Symposium pimping questions Flashcards
Where are they arytenoids
The corniculates sit superior of the arytenoids and move to open and close the vocal cords
How far above the carina does the ETT sit?
3-5 cm
What is the normal depth to a loss of resistance does an epidural?
4-6 cm
Ligaments passed for spinal
Supraspinous ligament
interspinous ligament
Ligmenta flavum
What nerve and muscle are simulated for a TOF on the arm
Ulnar nerve and adducor pollicis
Why do you assess pts Radial TOF
The diaphragm/ airway muscle will lose function before the adductor pollicis so that means you have sufficient blockade to continue with intubation
Main side effect of ketamine
secretions, consider for laryngospams
Lab to check for toradol
Platelets for bleeding concern
Meds that require ideal body weight
Roc, Vec, Panc, Remifent
What is MAC
concentration of med that 50% of pts did not move
What do you check to ensure the pt is adequately denitrogenated
exhaled oxygen >80%
Length to from the IJ and subclavian to the right atrium
RIJ 15
Rsub; 14
LIJ; 18
LSub; 17
What are lidocaine and fentanyl given for induction
Block the sympathetic response from intubation
What dose of reversal do you give for 1/4, 2/4, 3/4 and 4/4 twitches
2/4; okay to use neostigmine closer to the 0.07 dose;
and a glycopyrolate at .2 mg/ mg of neostigmine used
or use sugammades
Max dose of neostigmine
5mg
Triad of anesthesia
analgesia, amnesia, akinesia
What gauge is a central line
18 gauge with 2 20 gauge lumens
What are the ways to confirm cvc placement
cvp wave form
Aspiration
X ray
VBG
What are the normal VBG values
Schmidt numbers;
PO2; 40
CO2; 45
pH; 7.4
sat; 40-70%
HCO3; 19-25
What is the max pressure of a max seal
20cmH2o; higher than that = opening of the LES
What is the flow from the O2 flush valve
35-75 L/min
What 2 medications do you give for laryngospasm
succs at 1/10th dose
Propofol 10-20 mg
give positive pressure (press on larsons point)
S/s of local intrathecal vs intravenous infilatration
Intrathecal; loss of sensation/ motor within 5 min of administration
IV; circumoral numbess, ringing in the ears, altered mental status-> asysole
How are LMAs sized
kg
3; 30-40kg
4; 40-70kg
5; 70-100kg
What can you cause by not wiping betadine from the site of a spinal?
arachnoiditis/ aseptic meningitis
During neuraxial anesthesia, what is stimulated causing bradycardia/ hypotension?
bezold Jarish reflex
what noncardiac med is used to treat the bradycardia/ hypotension with neuraxial anesthesia?
Zofran
Reflex we are concerned about with abdominal insufflation?
celiac reflex; The celiac reflex is initiated by traction to the mesentery or other abdominal organs. This reflex is mediated by the vagus nerve and causes bradycardia and hypotension.
