 in brain

A

At PaCO2 of 40mmHg, there is 50mL/100g brain tissue/min
every 1mmHg increase in PaCo2=1-2mL increase in good flow
Max vasodilation @ 80-100mmHg
Max vasoconstriction @ 25mmHg
metabolic acidosis does not impact CBF

98
Q

PaO2 in brain

A

below 50-60mmHg=vasodilation and increases CBF

99
Q

hyperventilation and brain

A

PaCo2 30-35 mmHg
less than 30 increases risk due to vasocontriction and left shift of curve
effect lasts 6-20 hours

100
Q

therapy for vasospasm

A 
hypervolemia
hypertension
hemodilution- hit 27-32%
nimodine is only Ca channel blocker used
daily transcranial doppler
101
Q

Cerebral salt wasting syndrome

A

Occurs with SAH
from brain releasing natriuretic peptide
treated with isotonic crystalloids
Not SIADH

102
Q

Artery of Adamkiewicz

A

perfuses anterior cord in thoracolumbar region

most commonly T11-12 (75% of population T8-12, L1-2 in other 10%)

103
Q

Anterior spinal artery syndrome

A

also known as Beck syndrome
when aortic clamp is place above artery of adamkiewicz
symptoms- flaccid paralysis of lower extremities, bowel and bladder dysfunction, loss of temp and pain, preserved touch and proprioception

104
Q

tracts perfused by anterior spinal arteries

A

corticospinal tract- causes flaccid paralysis
autonomic motor fibers- causes bladder and bowel dysfunction
spinothalmic tract- causes temp and pain loss

105
Q

tracts perfused by posterior spinal arteries

A

dorsal column- touch and proprioception

106
Q

dorsal column medial leminiscal

A

fine touch, proprioception, vibration, and pressure
large, myelinated fibers
rapidly conduction (faster than anterolateral)
1st order- periphery to medulla
2nd order- medulla to thalamus (crosses)
3rd order- thalamus to parietal lobe

107
Q

Spinothalmic tract

A

anterolateral system
pain, temp, crude touch, tickle, sexual sensation
smaller, myelinated, slower conduction
1st order- periphery to spinal cord (ascends or descends 1-3 levels in Lissauer tract before synapse)
2nd order- dorsal horn of cord to RAS or thalamus (in anterior or lateral spinothalmic tract)
3rd order- to thalamus

108
Q

Corticospinal tract

A

Pyramidal system
Most important motor pathway
Lateral- cross in medulla, to limb muscles
Ventral- remain on ipsilateral side and descend into cord (typically in cervical or thoracic), axial muscles
upper motor neuron injury- hyperreflexia and spastic paralysis, Tested by Babinski
Lower motor neuron- ventral horn to NMJ, injury: paralysis on same side, impaired reflexes and flaccid paralysis , no babinski

109
Q

Dantrolene dosing

A

2.5 mg/kg IV, repeat 5-10min
1mg/kg for 6 hr infusion, or 0.1-0.3mcg/kg/hr for 48-72 hrs
if more than 20mg/kg reconsider diagnosis
20mg dantrolend and 3g mannitol per bottle
constituted with 60 mL preservative free water

110
Q

Ryanodex

A

2.5mg/kg IV

container 250 mg dantrole with 5mL sterile water diluent

111
Q

diseases linked to MH

A

king-denbourough syndrome
central core disease
multiminicore syndrome

112
Q

adrenal medulla secretion

A

80% epi, 20% norepi

NE to epi conversion occurs in the adrenal mudella

113
Q

metabolites of NE

A

preliminary- metanephrine, normetanephrine
final- vanillylmandelic acid (3 methoxy-4-hydroxymandellic acid)
elevated VMA in urine = pheochromocytoma

114
Q

Autonomic efferent pathway

A

Preganglionic efferent- myelinated B fiber, releases acetylcholine onto nicotinic type N receptor in autonomic ganglion
Post ganglionic efferent- nonmyelinated C fiber, PNS releases AcH onto effector organ, SNS releases NE onto effector organ (a few exceptions)

115
Q

SNS exceptions

A

postganglionic releases Ach onto N receptors of sweat glands, pilorector muscles, and some vessels
no postganglionic at adrenal medulla, chromafin cells release NE and epi into circulation

116
Q

ANS post to preganglionic ratio

A

SNS- 30:1, causes postsynaptic amplification

PNS- 1-3:1, precise control

117
Q

White rami

A

Preganglionic sympathetic fibers enter cord through ventral horn
get into sympathetic chain on white rami (myelinated)

118
Q

Grey rami

A

after exiting chain, reenter spinal nerve on grey rami to real with it to target organs
sweat glands, pilorector muscles, and vasculature

119
Q

Horner syndrome

A 
blockade of stellate ganglion, happens on ipsilateral side
Very Homely PAM
Vasodilaiton
Horner
Ptosis
Anhydrosis
Miosis
(also enopthalmus)
120
Q

resting rate of NE and epi release from adrenal medulla

A

NE- 0.05 mcg/kg/min

epi- 0.2 mcg/kg/min

121
Q

Baroreceptor sensors

A

Carotid sinus- in internal carotid right after bifurcation, carotid sinus nerves (nerves of Hering) converge with glossopharyngeal
Transverse aortic arch- sends info via vagus nerve

