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Preeti: Anesthesiology (2016) > Test 1: Definitions > Flashcards

Test 1: Definitions Flashcards

1
Q

A loss of sensitivity to pain

A

Analgesia

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2
Q

The neural process of encoding noxious stimuli;

does not require consciousness

A

Nociception

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3
Q

A state of behavior change where anxiety is relieved and the patient is relaxed, but also aware of its surroundings

A

Tranquilization

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4
Q

A state characterized by CNS depression accompanied by drowsiness. Patient is likely unaware of its surroundings

A

Sedation

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5
Q

A drug induced state of deep sleep from which a patient cannot be easily aroused; may or may not be accompanied by antinociception

A

Narcosis

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6
Q

Induced by drugs that dissociate the thalamocortical and limbic systems. Characterized by a catatonic state:

Swallowing reflexes are functional

Eyes remain open

Skeletal muscle rigidity is common unless a muscle relaxant is given in conjunction

A

Dissociative Anesthesia

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7
Q

Dissociative Anesthesia

is induced by which 2 drugs?

A

Ketamine

Tiletamine

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8
Q

Stage/plane of general anesthesia that provides unconsciousness, muscle relaxation, and analgesia sufficient for painless surgery

A

Surgical Anesthesia

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9
Q

Air without gas exchange

A

Dead Space

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10
Q

Gas that is a liquid at ambient temperature and pressure

A

Vapor

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11
Q

Exists as a gas at both ambient temp and pressure

A

GAS

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12
Q

Pressure exerted by molecules when liquid and vapor

phases are at equilibrium

A

Vapor Pressure

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13
Q

Solubility Concept:

At equilibrium, in the 3 compartments (gas,oil,water),

The # of anesthetic molecules

in the compartments _______,

but the pressure exerted by the anesthetic molecules

in the compartments ________.

A

At equilibrium, in the 3 compartments (gas,oil,water),

The # of anesthetic molecules

in the compartments DIFFERS

but the pressure exerted by the anesthetic molecules

in the compartments IS THE SAME!

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14
Q

The concentration ratio of an anesthetic in the solvent

and gas phases, which describes the capacity of a given

solvent to dissolve the anesthetic gas

A

Partition Coefficient

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15
Q

The most clinically useful number,

describes the amount of anesthetic in the blood vs. alveolar gas

at equal partial pressures

A

Blood-Gas Partition Coefficient

The anesthetic in the alveolar gas represents the concentration in the brain!

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16
Q

The ________ the blood-gas partition coefficient,

the more soluble the agent

A

higher

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17
Q

Order the major gas anesthetics in order of

decreasing solubility

A

Halo>Iso>Sevo>Des

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18
Q

The lower the blood-gas partition coefficient,

the _______ the time of induction and recovery

A

shorter

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19
Q

Which gas anesthetic is most potent

and has the longest induction and recovery?

A

HALOTHANE

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20
Q

What does FA stand for?

What does FI stand for?

A

FA = Alveolar concentration

FI = Inspired Concentration

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21
Q

In regards to rate of rise of FA to FI:

The less soluble the gas, the _____ the rise

The more soluble the gas, the ______ the rise

A

less soluble = FASTER rise (i.e. N20)

more soluble = SLOWER rise (i.e. Halothane)

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22
Q

Increasing anesthetic delivery and

decreasing removal from the alveoli

will do what to PA

A

INCREASE PA

PA = Anesthetic delivery to alveoli

PI = Inspired anesthetic concentration

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23
Q

A ______ PI is required at the start of anesthesia to

rapidly increase PA

A

HIGH

PA = Anesthetic delivery to alveoli

PI = Inspired anesthetic concentration

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24
Q

In regards to Hepatic Metabolism,

List the common anesthetic gases in order of

most metabolized to least metabolized

A

Halo > Sevo > Iso > Des

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25
Q

The minimum concentration of anesthetic in the alveoli

that prevents movement in 50% of patients

exposed to a noxious stimuli

A

Minimum Alveolar Concentration (MAC)

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26
Q

MAC allows comparison of ______ between agents

A

Potency

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27
Q

The _______ the MAC, the lower the potency

A

HIGHER

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28
Q

T/F:

Halothane has the highest MAC and is therefore the most potent

A

FALSE!

Halothane has the LOWEST MAC and is therefore

the most potent

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29
Q

List the anesthetic gases in order of

Lowest MAC to Highest MAC

A

Halo < Iso < Sevo < Des < Nitrous Oxide

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30
Q

List the anesthetic gases in order of potency from

most potent to least potent

A

Halo > Iso > Sevo > Des > Nitrous Oxide

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31
Q

Used to describe dose of gas in relation to effect

A

MAC Multiples

32
Q

1.2 to 1.4 times MAC ensures immobility in ____%

of patients

A

95%

33
Q

Inotropy

A

Cardiac CONTRACTILITY

34
Q

Chronotropy

A

HEART RATE

35
Q

Anesthesia effects:

Contractility (Inotropy) will _______

and

HR (Chronotropy) will _______ or ______

A

Contractility (Inotropy) will DECREASE

and

HR (Chronotropy) will NOT CHANGE or INCREASE

36
Q

Respiratory arrest occurs at

this range of MAC

A

1.5 - 3X MAC

37
Q

ICP increases at > ____X MAC

A

1X MAC

38
Q

The substance produced by sevoflurane breakdown

in the CO2 absorbent which causes renal toxicity.

