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AAA-ANESTHESIOLOGY > TYPES OF ANESTHESIA: LOCAL, REGIONAL, GENERAL (Part 1) > Flashcards

TYPES OF ANESTHESIA: LOCAL, REGIONAL, GENERAL (Part 1) Flashcards

1
Q

What are the four types of anesthesia as defined by the American Society of Anesthesiologists?

A

General Anesthesia (GA), Regional Anesthesia (RA), Monitored Anesthesia Care (MAC), Local Anesthesia (LA)

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2
Q

What are the two main categories of general anesthesia?

A

Intravenous Anesthesia and Inhalational/Volatile (Gas) Anesthesia

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3
Q

What are the two categories of Regional Anesthesia?

A

Central Nerve Blocks (Neuraxial Anesthesia) and Peripheral Nerve Blocks

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4
Q

What are the three types of Central Nerve Blocks?

A

Spinal Anesthesia, Epidural Anesthesia, Caudal Anesthesia

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5
Q

Name two examples of Peripheral Nerve Blocks.

A

Digital Nerve Block and Dorsal Penile Nerve Block

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6
Q

What is Monitored Anesthesia Care (MAC)?

A

A type of anesthesia that involves sedation and monitoring without loss of consciousness

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7
Q

What is the only inhalational anesthetic that can be used solely as an induction agent?

A

Sevoflurane

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8
Q

Name two drugs used for Rapid Sequence Induction (RSI).

A

Succinylcholine and Rocuronium

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9
Q

What are the five steps in the conduct of general anesthesia?

A

Preoxygenation, Induction, Intubation, Maintenance, Reversal and Emergence

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10
Q

What are the basic tools for intubation?

A

Macintosh and Miller laryngoscope blades

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11
Q

What is the purpose of the anesthesia machine?

A

To provide oxygenation, ventilation, and administration of inhaled anesthetics

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12
Q

What is Minimum Alveolar Concentration (MAC)?

A

The concentration of an inhalational anesthetic at which 50% of patients will not respond to a surgical stimulus

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13
Q

How does MAC change with age?

A

MAC decreases by 6% per decade of age

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14
Q

Name the three agents used to reverse non-depolarizing muscle relaxants.

A

Neostigmine, Edrophonium, Glycopyrrolate

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15
Q

What is the reversal agent for rocuronium and vecuronium?

A

Sugammadex

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16
Q

What is the sensory nerve supply of the airway?

A

Trigeminal nerve, Glossopharyngeal nerve, and Vagus nerve

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17
Q

What is the effect of unilateral superior laryngeal nerve injury?

A

Minimal effect or subtle clinical findings

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18
Q

What is the effect of bilateral superior laryngeal nerve injury?

A

Hoarseness or easy tiring of the voice

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19
Q

What is the effect of unilateral recurrent laryngeal nerve injury?

A

Hoarseness

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20
Q

What is the effect of bilateral acute recurrent laryngeal nerve injury?

A

Stridor and respiratory distress

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21
Q

What is the effect of bilateral chronic recurrent laryngeal nerve injury?

A

Aphonia

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22
Q

What is the effect of unilateral vagus nerve injury?

A

Hoarseness

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23
Q

What is the effect of bilateral vagus nerve injury?

A

Aphonia

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24
Q

Which nerve injury is most likely to cause respiratory distress?

A

Bilateral recurrent laryngeal nerve injury

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25
Q

What drug is commonly used in Total Intravenous Anesthesia (TIVA) as both an induction and maintenance agent?

A

Propofol

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26
Q

What is the purpose of preoxygenation in general anesthesia?

A

To increase oxygen reserves and prevent hypoxia during induction

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27
Q

What is the cricothyroid membrane used for in airway management?

A

It is incised during a surgical airway if intubation is impossible

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28
Q

Which sedation level involves reducing anxiety without affecting consciousness?

A

Minimum sedation (anxiolysis)

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29
Q

Which sedation level is typically used for procedures like colonoscopy or endoscopy?

A

Deep sedation

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30
Q

What are the four key parameters used to classify levels of sedation?

A

Responsiveness, Airway Management, Spontaneous Ventilation, Cardiovascular Function

31
Q

What is the normal interincisal distance for a proper mouth opening in preanesthetic airway assessment?

A

3 cm or more

32
Q

What is the ideal thyromental distance for airway assessment?

