OMSA Flashcards
2 chambers of heart contain
Right and left atria (receive) and right and left ventricles (pump)
Function of the 2 heart chambers
Right pumps to lungs left pumps everywhere else
Valve found between right atrium and right ventricle
Tricuspid
What do valves do
Prevent back flow of blood and separates chambers
What valve lies between the left atrium and left ventricle
Mitral
What valve allows blood to flow through right ventricle to pulmonary artery
Pulmonary valve
What valve allows blood to flow from the left ventricle into the aorta
Aortic valve
What noise is the first sound of the heart beat (lub) caused by
Mitral and tricuspid valves closing
What is the second sound of a heart beat (dub) caused by
Aortic and pulmonic valves closing
Angina pectoris
Decrease in blood supply to heart causing chest pain
Myocardial infarction
Necrosis of the heart caused by deprivation of oxygen for too long or heart attack
What does the info on the EKG represent
Electrical activity of contraction of the myocardium
What is another term for negative myocytes
Polarized
Cells while resting are
Negative
Beta one controls
Heart
Name the two systems that comprise the autonomic nervous system
Sympathetic and parasympathetic
Follow the blood flow of the heart: superior and inferior vena cava to the ____ atrium, past the ___ valve and into the ____ ventricle. Past the ____ valve to the ____ artery to the lungs for oxygen
Right, tricuspid, right, pulmonic, pulmonary
Trace the path of the conduction system through the heart: ___ node to the ___ node to the bundle of his to the ___ and finally to the ___
SA, AV, bundle branches,purkinjie fibers
The ___ valve lies between the right atrium and right ventricle, while the ___ valve lies between the left atrium and left ventricle
Tricuspid, mitral
From the lungs blood travels through the ___ vein to the ___ atrium past the __ valve to the __ ventricle then through the __ valve into the __ where it is pumped into the rest of the body
Pulmonic, left, mitral, left, aortic, aorta
Stimulation of the vagus nerve will ___ the heart rate
Decrease
Another name for the sympathetic nerve is the cholinergic system
False
Insufficient blood flow through the coronary arteries can result in
Angina
What is the difference between angina and myocardial infarction
Angina is chest pain due to inadequate oxygenation while myocardial infarction is death of the actual heart muscle
What does ischemia mean
Inadequate blood supply
What causes a heart murmur
Turbulence in the blood flow across the heart valves
Symptoms of right sided heart failure
Ascities and pitting edema
What is the mnemonic for a patient having a myocardial infarction
MONA
Symptoms of left sided heart failure
Shortness of breath, pulmonary edema
What medication is used in the treatment for angina
Nitroglycerin
What do beta blockers do
Reduce the heart rate and blood pressure
What are the two kinds of heart failure
Right and left
Left sided heart failure often leads to
Right sided heart failure
Which patient needs antibiotic premedication
A 70 year old with a prosthetic valve
The first heart sound is caused by
Mitral and tricuspid valves closing
A patient that has a history of CABG (Coronary Artery Bypass Grafting) needs to be premeditated with antibiotics
False
Causes of hypotension include what
Excessive medication, allergic reaction and cardiac dysthymia but not seizures
Symptoms of severe hypotension include what
Dizziness, fainting, orthostatic hypotension but not chest pain
Your pt wonders if they should stop their blood pressure medication the morning of their surgery since they can’t have anything to eat or drink. What do u tell them
Take your meds with a small sip of water
The blood pressure that is considered the upper level of normal is
140/90
2 kinda of stroke include
Ischemic and hemorrhagic
Treatment for a hypertensive crisis include
A beta blocker and vasodilator
High blood pressure may increase a chance of heart attack and
Stroke
Pt in hypertensive crisis may complain of
Headache
The pneumonic for diagnosing a stroke is
FAST: Face, Arm, Speech, Time
Sinus arrhythmia is the same as asystole
False
What is the correct sequence of impulses through the heart
SA node-AV node-Bundle of His-perkinjie fibers
The best treatment for ventricular fibrillation is
Defibrillation
Ur pt has an irregularly irregular pulse. They most likely have
Atrial fibrillation
The most common rhythm of cardiac arrest is
Ventricular fibrillation
The T wave is caused by
Repolarization of the ventricles
The QRS complex is caused by
Depolarization of the ventricles
What is the intrinsic rate of the SA node
60-100 beats per minute
The P wave is caused by
Depolarization of the atria
___ is more dangerous than ___
Multifocal PVC; unifocal PVC
A pt who is in a narrow complex tachycardia is complaining of chest pain. U notice that the BP is falling and the pt has an altered level of consciousness. What do u do
Sedate then perform a synchronized cardioversion
Vagal maneuvers can be used in diagnosis and treatment in pts with what rhythm
Supraventricular tachycardia
The first medication for a pt in ventricular fibrillation is
Epinephrine 1 mg IV
U come across a pt that is not breathing and is without a pulse. What do u do next?
