Mosier Test 2 Flashcards
When upper motor neurons are injured, that can cause ________ ________ not associated with _________ ________ and causes _________
Spastic paralysis; muscle atrophy; hyperreflexia
Lower Motor neuron injuries cause __________ ________and are associated with _________ ________ and causes ____________
Flaccid Paralysis; muscle atrophy; hyporeflexia
When upper motor neurons have been around long enough they can eventually cause _________ ________, but the board answer is that they do not.
Muscle atrophy
Injuries above ___ can cause __________ _________
and ___________ ___________, especially when ___ and ____ levels are damaged, and will cause paralysis below the level of the injury
T6; autonomic Dysreflexia; Neurogenic shock; T1-T4
Dysreflexia and hyperreflexia are _____________
Synonymous
Autonomic Hyperreflexia can lead to dangerously ______ blood pressure, and can be caused by ___ and above spinal cord injuries, and can be precipitated by ________ _______ below the level of the injury
high; T6; noxious stimuli
Spinal nerves ___ through ___ innervate the diagram,
C3; C5
__ thru __ injuries can cause quadriplegia and need for __________ _________
C1; C4
Injuries to ___ and above will cause difficulty with clearing _________
C5
_________ __________ _________ prepares body to rest and digest, originates in the ________ ________ of the spinal cord and brainstem, and uses _____ as its neurotransmitter
Parasympathetic nervous system; Cranial sacral; ACH
________ _________ _________ prepares the body for flight and fight, ___________ heart rate and contractility and __________ smooth muscles of the airways
Sympathetic Nervous System; increases; relaxes
Except for glands, viscera, and the adrenal medulla, the receptors of the ________ nervous system are ____ receptors, ____ receptors, and are referred to as _________ receptors
Sympathetic; Alpha; Beta; Adrenergic
The receptor of the PNS are the _________ receptors, and are referred to as the _________, and use ____ as their neurotransmitter
Muscarinic; Cholinergic, ACH
___ receptors cause vasoconstriction and ____________
A1; bronchoconstriction
___ activation inhibits the release of NE. What two medications are an example of an A2 agonist?
A2; Clonidine and Precedex
___ receptors are present in the heart. They ________ HR and contractility and can _________ AV nodal conduction
B1; increase; increase
B2 receptors cause vaso______ and broncho_______ and cause __________ ___________ _________
dilation; dilation; uterine muscle relaxation (terbutaline)
Activation of __________ __________ Decreases HR, contractility, and causes broncho_________ and vaso_______
muscarinic receptors; constriction; dilation
The __________ is the “captain” of the ____
Hypothalamus; ANS
Brainstem has control over __________ and ____________ ____________
Cardiovascular; pulmonary
Autonomic Reflexes will suppress _ branch of the ANS, whether it be the ____ or ____, while activating the other
1; SNS or PNS;
__________ __________ causes loss of vasomotor tone. Loss of vasomotor tone leads to __________
Neurogenic shock; hypotension
Neurogenic Shock cause diminished sympathetic innervation of the heart, which leads to __________
Bradycardia
ICP is normally __ to __ mmhg and is usually treated when it is above ___ mmhg.
5 to 15 (textbook answer); 20
ICP can be affected by anesthetic __________ and _________
administration and technique
CSF accounts for approximately ___ to ___ percent of intracranial volume
10 to 15%
The __________ _________ produces approximately 500cc of CSF per day. The total volume of CSF is approximately ____cc
Choroid Plexus; 150
Cerebral Edema can be caused by ________ _______, __________, and disruption of the _________ ________ ________
Ischemic Stroke, Meningitis, Blood Brain Barrier
Cerebral blood flow accounts for approximately ___ percent of cardiac output, is tightly coupled to _______, and is autoregulated to MAP of ____ to ____
14; CMR02; 60 to 160
Autoregulation of CBF can be lost to ________, ________, and _________ __________.
Acidosis, hypoxia, and volatile anesthetics
PAC02 is a potent _________ _________, and has a proximate __________ relationship to CBF, and is a potent determinant of _____
cerebral vasodilator; linear; CBF
Once _____ drops below 50mmhg the is an _________ in CBF, even in the presence of ____________
PA02; increase; hypocapnia
A PA02 of ___ equates to an approximate oxygen saturation in the low 80’s
50
Volatile anesthetics generally _________ CBF, _________ CMR02, and have a profound effect on _________ evoked potentials
increase; decrease; motor
Propofol and Etomidate __________ CBF and __________ CMR02
Decrease; decrease
Ketamine __________ CBF and __________ CMR02
Increases; increases
Opioids have no direct affect on ____ and Benzodiazepine have _________ effect on CBF. Studies have shown that there is no clinically significant ________ in CBF after Succs administration
CBF; minimal; increase
___________ ___________ ___________ are sensitive to Inhaled anesthetics. They require the patient not to be paralyzed for the entire case, but it is okay at the
Motor Evoked Potentials; beggining
Regarding evoked potentials, Ketamine and Etomidate have been reported to __________ the quality of _______ signals
enhance; SSEP
Propofol and Thiopental ___________ the amplitude of all modalities of EP monitoring, but do not ___________ them
attenuate; obliterate
Opioids, Benzos, and Precedex have __________ effects on the recording of _________ _________
negligible; Evoked potentials
Inhalation agents, including N02 generally have a more ___________ effect on evoked potential monitoring than ___ agents
depressant;IV
Volatile anesthetic can have a profound effect on the ________ and ________ of evoked potentials
amplitude; latency
Signal are obtainable under __________ _________ but the anesthetic is usually kept at ____ _____ doses
Volatile anesthetics; Sub MAC
_________ ________ can be used in any circumstance where there may be vascular compromise to the brain or restriction of blood flow
Cerebral Oximetry
A decrease in ____ percent from baseline is significant in cerebral oximetry
20
Cerebral oximetry can be used in any procedure where there can be compromise in CBF from patient _________
positioning
Regarding heart transplant patients, a spinal anesthetic will _____ SVR, and despite activation of _______ ________ and increased ________ _________ being sent to the brain via cranial nerves __ and __, the ________ _________ being sent to the heart have been lost, thus a __________ _________ in CO will be absent
decrease; baroreceptors Afferent signals; 9 and 10; efferent signals; reflexive increase
If treating a Heart transplant patient for hypotension after spinal, than an __ _______ should be used to increase SVR, and a __ ________ should be readily available to increase CO
A1 agonist; B1 agonist
Heart transplant patient becomes bradycardic and hypotensive after induction, you going to give what drug?
Epi
ER burn patient comes in and you need to urgently intubate them, what NMB is safe to use? Because when will Hyperkalemia become a problem? Burn patient comes in 3 Years later with Bowel obstructions and hypokalemia, what NMB would you use?
Succs; 48 hours after injury; Succs
Succs vs large dose Roc in RSI, which is better?
Succs
Chemical warfare, Serin being used (Acetylcholinesterase Inhibitor) - soldier has pinpoint pupils, shaking, frothing at the mouth, wheezing, nd confusion. What is the first drug your going to give?
Atropine