Higher concentrations are formed during prolonged anesthesia

A

COMPOUND A

39
Q

This anesthetic gas can cause hepatic toxicity

A

HALOTHANE

“Halothane Hepatitis”

40
Q

A myopathy caused by exposure to inhalant, especially

Halothane, the results in

uncontrolled muscle contraction, severe hyperthermia

and then death (very likely despite treatment)

A

Malignant Hyperthermia

41
Q

The first sign of Malignant Hyperthermia is a

rapid increase in

A

EtCO2

42
Q

What drug is administered if a

rapid rise in EtCO2 is seen,

indicative of malignant hyperthermia?

A

DANTROLENE

(muscle relaxant!)

43
Q

What is the solubility of Nitrous Oxide?

A

0.47

(low solubility)

44
Q

What is the max % administration of Nitrous oxide and why?

A

75% max

because need at least 25% oxygen

45
Q

The major concern when stopping N2O administration is

A

Diffusion Hypoxia

(Give 100% oxygen)

46
Q

A condition caused by opioids resulting in

unpleasant body sensations, nervousness, and anxiety.

A

Opioid DYSPHORIA

47
Q

How do you differentiate between pain and dysphoria?

A

Administer a short-acting opioid (FENTANYL)

If patient calms, it was pain

If patient is more distressed, it is dysphoria

48
Q

This category of drugs treats Dysphoria AND Pain

A

Alpha-2 Agonists

49
Q

Muscle injury secondary to hypoperfusion seen

in horses in recovery

A

Rhabdomyolysis

50
Q

The active process of retching

A

Vomiting

51
Q

The passive process of expelling material from

the esophagus or stomach into the oral cavity

A

Regurgitation

52
Q

T/F:

Fasting decreases incidence of vomiting, regurg, and reflux

A

FALSE!!

Fasting only decreases incidence of vomiting!

(not regurg or reflux- passive processes)

53
Q

Increased parasympathetic tone (vagal stimulation)

causes

A

Bradycardia

54
Q

The volume of blood ejected by the heart

A

Cardiac output

55
Q

The amount of blood ejected by the left ventricle in one contraction

A

Stroke Volume

56
Q

The average arterial pressure during a single cardiac cycle

A

MAP (Mean Arterial Pressure)

57
Q

the resistance to blood flow offered by all of the systemic vasculature, excluding the pulmonary vasculature.

This is sometimes referred as total peripheral resistance (TPR)

A

Systemic Vascular Resistance (SVR)

58
Q

partial pressure of carbon dioxide in arterial blood

A

PaCO2

59
Q

The partial pressure or maximal concentration

of carbon dioxide (CO2) at the end of an exhaled breath

Expressed as a percentage of CO2 or mmHg.

The normal values are 5% to 6% CO2,

which is equivalent to 35-45 mmHg.

A

End Tidal CO2

60
Q

The slope of the intrapleural pressure-volume curve

A

Compliance

61
Q

Non-invasive breath by breath technique used to

measure CO2,

where EtCO2 closely approximates PaCO2

A

Capnography

62
Q

Inconsistency between the amount of air

and the amount of blood in the lungs

A

ventilation/perfusion (V/Q) mismatch.

63
Q

An estimate of arterial oxygen saturation which refers to the amount of oxygenated hemoglobin in the blood

A

SPO2 (saturation of peripheral capillary oxygen)

64
Q

the inspired concentration of oxygen breathed

A

FiO2

65
Q

The ratio of partial pressure arterial oxygen and fraction of inspired oxygen;

the comparison between the

oxygen level in the blood and the

oxygen concentration that is breathed.

A

PaO2:FiO2 Ratio

66
Q

A disorder defined by the initial change

in HCO3- or PaCO2

A

Primary Acid-Base Disorder

67
Q

A change in HCO3- or PaCO2

in the opposite direction to the primary disorder

A

Compensation

68
Q

Refers to an increase or decrease in the amount of

base present in the blood, and defines the metabolic

component of acid-base disturbances

A

Base Excess

69
Q

The partial pressure of CO2 (mmHg) in the arterial blood

A

PaCO2

70
Q

The partial pressure of oxygen in the arterial blood

A

PaO2

71
Q

PAO2

A

Partial pressure of oxygen in the Alveolar space

72
Q

PaO2

vs.

PAO2

A

PaO2 = partial pressure in arterial blood

PAO2 = partial pressure in Alveolar space

73
Q

The upper limit of ______ is the PAO2

A

PaO2

  • The upper limit of the partial pressure of oxygen in arterial blod*
  • is the partial pressure of oxygen in the Alveolar space!*

(if gas exchange was ideal, the #s would be equal. In real life, pp of oxygen in

arterial blood is always LOWER than the pp of oxygen in the Alveolar space!)

74
Q

The insufficient oxygenation of arterial blood

A

Hypoxemia

75
Q

The insufficient oxygenation of tissues

A

Hypoxia

76
Q

The ratio of inspiratory and expiratory times

A

I:E Ratio

Preeti: Anesthesiology (2016) (5 decks)

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