Start chest compressions
All bradycardias with a rate lower than 50 beats should be given atropine
.5 mg
False
When doing CPR what is the rate of chest compressions per minute
100
A pt in ventricular fibrillation has a pulse
False
You can defibrillate asystole
False
The second medication used in the treatment for ventricular fibrillation is
Amiodarone
The hairlike projections on the cells within the trachea are called
Cilia
Foreign bodies that are aspirated usually go down the ____ mainstem bronchus
Right
Inspiration is more of a ___ process and expiration is more of a ____ process
Active; passive
The anatomic structure where a circothyrotomy is performed is
Through the circothyroid membrane
Oxygen is carried by the
Red blood cell
The order of airflow of the upper respiratory system is
Nasopharynx, oropharynx, larygopharynx, trachea
The __ bronchus is straighter and wider while the __ bronchus is narrower and at a more acute angle
Right, left
Gas exchange (where oxygen goes from the air to the blood and CO2 goes from blood to the air) takes place in the:
Alveoli
Control of respiration is dependent on
The level of carbon dioxide in the blood
The order of airflow in the lower respiratory system is
Trachea, right and left mainstream bronchi, bronchioles, alveoli
Asthma is a disease of
Bronchoconstriction
An LMA is the most ideal, preferred method to maintain airway
False
With nitrous oxide delivery systems, at the maximum nitrous oxide delivery rate, at least how much oxygen should be concurrently delivered
22%
Rescue inhalers are usually a
Bronchodilator
Ideally, how long should a patient stop smoking before a procedure
8 weeks
You can insert an LMA (laryngeal mask airway) on a conscience patient with an intact gag reflex
False
Normal adult patients should show a pulse oximeter reading of __% on room air
96
What medication is NOT used for asthma
A (alpha) agonist
What medications ARE used for asthma
Corticosteroids, B agonist (bronchodilator), antihistamines
Pulse oximeter readings can be affected by
Patient movement, nail polish, chronic exposure to nicotine, cold extremities, venous congestion
Treatment of emesis is to turn the patient to the
Right
Medication to treat persistent laryngospasm is
Succinylcholine (10-20mg)
Treatment for respiratory depression from an overdose of narcotics and benzodiazepines is __ and __ respectively
Naloxone, flumazenil
Initial treatment for laryngospasm is
Suction the oropharynx
The most common cause of airway obstruction is
Tongue
The symptoms of hyperventilation are caused by
The decrease in blood CO2
Medication to treat bronchospasm are usually
Beta agonists
If a patient hasn’t had asthma in year, you don’t have to have them puff their inhaler
False
The crowing sound indicating a laryngospasm is called
Stridor
Protective reflex closure of the vocal chord is
Laryngospasm
What is the danger of doing surgery on a patient who is adrenally suppressed
They may experience a drop in blood pressure and shock
What is the normal blood glucose level
70-100
What is the problem with performing surgery on a patient who’s blood sugar is too high
They will have difficulty with wound healing
What does the thyroid do
Produces hormones that control metabolism and growth
The two types of diabetes are
Type 1: beta cells don’t produce insulin at all
Type 2: insulin binds to cells but gates don’t open for glucose
What is the function of insulin
To drive glucose into the cells
What is the endocrine system
The study of glands that secrete hormones that regulate the body
What are symptoms of diabetes
Polyphagia (always hungry), polydypsea (always thirsty), polyuria (frequent restroom)
What is the function of glucagon
To release glucose from the cells into the bloodstream
Where is insulin produced
Pancreas
An important blood level count to inquire about in an HIV positive patient is
T helper cell count
What are signs of a true allergic reaction
Itchy rash
In a patient in anaphylactic shock, the two most important considerations are: 1-the drop in blood pressure and 2-
Laryngeal edema
An extreme allergic reaction is called
Anaphylactic shock
Patients with liver disease should be given high doses of anesthetic agents
False
Indications for patients to be on Coumadin are
Stroke or cerebral vascular accident
Your patient is in kidney failure and requires dialysis. He is on a Monday Wednesday Friday dialysis schedule. Which day do u want to do surgery on?
Tuesday Thursday
The optimal time for elective procedures to be performed on a pregnant patient is
Second trimester
Medication for allergic reaction include Benadryl and
Decadron
Johnny’s mother states he is allergic to penicillin because he got sick to his stomach last time he took it. You calmly tell mom:
No Mom, Johnny had an adverse reaction not a true allergy
What is the preferred IV fluid
NS
The danger of an intra-arterial injection is
Intense chemical inflammation destroying the inner layer of the artery, preventing blood supply tot he limb
Which is the preferred vein for the IV site for oral surgery procedure
Antecubital fossa
Why must you run the IV fluid through the line before administering to the patient
To prevent air embolus
Treatment of an intra-arterial injection is
10cc 1% procaine
Less severe venipuncture complications include
Phlebitis and extravasation
The preferred method of starting an IV is to use
A catheter
When inserting the catheter which artery is at risk
Brachial artery
Treatment for phlebitis includes
Pressure, moist heat and elevation
Inflammation of the vein is called
Phlebitis
The stimulus for respiration is
Increasing CO2 levels
Increased heart rate and blood pressure are due to stimulation of the
Sympathetic system
Anesthetic agents act by
Interfering with the depolarization of the membrane
Increase in salivation is due to stimulation of the
Parasympathetic system
Normally a nerve cell is polarized. This means…
There are more positive ions on the outside of the cell membrane and more negative ions on the inside of the cell
Nerves conduct impulses by
Depolarization of the nerve membrane
The main organ that eliminates the drugs is
Kidney
The two components of the autonomic nervous system are
Parasympathetic and sympathetic
Your patient is very very nervous. You probably want to give them an anesthetic Agent targeted at
The center for emotion
The main organ that Processes the anesthetic drugs and changes the chemical Structure of the drug is
Liver
Nitrous oxide is
Stored in blue tanks, is a non-flammable gas, should always be administered with oxygen, Produces euphoria and promotes relaxation
Atropine or glycopyrrolate are sometimes given to
Reduce salivary secretions
Steroids are used to
Decrease swelling and inflammation
The function of a narcotic is to
Minimize or eliminate pain
Benzodiazepines are reversed by
Romazicon (flumazinil)
The most rapid an effective method of administering drugs is
Intravenously
Oxygen is
Stored in green tanks, Should be administered to every patient undergoing surgery with sedation, Should be administered at a concentration of 30%Or higher when given with other inhaled agents,Should be given with caution two patients with COPD
The action of benzodiazepines are
To relax and sedate the patient
Morphine is stronger than Fentenyl
False
Simply shutting off the nitrous oxide and allowing the patient to breathe room air can result in
Diffusion hypoxia
Early signs of a local anesthetic overdose include
Anxiety, Disoriented, talkative
Ketamine is classified as a
Disassociative anesthetic
Contra indications for use of propofol are allergies to
Soy, egg, sulfa
What category of patients will usually require more propofol
Children and women
Ketamine can cause respiratory depression
False
Acetaminophen toxicity affects which organ
Liver
Brevital is classified as a
Barbiturate
Propofol is classified as a
Sedative hypnotic
Brevital can cause respiratory depression
True
Brevital may predispose the patient to
Laryngospasm
It is easy to prevent the patient from progressing From a Moderate sedation to a general anesthesia
False
A 78-year-old female is given 5 mg of verse said and 50 µg of fentanyl. She now needs her chin tilted upwards to keep her airway openAnd she does not respond to verbal stimuli. Her level of sedation is
Deep sedation possibly general anesthetic
A target organ for anesthetic drugs is
Brain
Versed is classified as a
Benzodiazepine
ASA NPO Guidelines recommend Restriction of clear fluids __ hours Before the procedure and restriction of solid food for __ hours Before the procedure
2, 6
Agents that induce respiratory depression include
Opioids, benzodiazepines, alkylphenols
What agents do not induce respiratory depression
Disassociative anesthetics