122
Q

Beta 1 selective antagonists

A 
MABE AB
Metoprolol
Atenolol-kideny is primary route of elimination
Betaxolol
Esmolol- RBC esterases
Acebutolol
Bisoprolol
123
Q

Nonselective beta antagonists

A

Labetolol- mixed beta and alpha, 7:1, intrinsic sympathomimetic activity
Timolol
Propranolol
Pindolol- intrinsic sympathomimetic activity
Nadolol
Carvediolol- mixed beta and alpha, 10:1

124
Q

Alpha blockers

A

Phentoalamine- short acting, nonselective, competitive alpha blocker
Phenoxybezamine- long acting, non selective, noncompetitive alpha blocker
Prazosin- selective alpha 1

125
Q

Origin of efferent SNS pathways

A

T1-L3
axons exit via ventral roots
synapse in 22 sympathetic ganglia

126
Q

Origin efferent PNS pathways

A

CN 3,7,9,10
Sacral 2-4
synapse on effector organ

127
Q

Catecholamines by size

A

smallest to largest

dopamine, NE, epi, isoproterenol, dobutamine

128
Q

Renal medulla structures

A

loops of henle, collecting ducts

129
Q

Kidneys portion of CO

A

20-25%, 1000-1250 mL/min

130
Q

Livers portion of CO

A

30%, 1500mL/min

131
Q

Blood and O2 puppy to liver

A

Hepatic artery- 25% blood flow, 50% O2

Portal vein- 75% blood flow, 50% O2

132
Q

Portal vein pressure values

A

7-10, >20-30=portal hypertension

133
Q

hepatic arterial buffer response

A

hepatic artery perfusion pressure= MAP- hepatic vein pressure

mediated by adenosine

134
Q

coag factors not produced by hepatocytes

A

Von Willebrand factor- vascular endothelial cells
Factor 4
Factor 3- vascular endothelial cells
Factor 8- liver sinusoidal cells and endothelial cells

135
Q

end of subarachnoid space in adults and children

A

adults- S2

children- S3

136
Q

Spine landmarks

A

L1- conus medullaris
L4-5 interspace= Tuffier’s line (correlates with iliac crests)
S2- dural sac ends (correlates with superior iliac spines) (S3 in neonates)
S5- sacral hiatus and sacrococcygeal ligament

137
Q

Spinal differential blockade

A
  1. autonomic fibers
  2. sensory fibers
  3. motor fibers
    autonomic block 2-6 dermatomes higher than sensory
    sensory block 2 dermatomes higher than motor
138
Q

Epidural differential blockade

A

no autonomic differential

sensory block 2 dermatomes higher than motor

139
Q

order of block onset by nerve fibers

A
  1. B- preganglionic ANS
  2. C- postganglionic sympathetic, slow pain, temp, touch
  3. A gamma- skeletal muscle tone, A delta- fast pain, temp, touch
  4. A alpha- skeletal muscle motor and proprioception, A beta- touch, pressure

pre ganglionic sympathetic, temp, pin prick (fast pain), touch, motor

140
Q

valve lesions to consider with neuraxial

A

severe aortic stenosis
severe mitral stenosis
hypertrophic cardiomyopathy

141
Q

MS and neuraxial

A

epidural safe

spinal may exacerbate symptoms

142
Q

CSF specific gravity

A

1.002-1.009

143
Q

Baricity of LA

A

dextrose= hyperbaric
NS= isobaric
water= hypobaric
EXCEPTION- 10% procaine in water is hyperbaric

144
Q

depth of epidural catheter

A

3-5cm into epidural space

145
Q

caudal anesthesia kids dosing

A

sacral- 0.5 mL/kg
sacral to T10- 1mL/kg
sacral to mid thoracic- 1.25mL/kg
can add clonidine 1mcg/kg

no dose greater than 2.5-3mg/kg

146
Q

caudal anesthesia adult dosing

A

sacral: 10-15 mL
sacral to T10: 20-30mL
sacral to mid thoracic- NA

147
Q

side effects of neuraxial opiods

A

pruritis- most common
respiratory depression
urinary retention- most common in young males
N/V

148
Q

conus medullaris

A

adult: L1-2
neonate: L3
end of SC

149
Q

cauda equina syndrome

A

exposure of high concentration to LA’s
5% lido and micro spinal catheters
bowel/bladder dysfunction, paralysis, sensory deficits
supportive treatment

150
Q

transient neurologic syndrome

A

unlikely it is caused by toxicity
lidocaine, lithotomy, knee scope, ambulatory surgery
severe back pain radiating to butt and legs
within 6-36 hours and resolves in 1-7 days
NSAIDs, opioids, and trigger point injections

151
Q

most resistant nerve roots to LA

A

L5 and S1

Largest spinal nerves

APEX (6 decks)

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