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Fall 2020 - Physiology 3 - Neuro > Quiz 2 Review > Flashcards

Quiz 2 Review Flashcards

1
Q

What do Upper Motor Neuron Injuries cause?

A

Spastic Paralysis & Hyperreflexia

No Muscle Atrophy til Later

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2
Q

What do Lower Motor Neuron injuries cause?

A

Flaccid Paralysis & Hyporeflexia w/ Muscle Atrophy

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3
Q

What do injuries above T6 cause?

A

Autonomic Dysreflexia

&

Neurogenic Shock

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4
Q

What happens with T1-T4 damage?

A

Paralysis below level of Injury

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5
Q

What is a main sign of Autonomic Hyperreflexia?

A

Dangerously High BP precipitated by Noxious Stimuli below the Injury Level

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6
Q

Which patients are infamous for Autonomic Hyperreflexia?

A

Cysto Patients

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7
Q

What does C3-C5 Innervate?

A

Phrenic Nerve - Diaphragm

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8
Q

What do C1-C4 injuries cause?

A

Quadriplegia requiring Mechanical Ventilation

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9
Q

Injuries at what level would cause Difficulty Clearing Secretions?

A

C5 & Above Injuries - Indicates Intubation

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10
Q

What is the Neurotransmitter of the Parasympathetic Nervous System?

A

Acetylcholine

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11
Q

Where does the Parasympathetic Nervous System orginate from?

A

Cranial & Sacral Areas of Spinal Cord & Brainstem

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12
Q

What does the Sympathetic Nervous System do?

A

Increase HR & Contractility

+

Relax Airway Smooth Muscles

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13
Q

Which adrenergic receptors are stimulated by the Sympathetic Nervous System?

A

Alpha & Beta Receptors

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14
Q

How do Alpha & Beta receptors affect the Airway?

A

Alpha: Minor - Contraction & Bronchconstriction

Beta: Major - Bronchodilation

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15
Q

What is not included in regards to Sympathetic Nervous System receptors?

A

Glands

Viscera

Adrenal Medulla

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16
Q

What are the receptors of the Parasympathetic Nervous System?

A

Cholinergic / Muscarinic Receptors

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17
Q

What are the effects of Alpha-1 Receptors?

A

Vasoconstriction & Bronchoconstriction

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18
Q

What happens when Alpha-2 Receptors are activated?

A

Inhibition of Norepi Release

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19
Q

What are examples of Alpha-2 Agonists?

A

Clonidine & Precedex

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20
Q

Where are Beta-1 Receptors located and what do they do?

A

Increase HR, Contractility, & AV Node Conduction in the Heart

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21
Q

What does Beta-2 Stimulation do?

A

Vasodilation, Bronchodilation, & Uterus Relaxation

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22
Q

What happens when Muscarinic receptors are activated?

A

Decrease HR & Contractility

Bronchoconstriction

Vasodilation

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23
Q

What controls the Autonomic Nervous System?

A

Hypothalamus - Captain of the ANS

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24
Q

What does the Brainstem control?

A

CV & Pulmonary Function

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25
Q

How do Autonomic Reflexes affect the SNS & PNS?

A

Activates one while supressing the other

26
Q

What does Neurogenic Shock cause?

A

Loss of Vasomotor Tone

Diminished SNS

Hypotension

Bradycardia

27
Q

What is the normal ICP?

28
Q

When should the ICP be treated?

A

20 mmHg or Higher

29
Q

What can affect ICP?

A

Anesthetic Meds & Techniques

30
Q

How much of the Intracranial volume is CSF?

31
Q

How much CSF does the Choroid Plexus produce a day?

A

~500 mL/day

32
Q

How much total CSF is there at any one time?

33
Q

What can cause Cerebral Edema?

A

Ishemic Stroke

Meningitis

BBB Disruption

34
Q

How much Cardiac Output goes to Cerebral Blood Flow?

35
Q

Cerebral Blood Flow is tightly coupled to _______

A

Cerebral Blood Flow is tightly coupled to CMRO2

36
Q

At what MAP is Cerebral Blood Flow autoregulated?

A

MAP of 60-160 mmHg

37
Q

What can cause of loss of Cerebral Blood Flow autoregulation?

A

Acidosis

Hypoxia

Volatile Anesthetics

38
Q

What is a potent Cerebral Vasodilator & has a linear relationship to CBF?

39
Q

What level of PaO2 will cause an increase in Cerebral Blood Flow, even with Hypocapnia?

A

PaO2 < 50 mmHg

40
Q

PaO2 of 50 mmHg = ? SaO2

A

PaO2 of 50 mmHg = ~80% SaO2

41
Q

How should O2 Saturation be managed for patients w/ Increased ICP?

A

Dont let O2 Saturation go below 80%

42
Q

What are the Neuro Effects of Volatile Anesthetics?

A

↑CBF

↓CMRO2

Profoundly affects Motor EPs

43
Q

What are the Neuro Effects of Propofol & Etomidate?

A

↓CBF

&

↓CMRO2

44
Q

What are the Neuro Effects of Ketamine?

A

↑CBF

&

↑CMRO2

45
Q

How do Opioids affect Cerebral Blood Flow?

A

No Direct Effect, but respiratory depression can ↑CO2 & ↑ICP

46
Q

How do Benzos affect Cerebral Blood Flow?

A

Minimal Effect

47
Q

How does Succinylcholine affect Cerebral Blood Flow?

A

No Significant Increase

48
Q

What is required to be able to monitor Motor Evoked Potentials (MEPs)?

A

Patient CANNOT be paralyzed for entire case, only the beginning of case is OK

49
Q

How do Ketamine & Etomidate affect Evoked Potentials?

A

Enhances SSEP

50
Q

How do Propofol & Thiopental affect Evoked Potentials?

A

Attenuates Amplitude without Obliteration

51
Q

How do Opioids, Benzos, and Precedex affect Evoked Potentials?

A

Negligible Effects

52
Q

How do N2O & Inhalation agents compare to IV Agents regarding Evoked Potentials?

A

N2O & Inhalation Agents have more Depressant Effects

53
Q

How do Volatile Agents affect Evoked Potentials?

A

Profound influence on Amplitude & Latency - Sensory & Motor

54
Q

How should Inhalation Agents be managed in order to obtain Evoked Potential signals?

A

Keep below full MAC

55
Q

When should Cerebral Oximetry be used?

A

Any case where Vascular Compromise to Brain d/t from blood flow restriction is possible

56
Q

A decrease of Cerebral Blood Flow of ______ is considered Significant

A

A decrease of Cerebral Blood Flow of 20% is considered Significant

57
Q

True/False: Acute Burns is a contraindication for Succinylcholine?

A

False - only contraindicated if it has been 2-3 days since burn

58
Q

What meds will NOT work for patients who have had a Heart Transplant?

A

Vagolytics & Sympathomimetics such as Atropine or Ephedrine

59
Q

Which meds should be used to for patients who have had a Heart Transplant?

A

Direct Acting Agents - Epinephrine

60
Q

What is the antidote for Seron, an Aerosolized Neostigmine?

A

Atropine - Antimuscarinic

Fall 2020 - Physiology 3 - Neuro (2 decks)

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