ortho surg lecture Flashcards
ideally pressure for tourniquet is
100 mmHg above BP for thigh, 50 mmHg above for arm
bier block gives coverage for about
an hour
bier block is limited to areas
below elbow or below knee - tourniquet
Bier block tourniquet
Double tourniquet
- inflate upper cuff to 250 mmHg
ventilation perfusion changes in lateral decubitus.
NOT ANESTHETIZED: lateral decubitus
dependent lung: better ventilation AND perfusion
non-dependent lung:decrease in V/P
ANESTHETIZED: lateral decubitus:
dependent: decreased ventilation, increased perfusion
non-dependent: increased ventilation, decreased perfusion
excess neck flexion can lead to
obstruction of internal jugular vein - venous engorgement
excess neck extension can lead to
obstruction of CBF - cerebral ischemia
macroglossia is a complication of
beach chair, likely some neuro component
brachial plexus supplies innervation for all UE muscles except
trapezius and levator scapulus - spinal accessory (CN11)
brachial plexus supplies sensory innervation to al the UE except
area of skin near axilla - intercostobrachial nerve
blood loss from THA
1L to 1500 mL
BCIS
Bone cement implant syndrome decrease SVR, hypotension hypoxia, cardiac, arrrthymias, increase PVR, loss of consciousness if awake, end of etco2 if GA.
physiological changes for 2-17% with methyl methacrylate
post-cement hypoxia
Hypoxia immediately after insertion of a cemented prosthesis and for up to 5 days into the post-operative period.
with post-cement hypoxia, you should rule out
atelectasis (esp with lateral position), hypoventilation, fluid overload.
post-cement hypoxia is graded in terms of severity
grade 1: moderate hypoxia <94% and hypotension with >20% drop in SBP
grade 2: severe hypoxia 88% or less and >40% drop in SBP
grade 3: CV collapse -> CPR
