Surgical Subspecialties Flashcards
What is a CABG procedure?
coronary artery bypass graft
What is the most common artery used when doing a CABG procedure?
mammary artery
The use of the term dissection in “Aortic arch dissection” refers to what?
tearing of the wall of the aortic arch
What anesthetic concerns are there with CV cases?
general anesth sternotomy cario-pulmonary bypass invasive monitoring chest tubes
When doing thoracic cases, what is the most common position?
lateral decubitus
What kind of tube is used for one-lung ventilation?
double lumen tubes
What anesthetic concerns are there with thoracic cases?
general anesth
sternotomy
invasive monitoring
chest tubes
How do you confirm a double lumen tube placement?
Fiber optic scope
What procedure in neurosurgery cases puts that bone back onto skull at the end of the surgery?
Cranioplasty
What anesthetic concerns are there with neurosurgery cases?
GA/local/mac invasive monitoring hyperventilation: keeps EtCO2 28-33 which decreases cerebral blood flow positioning very deeply paralyzed
What is burst suppression?
Where propofol is given to make brain electrical activity 0 which decreases need for O2 and blood supply
What do you have to monitor closely when using burst suppression?
Blood pressure
What is min intracranial pressure?
> 15 mmHg
In ortho cases, what is the maximum amount of time you want to leave tourniquet up?
2 hours
With tourniquet pain, what is the remedy?
Only remedy is to turn pressure from tourniquet down.
Hypotension results from release of tourniquet
When doing Optho cases, what gas should never be used and what can the pt not do for days after surgery?
No N2O because of tendency to go into air pocket
No getting on airplanes b/c same reason with pressure fluctuations
What is the oculocardiac reflex?
When lateral muscle of eye is pulled on that causes severe drop in HR
Surgeon must release or get atropine ready
What is claudication?
stenosis in vasculature of legs that causes the pins and needles sensation after sitting on the leg
When doing a cholecystectomy, what are you working on?
gall bladder
What gas is used to insufflate the abdomen during laparascopic cases?
CO2
What anesthetic concerns are there with laparascopic cases?
GA
abdominal insufflation
Positioning KEY
EtCO2 increases
What position would you place the patient in a lap gastic bypass?
reverse trendelenburg
What position would place a patient for a lap pelvic surgery?
Trendelenburg
What must all patients undergoing a lap case get?
FOLEY
must be aware of bladder pain and tear
For transplant cases, how long is the kidney good for?
24 hours
For dialysis patients, the iv must go on the _______ side of the fistula?
opposite
For transplant cases, how long is the heart good for?
4 hours
For transplant cases, how long is the liver good for?
12 hours
For transplant cases, how long are the lungs good for?
Not very
very delicate and very sensitive
For transplant cases, all surgeries need an artline except?
Kidney transplants
What do you want to keep the volume status at of a patient undergoing kidney/liver transplant?
Hypervolemic
What do you want to keep the volume status at of a pt undergoing a heart transplant?
Hypovolemic
What drug do you not want to pregnant patients?
Versed
can cause birth defects
When giving fentanyl to mother, what must be accounted for in fetus?
Respiratory depression b/c drug crosses placenta
When positioning during labor, what is the key thing to remember?
Place a pillow under right hip to slide the weight of the baby off the vena cava which helps elevate BP
When doing blocks for OB, which is more of the motor block?
Spinal block
When doing blocks for OB, which is more of the sensory block?
Epidural placement
What is the APGAR test used for?
measure of the baby vitals after birth
What does procedure that ends at -scopy do?
Looking at the organ/area
What does the procedure that ends with -ectomy do?
Takes the organ out
