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FA2 Anesthesiology > Lecture 1 8/21/24 > Flashcards

Lecture 1 8/21/24 Flashcards

1
Q

What is anesthesia?

A

loss of sensation in a body part/whole body

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2
Q

What are the characteristics of general anesthesia?

A

-drug-induced, reversible, and controlled
-patient is not arousable by painful stimulus
-signs of anesthetic depth vary

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3
Q

What are the characteristics of local anesthesia?

A

-drug-induced loss of pain sensation
-occurs in circumscribed body area

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4
Q

What are the characteristics of regional anesthesia?

A

-drug-induced loss of pain sensation
-in a larger but limited body area

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5
Q

What is analgesia?

A

absence of pain in response to a normally painful stimulus

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6
Q

What is balanced anesthesia?

A

general anesthesia achieved through use of multiple drugs and techniques

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7
Q

What is dissociative anesthesia?

A

cataleptic state induced by use of agents that transiently disrupt neurotransmission between thalamocortical and limbic systems

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8
Q

What is nociception?

A

neural process encoding noxious stimuli that can still occur during unconsciousness

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9
Q

What is sedation?

A

state of CNS depression with muscle relaxation and lack of awareness of surroundings

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10
Q

What is tranquilization?

A

behavioral change resulting from stress relief

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11
Q

What are the components of the pre-anesthetic patient evaluation?

A

-history
-physical exam, including BP and pain assessment
-lab testing
-imaging

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12
Q

Which aspects of patient history are most important for anesthesia?

A

-co-morbidities
-all medications
-prior anesthetic events/records

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13
Q

What aspects of the cardiovascular system should be evaluated prior to anesthesia?

A

-hx of exercise intolerance/cardiac disease
-murmurs and their characteristics
-pulse rate and quality
-heart rate
-rhythm
-blood pressure
-imaging of chest

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14
Q

What aspects of the respiratory system should be evaluated prior to anesthesia?

A

-hx of respiratory distress
-respiratory effort
-breathing pattern
-resp rate
-auscultation
-brachycephalic vs normal airway
-imaging of chest

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15
Q

What aspects of the CNS should be evaluated prior to anesthesia?

A

-hx of central neurologic disease
-mentation
-potential for increased intracranial pressure
-recovery concerns

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16
Q

Which patient-related considerations need to be considered when selecting anesthetic regimen?

A

-species and size
-age
-temperament
-species and/or breed specific sensitivities
-co-morbidities

17
Q

Which procedure-related considerations need to be considered when selecting anesthetic regimen?

A

-duration
-nature
-invasiveness
-expected degree of pain at sx site

18
Q

What is pre-anesthetic stabilization?

A

optimizing the current condition of the patient to improve prognosis

19
Q

What should be corrected during pre-anesthetic stabilization?

A

-hypotension
-intravascular volume
-electrolyte and acid-base imbalances
-anemia and/or thrombocytopenia
-hypoproteinemia
-clotting abnormalities
-cardiac dysrhythmias
-respiratory abnormalities

20
Q

What are the ASA scales?

A

1: normal patient with no disease
2: patient with mild systemic disease that does not limit normal function
3: patient with severe systemic disease that limits normal function
4: patient with severe systemic disease that constantly threatens life
5: patient that is moribund and not expected to live 24 hours without surgery
E: emergency patient

21
Q

What are the uses of sedation?

A

-restraint
-minor diagnostic procedures
-medical procedures
-improved quality of GA induction, maintenance, and recovery
-euthanasia

22
Q

Which routes of administration are most commonly used for general anesthesia?

A

IM and IV

23
Q

What are the effects of IM administration?

A

-onset within 10-15 minutes
-peak effect within minutes to hours
-less predictable and more prolonged effects

24
Q

What are the effects of bolus IV administration?

A

-onset almost instantaneous
-peak effect obtained rapidly
-short duration of action
-effects generally more intense

25
Q

What are the effects of continuous IV administration?

A

-effect remains as long as it is delivered
-recovery after termination is slower

26
Q

What are the effects of inhalation administration?

A

-peak effect occurs rapidly
-effect remains as long as it is delivered
-recovery after termination is rapid

27
Q

What are the uses of anesthesia?

A

-surgery
-major diagnostic procedures
-medical procedures
-euthanasia

28
Q

What are the three main components of general anesthesia?

A

-analgesia
-unconsciousness
-muscle relaxation

29
Q

What is the dose-dependent continuum of events in general anesthesia?

A

-alert wakefulness
-lethargy and drowsiness
-unconsciousness
-coma
-death

30
Q

What are the characteristics of Stage 1 anesthesia?

A

-right after administration of inhalant/injectable anesthetic starts
-consciousness still present
-patient exhibits CNS stimulation, ataxia, analgesia

31
Q

What are the characteristics of Stage 2 anesthesia?

A

-consciousness altered
-common with inhalants
-uncommon with injectables
-patient exhibits intense CNS stimulation that may involve excitement and/or delirium
-potential for laryngospasm

32
Q

What are the three planes of Stage 3 anesthesia?

A

-light
-medium/surgical
-deep

33
Q

What is exhibited by patients in Stage 3 anesthesia?

A

-ceased eye movements
-eyes in ventromedial position
-intense muscle relaxation
-depressed breathing

34
Q

What are the characteristics of Stage 4 anesthesia?

A

-severe medullary depression
-patient exhibits eyes in central position with no reflexes, muscle flaccidity, severe cardiovascular depression/arrest, and severe respiratory depression/arrest
-not reversible and precedes death

35
Q

What occurs during the anesthetic maintenance period?

A

-patient is monitored for anesthetic depth and cardiorespiratory parameters
-patient’s organ function is supported with IV fluids, drugs to support CV system, and mechanical ventilation
-changes in inhalant/injectable anesthetic titrations are made to adjust patient’s depth

36
Q

What are the possible morbidities experienced during anesthesia?

A

-hypotension
-hypoventilation
-regurgitation
-hypothermia

FA2 Anesthesiology (19 decks)

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