838-year-old female presents for a consultation. Her past medical history includes asthma, for which she takes daily medication, Adviar, as well as a rescue inhaler. She also has diabetes for which she takes metformin And insulin. Her ASA classification is
Class III
The function of a narcotic is
Analgesia or relief of pain
A Dr. request his assistant to take the patient’s vital signs Which include
Blood pressure, temperature, pulse
Examination of a patient with a protruded tongue reveals Visualization of the soft palate and the base of the uvula Only. This patient’s malampatti classification is
Class III
Eyelash reflex is a form of ___ reflex
Palpebral
It is OK to use the patient’s family to watch them during recovery while we deal with the next patient
False
Elderly patients require ___ medications than younger adults
Less
The most ideal airway management is
Endotracheal intubation
The following questions should be asked to a patient in recovery in the order of
Do they still need airway assistance, what is there oxygen saturation in room air, Is the patient awake
The trachea is ___ To the esophagus. This means that when the patient is laying supine The trachea will be __ To the esophagus
Anterior, superior
Johnny is a five-year-old male who requires extraction of four carious baby teeth. His mom calls the day before surgery stating he has come down with a cold. You should tell her
Wait until Johnny feels better and then we will schedule an appointment for two weeks after he is well
The stage of Anastasia or surgery can be Performed is
Stage three
Passage of the air into the lungs follows the course of
Nose/mouth, nasopharynx, oropharynx, larynx,trachea,
Children have __ Heart rates and __ blood pressure When compared to adults
Higher, lower
Your sedated patient vomits mid procedure. What do you do
Roll the patient to the right side and suction airway
Treatment for respiratory depression is
Narcan .4 mg IV
Laryngospasm is
Protective closure reflex of the vocal cords To prevent foreign material from Entering into lungs
The most common cause of airway obstruction is
Base of tongue falling back and occluding the airway
Bronchospasm occurs when
Constriction of smooth muscle walls of the bronchioles
The danger of administering Narcan For treatment of respiratory depression is
The Narcan may wear off before the respiratory depressive Effect of the narcotics wears off
Treatment of bronchospasm is
Suction airway, positive pressure ventilation
Bronchospasm could be diagnosed by
Expiratory wheeze and difficulty in positive pressure Ventilation
The side effect of succinylcholine to be careful of is
It’s a muscle relaxant and can cause the patient to stop breathing
Treatment for angina is
Nitroglycerin
The drug for treatment of a narcotic overdose is
Narcan
Preliminary treatment of a patient with hypotension is
Fluid challenge
The difference between angina and myocardial infarction is
Angina is caused by lack of oxygen in the coronary arteries while an MI implies necrosis or death of the heart muscle
MONA stands for
Morphine, Oxygen, nitroglycerin, aspirin
If a pt doesn’t take their antihypertensive medication before surgery it can result in
Rebound hypertension
Patients with ____ are more at risk of cardiovascular disease
Smokers, hypercholesterolemia, fam history, diabetes, obesity, sedentary life style, hypertension, advancing age, history of MI congestive heart failure, heart valve dysfunction
Treatment for a hypertensive crisis includes
Beta blocker
Symptoms of angina include
Crushing, squeezing chest pain
If your pt is determined to be in respiratory depression with a respiratory rate of 7 you
Head tilt to open the airway and apply full face mask with positive pressure O2
The medication used to treat overdose of a benzo is
Romazicon
What is more dangerous multifocal PVC or unifocal PVC
Multifocal
A patient is in asystole, your next move is to
Start CPR and give epinephrine 1mg
Is it possible to see a normal sinus rhythm on an EKG with no pulse
True
The cardiac rhythm in which the pt does not have a pulse are asystole, pulseless ventricular tachycardia, pulseless electrical activity and
Ventricular fibrillation
The drug of choice to speed up the heart in a symptomatic bradycardia is
Atropine
Pts with a dysrhythmia who are symptomatic will complain of chest pain, shortness of breath and
Dizziness and hypotension
The drug of choice used to treat a supraventricular tachycardia is
Adenosine
