Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AP 1 > Test 1 part IV (CM) > Flashcards

Test 1 part IV (CM) Flashcards

1
Q

Electrical activity from the surface of the brain observed through electroencephalogram (EEG)

A

Electrical Brainwaves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are indications of EEG monitoring?

A

diagnosis of hypoxia, brain trauma, ischemic/hemorrhagic CVA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The rate/duration between impulses

A

Frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The peak to peak measurements

A

Amplitude

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The shape comprised of wave amplitude and frequency

A

Morphology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which EEG wave: high level information processing

A

Gamma (>40)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which EEG wave: normal awake consciousness, alertness, logic, & critical thinking. During an awake state, these are most prominent

A

Beta (14-40)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which EEG wave: occurs with eyes closed during deep relaxation

A

Alpha (7.5 - 14)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which EEG wave: appear during light sleep. Appear with increases in ischemia/hypoxia.

A

Theta (4 - 7.5)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which EEG wave: appear in deep sleep

A

Delta (0.5 - 4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The onset of irreversible damage can be determined when there is complete electrical silence, evidenced by an ________ EEG pattern.

A

Isoelectric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the neurophysical parameters that can be monitored during anesthesia & surgery?

A
  1. Cerebral electrical activity
  2. Cerebral blood flow
  3. Cerebral O2 content
  4. ICP
  5. Cerebral metabolic rate of O2 consumption (CMRO2)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The majority of anesthetic agents inhibit neuronal activity and depress EEG waveforms. How does this manifest on the EEG waveform?

A

Increased frequency and decreased amplitude of the EEG waveform.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the effects of inhalational agents on an EEG?

A

Dose-dependent reduction in CMRO2, decreased regional tissue O2 consumption, and vascular constriction

Global reduction in CBF → dependent on the direct vasodilatory properties of the individual drug and the vasoconstricting effects associated with catecholamine release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which is worse for depression of an EEG, Inhalational agents or TIVA?

A

Inhalational > TIVA in depression of EEG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

______ & ______ provide a summary of each wave over a period of time & analyze for waveform relationships using amplitude frequency and graphs. Used to determine depth of anesthesia or unilateral injury

A

Compressed Spectral Array (CSA) & Density Spectral Array (DSA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

An EEG pattern associated with alternating high-voltage, mixed frequency, slow wave activity with periods of electrical suppression.
-Electrical activity is unpredictable, and duration is variable.

A

Burst Suppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What conditions usually result in Burst Suppression?

A
  1. A decrease in cerebral circulation & oxygenation
  2. Hypothermia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

May be desirable during manipulation of brain tissues as it decreases CMRO2 , which is neuroprotective.

A

Burst Suppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What type of burst suppression is indicative of ischemia or injury to the brain?

A

Unilateral Burst Suppression

21
Q

Which anesthetic agents cause Burst Suppression?

A
  1. Etomidate
  2. Propofol
  3. Dexmedetomidine
  4. Inhalation agents
22
Q

At what dose range do inhalational agents cause Burst Suppression?

A

> 1.2 - 1.5 MAC

23
Q

What is the effect of Etomidate on an EEG?

A

Suppression of electrical activity (inc frequency and dec amplitude of beta waves) and epileptiform activity.
-Burst Suppression achieved at higher dose ranges

24
Q

What is the effect of Propofol on an EEG?

A

Suppression of electrical activity (inc frequency and dec amplitude of beta waves).
-Burst Suppression achieved at higher dose ranges, but at higher doses, Propofol decreases SVR, leading to a drop in CPP.

25
Q

What is the effect of Dexmedetomidine on an EEG?

A

Suppression of electrical activity
-Can cause Burst Suppression

26
Q

Which anesthetic agents do NOT cause Burst Suppression?

A
  1. Nitrous Oxide
  2. Benzos/Opioids
  3. Ketamine
27
Q

What is the effect of Benzos/Opioids on an EEG?

A

Suppression of electrical activity, but do not cause Burst Suppression

28
Q

What is the effect of Ketamine on an EEG?

A

Disorganized and epileptiform activity, but does not cause Burst Suppression

29
Q

Does Nitrous Oxide cause Burst Suppression?

A

No

30
Q

Non-invasive transcutaneous monitoring of the adequacy of oxygenation specific to the brain (allows practitioner to detect decreases in CBF in relation to CMRO2).

A

Cerebral Oximetry

31
Q

What does Cerebral Oximetry measure?

A

Near infrared spectroscopy (NIRS)
-Goal is to maintain NIRS at a minimum of 75% of baseline reading

32
Q

What Law is used in Cerebral Oximetry monitoring?

A

Beer Lambert Law

33
Q

If NIRS level is low, what does that indicate?

A

Cerebral Hypoxia

34
Q

What are some treatments for a low NIRS score (cerebral hypoxia)?

A
  1. Increase BP/CO
  2. Increase FiO2
  3. Increase PaCO2 (hypoventilate to decrease vasodilation)
  4. Transfuse PRBCs
35
Q

Measures the O2 supply vs demand within a region of the brain

A

Cerebral Oximetry

36
Q

What specific types of surgeries is Cerebral Oximetry typically used during?

A
  1. Neonatalogy
  2. Cardiac Surgery
  3. Cardiac endarterectomy
37
Q

A non-invasive monitor of CBF within large arteries of the brain (middle cerebral artery) via a probe positioned on the temporal bone that emits ultrasound waves.

A

Transcranial Doppler

38
Q

Does a transcranial doppler determine the actual CBF?

A

No, it determines flow direction, velocity, acceleration time, and intensity of pulsatile flow.

39
Q

Flow velocity > expected on transcranial doppler indicates what?

A
  1. Stenosis
  2. Emboli
  3. Spasm
40
Q

What is transcranial doppler monitoring used for?

A

Microemboli detection and cerebral integrity during surgery.

41
Q

Accuracy of transcranial doppler monitoring is limited by ______.

A

Thick temporal bones.

42
Q

A type of CBF monitoring that estimates the degree of global O2 extraction by the brain.

A

Jugular Bulb Venous Oxygenation (SjVO2)

43
Q

What are some indications for Jugular Bulb Venous Oxygenation (SjVO2) monitoring of CBF?

A
  1. Evaluate cerebral ischemia and guide hyperventilation therapy
  2. Fiberoptic catheter inserted through IJ into jugular bulb
  3. Estimate global CBF & CMRO2 balance
44
Q

SjVO2 between _________ with a ________ ICP indicate positive outcomes for TBI.

A

55-75%; normal ICP

45
Q

SjVO2 > 75% or <55% with an elevated ICP = ?

A

Poor Outcomes

46
Q

What are causes of SjVO2 < 55%?

A
  1. Decreased O2 Supply
  2. Increased O2 Demand
47
Q

What are some causes of decreased O2 supply and what are the correct treatments?

A

Causes:
1. Anemia (transfuse)
2. decreased CBF (maintain CPP)
3. Hypoxemia (correct this)

48
Q

What are some causes of increased O2 supply and what are the correct treatments?

A

Causes:
1. Agitation (sedation)
2. Pain (analgesia)
3. Fever/sepsis (control temp)
4. Seizure (anticonvulsants)

AP 1 (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions