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Blink > Module 1 > Flashcards

Module 1 Flashcards

1
Q

Where are stimulator electrodes placed?

A

directly over ulnar groove, proximal to wrist crease

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2
Q

Electrode 1 placement

A

Adductor Polices, distal to the thenar eminence

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3
Q

Electrode 2 placement

A

On first dorsal interosseous muscle on back of hand

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4
Q

Ground (G) placement

A

Index Finger

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5
Q

Neuromuscular Blockade means…(simplified)

A

airway muscles are not ready

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6
Q

Potential Adverse Effects of Residual Neuromuscular Blockade in Postoperative Period

A
  • Need tracheal reintubation
  • Impaired oxygenation and ventilation
  • Impaired pulmonary function
  • Increased risk of aspiration and pneumonia
  • Pharyngeal Dysfunction
  • Delayed discharge from PACU
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7
Q

Intubation

A

Endotracheal tube placed down patients throat to assist with breathing. Once intubated, tube is connected to ventilator

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8
Q

Triad of Anesthesia

A
  • Hypnosis
  • Analgesia
  • Muscle Relaxation
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9
Q

Hypnosis

A

Put the brain to sleep

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10
Q

Analgesia

A

Control pain

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11
Q

Muscle Relaxation

A

Paralytics

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12
Q

NMBA

A

Neuromuscular Blocking Agents

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13
Q

Neuromuscular Blocking Agents

A

Administered adjectively to anesthesia to produce paralysis

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14
Q

NMBAs 2-steps

A

Step 1: Paralyze vocal cords to allow intubation of the trachea
Step 2: Optimize surgical field by inhibiting spontaneous breathing and causing relaxation of the skeletal muscles

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15
Q

2 Types of NMBAs

A

Depolarizing and Non-Depolarizing Agents

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16
Q

Depolarizing NMBAs

A

cause rapid depolarization which makes muscle fibers resistant to stimulation by Acetylcholine (Ach)

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17
Q

Duration of Depolarizing agents

A

rapid (seconds), 7-12min durations

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18
Q

Non-Depolarizing NMBAs

A

cause total paralysis by blocking the binding of acetylcholine and the inotropic activity of Ach receptors

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19
Q

Duration of Non-Depolarizing NMBAs

A

takes effect in minutes, lasts 30min-2hr

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20
Q

Depolarizing NMBA examples

A

Succinylcholine (Anectine)

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21
Q

Non-Depolarizing NMBA examples

A

Cisatracurium
Pencuronium
Rapacuronium
Miuccuronium
Attracurium
Vecuronium

22
Q

What reverses non-depolarizing agents

A

anticholinestease inhibitors

23
Q

Most popular depolarizing agent

A

Succinylcholine (anectine)
- does NOT exhibit TOF fade

24
Q

Which agents will cause TOF fade

A

Non-depolarizing agents ending in ‘-ium’

25
Q

Reversal Agents def and examples

A

any drug used to reverse anesthetics, narcotics, potentially toxic agents
- Suggamedex
- Neostigmine

26
Q

What is given in combo with Neostigmine

A

Glycopyrollate

27
Q

Glycopyrrolate

A

given to counteract Neostigmine potential cardiac, pulmonary, or gastrointestinal side effects
- an anticholinergic drug

28
Q

NMJ

A

Neuromuscular Junction

29
Q

Neuromuscular Junction

A
  • The synaptic connection between the terminal end of the motor nerve and a muscle
  • The site for transmitting action potential from nerve to muscle
  • It is the site for many diseases and site of action for many pharmacological drugs
30
Q

3 main parts NMJ

A
  • Nerve Terminal – presynaptic part
  • Motor End Plate – Post synaptic part
  • Synaptic Cleft – area between nerve terminal and motor end plate
31
Q

3 Sites of Stimulation

A
  • Orbicularis Oculi
  • Flexor Hallucis Brevis
  • Posterior Tibial Nerve
32
Q

Orbicularis Oculi

A

Facial muscles surrounding each orbit, primary function to close the eylid

33
Q

Flexor Hallucis Brevis

A

Small intrinsic muscle in foot, primary function is to flex big toe and innervated by posterior tibial nerve

34
Q

Posterior Tibial Nerve

A

Medial aspect of the ankle between medial malleolus and achilles tendon

35
Q

AchE

A

Acetylcholinesterase (aka acetylhydrolase)

36
Q

Acetylcholinesterase

A

Is the primary cholinesterase in the body. It is an enzyme that catalyzes the breakdown of acetylcholine into acetate and choline

37
Q

Ach

A

Acetylcholine

38
Q

Acetylcholine

A

The neurotransmitter used at the NMJ . It is the chemical that motor neurons of the nervous system release to activate muscles

39
Q

Cholinergic

A

Inhibit, enhance, or mimic the action of the neurotransmitter Ach, the primary transmitter of nerve impulses within the parasympathetic nervous system. (ie, that part of the autonomic nervous system that contracts smooth muscles and dilates blood vessels, etc.)

40
Q

nchR

A

Nicotinic Receptor

41
Q

Nicotinic Receptor

A

A type of Ach receptor that responds to nicotine and Ach
- receives Ach and NMBAs

42
Q

Neuromuscular Activation

A
  • An influx of Ca++ in nerve terminals leads to the release of ACh
  • Ach binds nicotinic receptors at the motor end plane and causes depolarization / NA+ entry
  • Action potential caused by Na+ depolarizes muscle fibers
43
Q

Action Potential

A

The change in electrical potential is associated with the passage of an impulse along the membrane of a muscle cell or nerve cell

44
Q

TOF

A

Train of Four

45
Q

TOFR

A

Train of Four Ratio

46
Q

TOFC

A

Train of Four Count

47
Q

PTC

A

Post Tetanic Count

48
Q

MMG

A

Mechanomyography

49
Q

AMG

A

Acceleromyography

50
Q

EMG

A

Electromyography

51
Q

KMG

A

Kinemyography

Blink (2 decks)

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