Your pt is extremely nervous and apprehensive. The EKG shows a sinus rhythm of 135 bpm. Your next step is to
Go ahead and sedate the pt because sinus tachycardia is normal to see in an anxious pt
An example of a vagal maneuver is
Have the pt bear down as if having a bowel movement
The most effective treatment for a pt in ventricular fibrillation is
Defibrillation
If a patient with a known seizure disorder doesn’t take his medication It can precipitate a seizure
True
For moderate allergic reactions in addition to Benadryl, This drug is often added
Decadron
Treatment of a mild allergic reaction Usually is prescribing
Benadryl
Treatment for syncope is
02, Trendelenburg position
If a diabetic take their medication as usual the day of the surgery We would worry about
Hypoglycemia
The first medication to consider in an anaphylactic crisis is
Epinephrine
The causes of syncope is
Slowed heart rate and blood pressure
A patient’s mother states the patient is allergic to Vicodin. She says he becomes nauseated with it is this a true allergy
No
The most common presentation of an allergic reaction is
Itchy red rash
A severe allergic reaction is called
Anaphylaxis
The trachea branches into the right and left main stem Bronchus. The patient is undergoing general anesthesia in your office To remove a tooth. The patient aspirates the tooth. Which long would you guess the tooth ended up in
Right
A patient with type two (non-insulin-dependent) Diabetes would typically be taking pills To control their blood glucose and their diabetes
True
You have a 17-year-old patient that is undergoing General Anastasia to remove four wisdom teeth. During the surgery you hear a high-pitched crowing sound. You look down and her chest and abdomen are not in sync When she is breathing. Her oxygen saturation begins to fall rapidly. Your diagnosis and treatment are
Laryngospasm: Administer positive pressure and succinylcholine if needed
The right side of the heart carries deoxygenated blood
True
Which of the following general drug categories Are used to treat someone experiencing an asthma attack
Beta agonist
A laryngospasm is a disorder of the
Upper airway
Your patients presents for surgery at 10am. He states that he has not had anything to eat or drink but out of habit he took his daily dose of insulin. He is pale trembling and no feeling well. You perform a finger stick as you do with all your diabetic patients. His blood glucose is 50. You have not started an IV yet. The best treatment option for this pt is to…
Start an IV and give D5W as your IV fluids
The most Common cardiac rhythm on an EKG For an adult patient in cardiac arrest is
Ventricular fibrillation
The classification of drugs Used to relieve pain is
Narcotics
Your patient is a relatively difficult anesthetic patient. He is morbidly obese With a short neck, recessed jaw, and a mallampatti class of four. You’re struggling to chin him. You already have a nasopharyngeal airway in. What else might you try before you into beat him
Laryngeal mask airway
The most frequent anatomical airway obstruction is
The tongue
The most concerning signs and symptoms of An acute anaphylactic reaction are
Airway edema and circulatory collapse
Two types of diabetes that are characteristically classified as the following
Type one: Insulin-dependent and type two: non-insulin-dependent
A patient with type one diabetes would typically be giving themselves shots Of insulin to control their blood glucose And to control their Diabetes
True
The correct air flow sequence from the nose to the lungs is
Nose, nasal pharynx, oral pharynx, laryngopharynx, Trachea, lungs
The agent used to reverse the effects of versed is
Romazicon (flumazenil)
The acronym fast refers to facial droop, Arm weakness, Speech problems, and time to call 911. This refers to what condition
Stroke
Which monitor gives the most information About ventilation
Capnograph
Dilation or widening of blood vessels And arteries will cause your blood pressure to increase
False
You are starting an IV on your patient through the anti-cubital fossa. The artery you want to avoid in the anti-cubital fossa is
Brachial artery
The ASA classification is used For assessing patients prior to General Anesthesia As a risk assessment tool. You have a patient with a history of only hypertension, high blood pressure, what classification would they be
ASA 2
The QRS complex on the EKG represents
Ventricular depolarization
