Miller Questions Flashcards
What is the arterial blood supply to the brain?
.In what proportion of human brains is the classic depiction ofthe circle of Willis found
What make up the blood-brain barrier?
Name some factors that influence cerebral blood flow.
What is normal cerebral blood flow
What is the relationship between cerebral metabolic rate and cerebral blood flow?
8. For every 1 C decrease in temperature below normal body temperature, what is the
corresponding decrease in cerebral blood flow?
Define cerebral perfusion pressure
Within what range of mean arterial pressures will cerebral blood flow remain
relatively constant
What is the time course within which cerebral vasculature changes in response to
alterations in mean arterial pressure? What is the clinical implication of this?
What are factors that impair the autoregulation of cerebral blood flow?
Describe the relationship between PaCO2 and cerebral blood flow.
How much does cerebral blood flow change for every 1 mm Hg increase or decrease
in PaCO2 from 40 mm Hg?
What is a potential risk of prolonged, aggressive hyperventilation to a PaCO2 of less
than 30 mm Hg?
Below what PaO2 will cerebral blood flow increase?
What are the effects of volatile anesthetics on cerebral blood flow and intracranial
pressure?
What are the effects of nitrous oxide on cerebral blood flow and intracranial
pressure?
What are the effects of ketamine on cerebral blood flow and intracranial pressure?
- What are the effects of thiopental on cerebral blood flow and intracranial pressure?
What are the effects of propofol on cerebral blood flow and intracranial pressure?
What are the effects of propofol on cerebral blood flow and intracranial pressure?
- What are the effects of etomidate on cerebral blood flow and intracranial pressure?
What are the effects of dexmedetomidine and clonidine on cerebral blood flow and
intracranial pressure?
What are the effects of benzodiazepines on cerebral blood flow and intracranial
pressure?
What are the effects of opioids on cerebral blood flow and intracranial pressure?
What are the effects of neuromuscular blocking drugs on cerebral blood flow and
intracranial pressure?
What is a normal intracranial pressure?
How does the body compensate for increasing intracranial pressure? What
implications does this have clinically?
How do drug-induced increases in cerebral blood flow affect the intracranial
pressures of normal patients and of patients with intracranial tumors?
- Name some methods used to decrease elevated intracranial pressure
Name some signs and symptoms that may be noted preoperatively that provide
evidence that a patient may have an increased intracranial pressure.
What is the current recommendation regarding the use of induced hypothermia
for neuroprotection?
What is the current recommendation regarding the use of intravenous anesthetics
for neuroprotection?
What monitors are typically used for intracranial neurosurgery?
What two devices can be used to measure the intracranial pressure?
What measures can an anesthesiologist undertake to attenuate increases in arterial
blood pressure and intracranial pressure during direct laryngoscopy?
How is maintenance anesthesia usually achieved in patients undergoing
intracranial neurosurgery?
What minimum alveolar concentration (MAC) of volatile anesthetic should be
administered when used for maintenance anesthesia in patients undergoing
intracranial neurosurgery?
What minimum alveolar concentration (MAC) of volatile anesthetic should be
administered when used for maintenance anesthesia in patients undergoing
intracranial neurosurgery?
What is the desired range of PaCO2 to optimize cerebral blood flow intraoperatively?
What is a potential problem of the administration of positive end-expiratory
pressure (PEEP) during mechanical ventilation of the lungs in patients undergoing
intracranial neurosurgery?
How do peripheral vasodilators affect cerebral blood flow? What is the
recommendation regarding the use of these drugs intraoperatively in patients
undergoing intracranial neurosurgery?
Why might neuromuscular blockade be maintained throughout intracranial
surgical procedures?
How can cerebral swelling be treated intraoperatively?
What are some potential problems that can occur with the administration of
mannitol?
How should intravenous fluid administration be managed intraoperatively in
patients undergoing intracranial neurosurgery?
Why should glucose-containing intravenous solutions be avoided in neurosurgical
patients?
Why should coughing and straining by patients awakening from anesthesia be
avoided after intracranial surgery? What are some methods by which these
responses by the patient can be avoided?
Why is rapid awakening desirable in neurosurgical procedures?
How should delayed recovery after intracranial surgery be evaluated? When should
tension pneumocephalus be considered as a possible cause of postoperative delayed
recovery?
Why are patients undergoing neurosurgical procedures at an increased risk for
venous air embolism?
Why are patients undergoing neurosurgical procedures at an increased risk for
venous air embolism?
Describe the pathophysiology of a venous air embolism. What percent of adult
patients have a probe patent foramen ovale?
What are methods by which a venous air embolism can be detected? Which of these
is the most sensitive?
What are some signs of a clinically significant venous air embolism?
What is the treatment for a venous air embolism?
Why should nitrous oxide administration be discontinued in the presence of a
venous air embolism?
What are the advantages of a pulmonary artery catheter in the presence of a venous
air embolism?
How efficacious is the use of PEEP in the prevention of a venous air embolism?
What typically causes death in a fatal venous air embolism?
What are some of the presenting signs and symptoms of patients with an
intracranial tumor?
What are the anesthetic goals for patients undergoing surgical resection of an
intracranial tumor?
Why is it important to limit drug-induced depression of ventilation with
preoperative medicines in patients who are scheduled to undergo surgical resection
of an intracranial tumor?
How is the induction of general anesthesia in patients undergoing surgical resection
of an intracranial tumor achieved?
What are the advantages and disadvantages of the sitting position for the resection
of intracranial tumors?
Name some anesthetic considerations that are unique to posterior fossa tumors
