Full Review Flashcards
Local Anesthetics
Should not irritate tissues, no permanent damage, non-toxic, predictable action and duration
Lidocaine and bupivacaine
Block transmission of impulse by acting on cell membrane -> no pain
Combined with epinephrine in order to reduce bleeding
Regional Anesthetics
Aka spinal block
Pt will remain awake, manage their airway, and need anti-anxiety
Peripheral vein is cannulated, remove as much blood by elevating or tourniquet, then infuse
Spinal @ cauda equina (L2-S2) directly into CSF (subarachnoid)
Can cause hypoTN, headache, auditory/visual disturbances, arrest, neurological defects, hematomas
Epidural: space next to dura, outside the actual cord
C-sections, lower abdominal, legs
Can cause hypoTN, systemic toxicity, accidental total spinal anesthesia (if it enters CSF)
General Anesthesia
Four phases: induction, maintenance, emergence, recovery
Induction: small dose, muscle weakness, loss of consciousness (eyelash), muscle relaxant, hyperoxygenate, intubate
Maintenance: when surgery happens, balanced anesthesia
Emergence: d/c anesthetic agents, waking up, reversal agents, flush with O2
Diffusion hypoxia: N2O use = large amounts diffuse back out of compartments into alveoli, dilutes O2 so that’s why we need 100% O2 to prevent hypoxia
Ketamine: Catalepsy, Sedation, Amnesia, Analgesia
Regional Blood flow:
Vessel rich viscera: 70%, brain/heart/liver/kidney
Muscle: 25%
Adipose tissue: 4%
Vessel poor tissue: 1%, skin/cartilage/bone
Compartments “fill” in that order, muscle can hold the most, VRV holds the least but is affected first.
Elimination of Drugs
Elimination: removal of drugs
Metabolism = liver
Excretion = kidney
Propofol
Loading Dose: 1.5-2.5 mg/kg
Action: Quick onset and elimination
Side Effects: Vivid dreams, transient apnea, anti-emetic, amnesiac
Needle Sizes
The higher the number on a needle means the smaller the needle
On a circle rebreathing system, the PEEP valve is located where?
In a circle rebreathing system, much like any ventilator circuit, a PEEP valve must be place in the expiratory circuit before the expiratory valve.
Which of the following are sources of humidity when a patient is breathing on a circle system during anesthesia?
Added heated humidifier
Exhaled gases
CO2 absorber
“All of the above” is the answer since the reaction produced by the CO2 absorber has water as a byproduct. The exhaled gases will have had their water content increased when in the airways, and the heated humidifier will usually match the water content of that which is in the body.
Which of the following is the flow rate that the oxygen flush valve should flow at when depressed?
A oxygen flush valve must have flow rates between “35-75 L/min”, and is therefore the answer. It allows the gas to bypass the vaporizer and deliver directly to the anesthetic circuit via the common gas outlet