A pediatric airway is different from an adult airway in that
Kids have a large tongue and conical shaped airway
Your patient has stopped breathing. What is the main primary physiological Mechanism that will restart this patient’s breathing
Excess of carbon dioxide
Drugs given to patients are usually metabolized In the body by what organ
Liver
You have a 68-year-old male patient with a history of hypertension. He had a heart attack a while back. When he had a heart attack He states he had it angioplasty with one stent placed. He’s anxious and wants to go to sleep for his extractions. Which anesthetic agent would you want to avoid
Ketamine
A patient calls one day after the removal of an infected tooth. She reports an itchy red rash all over her body after taking amoxicillin That your doctor prescribed. She is worried that she is allergic to amoxicillin. Your recommendation to her is
Stop the amoxicillin and take over-the-counter Benadryl
The difference between angina and myocardial infarction is
A myocardial infarction implies death or necrosis of the heart muscle
Your doctor has started an IV. You are hooking the IV line with the catheter. Which bag of IV fluids is the preferred Fluid for a routine healthy patient
LR
There are two main categories of local anesthetics used in dentistry. Most common category of local anesthetic used in oral and maxillofacial surgery’s is
Amide
What drug is most commonly associated with respiratory depression when given IV
Fentanyl
The P-wave in the EKG represents
Atrial depolarization
Constriction of or narrowing Of the coronary arteries can cause angina
True
Indications for patients to be on anticoagulants are
Stroke, pulmonary embolism, History of blood clot in the legs
The doctor asks you to assess the patient’s ventilation. The things you look at include the rising and falling of the chest and
Oxygen saturation and end title CO2
When insulin is given to a patient at lowers the patient’s blood glucose
True
Myocardial infarction of the heart muscle is reversible
False
A contraindication for the use of propofol is
Allergy to eggs
A patient has taking 20 mg of prednisone daily for the last 30 years for the rheumatoid arthritis. Your doctor is planning to remove a difficult deeply impacted wisdom tooth. Our concern preoperatively for this patient is
The patient will not be able to properly handle a flight or fight response From a stressful procedure
Anginas potentially reversible
True
Asthma is a disease of the long. Specifically Considered a disease of the
Lower airway, bronchiolar constriction
Normal pathway of the conducting system in the heart is
SA node, AV node, Bundle of his, Purkinje fibers
Stimulation of the sympathetic nervous system will result in
Increased heart rate, increased blood pressure
Classic symptoms of congestive heart failure include
Shortness of breath, Swollen ankles
Angina is due to
Decreased blood flow to the heart muscle
Atrial fib relation is a type of heart rhythm. Patients who have this rhythm will have an irregular pulse
True
Ketamine can cause hallucinations. The best medication to give with ketamine To reduce the incidence of the side effects is
Versed
In compartment syndrome, one can see an increase pressure in the forearm. This can be caused by venipuncture. This is considered a true medical emergency
True
Epinephrine is one of the components of local anesthesia. When epinephrine is added to local anesthesia It helps maintain the local anesthetic Close to the inferior alveolar nerve Potential he making it more effective for profound Local anesthesia. They should theoretically
Decrease the number of cartridges used to obtain a profound local anesthesia
Insulin converts
Glucose into glycogen
Can you compare the ventricles of the heart to the atria of the heart, The walls of the ventricles are thicker than the atria
True
Constrictions of or narrowing of the blood vessels and arteries Will cause your blood pressure to increase
True
One way for your doctor to know that they have inadvertently Placed an IV into an artery is
Pulsatile movement and bright red blood in the IV line
The left side of the heart carries deoxygenated blood
False
You just completed a surgical procedure on a patient. This patient received fentanyl, versed, and propofol Intravenously with LR As the fluids. The patient has been in recovery for 45 minutes And is still drowsy. Which medication is most likely causing them to be drowsy
Versed
The following is the correct sequence of blood flow through the heart
Superior/inferior vena cava, Right atrium, tricuspid valve, Right ventricle, Pulmonic valve, Pulmonary artery, pulmonary vein, Left atrium, mitral valve, left ventricle, Aortic valve, aorta
A patient with type one diabetes calls the morning of the surgery. She states that she knows she’s not supposed to have anything to eat or drink and is not sure what to do about her insulin. She Asks for instructions On her insulin that she normally injects her self with every morning. You instruct her to
You tell her to inject yourself with half the normal dose
Drugs given to the patient are usually excreted from the body after passing through what organ
Kidney
Signs and symptoms of a myocardial infarction
Chest pain not relieved by nitroglycerin, pain may radiate down the left arm or up to the left jaw, Blood pressure will drop with weak pulse, may experience nausea or vomiting
Signs and symptoms of congestive heart failure
Right sided failure: swelling of ankles and belly and distended neck veins. Left sided failure coughs pink frothy sputum, shortness of breath when they lay down, often wakes upIn the middle of the night gasping for air
Cerebral vascular accident is another name for
Stroke
What are the two types of strokes
Embolic stroke: a blood clot causes the blood vessel to become occluded Hemorrhagic stroke: a blood vessel ruptures and bleeds
Signs and symptoms of stroke
Weakness in extremities usually right side, facial palsy/slurred speech, headache
What What does not show up on an EKG
Atrial repolarization
What is considered bradycardia
A heart rate less than 60
What is tachycardia mean
Heart rate over 100
What are corticosteroids used for
Suppress inflammation
Where is cortisol produced
In the adrenal gland
Symptoms of adrenal insufficiency
Hypoglycemia, dehydration, weight loss, disorientation
What does your thyroid gland do
Produces hormones that regulate metabolism and growth
What does PVC stand for
Premature ventricular contraction (wide bizarre QRS complex) wave not traveling along right/left perkinjie fibers simultaneously
What is multifocal PVC caused by
Hypoxia
What is ventricular tachycardia
Looks like string of PVC run together. Potentially fatal. Low blood output.
What is SVT
Supraventricular Tachycardia
What is bigeminy
A PVC every other beat
On an ekg graph how much time is measured from dark line to dark line
.2 seconds
On an elf graph how much time does one square represent
.04
What is the intrinsic rate of that atria
60-80 bpm
What is the inherit rate of the ventricles
20-40 bpm
What is an ectopic foci
Excitable cell area of heart fired out of normal rhythm
What are PJC’s
Premature junctional contraction
What is congestive heart failure
Pump failure causing blood to back up.
What is the treatment for CHF
Diuretic
What are Korotkoff sounds
The force of ventricular contraction (systolic number)
What is the rule of 2’s
If pt has taken more than 20mg of hydrocortisone more than 2 weeks in the last 2 yrs then double their dose before surgery
Pts that have had chemotherapy need to have what checked before surgery
CBC (complete blood count)
What does LR stand for
Lactated ringers (like saline but with more electrolytes
What is normal physiologic tonicity of human fluid
.9%
What does 1:100,000 mean
1 gram in 100,000 cc or solution
What is a millimeter
One thousandth of a liter
What is a milligram
One thousandth of a gram
Anatomy from top to bottom of arm
Biceps brachii, brachialis muscle, median nerve, brachial artery, tendon of biceps brachii, pronator teres, brachioradialis, flexor carpi radialis
What are some drugs that are considered narcotics
Morphine, fent, Demerol, codeine
What does ketamine do
Dissociative anesthetic. Causes blockade of an excitatory neurotransmitter. Potent analgesia and amnesia
What is cyanosis
Blue skin color
What are normal values of CO2 expiration
5-6% or 35-45 mm Hg
What can happen with pts with compromised liver function
May not be able to clot and cannot process drugs as fast and therefore will need less
What does propofol affect
Wakefulness, euphoria, and is an anti-nausea
Another word for zofran
Ondansetron (for nausea)
What is dyspnea
Difficultly breathing
What is bronchitis
Acute inflammation of mucus membranes of bronchial tube