A

Greater than 3 cm

33
Q

What neck circumference is associated with difficulty visualizing the glottic opening?

A

Greater than 17 cm

34
Q

What is the Mallampati classification used for?

A

To assess tongue size in relation to the oral cavity

35
Q

What is visible in Class I of the Mallampati classification?

A

The entire palatal arch, including bilateral faucial pillars, down to the bases of the pillars

36
Q

What is visible in Class II of the Mallampati classification?

A

The upper part of the faucial pillars and most of the uvula

37
Q

What is visible in Class III of the Mallampati classification?

A

Only the soft and hard palates

38
Q

What is visible in Class IV of the Mallampati classification?

A

Only the hard palate

39
Q

What does Class I in the Mallampati classification indicate?

A

An easy intubation

40
Q

What is the purpose of the Cormack-Lehane classification?

A

To assess the view of the larynx and vocal cords during intubation

41
Q

What is SARI in airway assessment?

A

Simplified Airway Risk Index, a multivariable risk model of seven independent risk factors for difficult intubation

42
Q

What routine equipment is needed for airway management?

A

Oxygen source, bag and mask, laryngoscopes, endotracheal tubes, suction machine, pulse oximeter, capnometry, and more

43
Q

What sizes of endotracheal tubes (ETTs) should be prepared?

A

The approximate size for the patient, one size larger, and one size smaller

44
Q

What is a Guedel airway?

A

An oropharyngeal airway (OPA) invented by Dr. Guedel

45
Q

How is a nasopharyngeal airway (NPA) inserted?

A

Using a vasoconstrictor spray or lidocaine

46
Q

What position is recommended for airway management in obese patients?

A

Ramped position

47
Q

What is the sniffing position used for in airway management?

A

To align the oral, pharyngeal, and laryngeal axes for easier intubation

48
Q

What is the purpose of preoxygenation before airway management?

A

To denitrogenate and increase oxygen reserves, improving apnea duration without desaturation

49
Q

What is the primary purpose of bag and mask ventilation (BMV)?

A

To ventilate the patient after preoxygenation, except in cases like RSI or awake intubations

50
Q

What are supraglottic airway devices (SGAs) used for?

A

As conduits for endotracheal intubations or as rescue airways during anesthesia

51
Q

Who introduced laryngeal mask airways (LMAs) in 1983?

A

Dr. Archi Brain

52
Q

What are the main indications for endotracheal intubation?

A

Airway protection, general anesthesia, ventilator management, and resuscitation

53
Q

What are the standard ETT sizes for adult males and females?

A

7.5–9.0 mm for males, 7.0–7.5 mm for females

54
Q

What is the purpose of a double-lumen ETT?

A

To ventilate each lung independently during thoracic surgery

55
Q

What is a flexible fiberoptic bronchoscope used for?

A

For intubation in patients with problematic airways or small mouth openings

56
Q

What are the steps for endotracheal intubation?

A

Open the mouth, sweep the tongue, visualize the vocal cords, insert the ETT, inflate the cuff, and secure the tube

57
Q

When is nasotracheal intubation indicated?

A

When oral intubation is difficult or contraindicated

58
Q

What spray can be used to prepare the nasal passages for nasotracheal intubation?

A

Phenylephrine (0.5% or 0.25%)

59
Q

What are the advantages of fiberoptic intubation (FOI)?

A

Minimizing cervical spine movement, managing small mouth openings, and avoiding airway obstructions

60
Q

When is a surgical airway required?

A

In ‘can’t intubate, can’t ventilate’ (CICO) scenarios

61
Q

What is the purpose of transtracheal catheter jet ventilation?

A

To provide oxygenation in emergencies using short bursts of oxygen

62
Q

What is the significance of the cricothyroid membrane in airway management?

A

It is incised during surgical cricothyroidectomy if intubation is impossible

63
Q

What is retrograde intubation?

A

A wire-guided intubation technique using the cricothyroid membrane for ETT placement

64
Q

What type of laryngoscope is used for difficult intubations?

A

Videolaryngoscopes or fiberoptic bronchoscope

65
Q

What is the purpose of preoxygenation in patients with compromised airways?

A

To ensure oxygen reserves and prevent desaturation during apnea

66
Q

What factors increase airway management difficulty?

A

Obesity, limited neck movement, small mouth opening, and anatomical abnormalities

67
Q

How is a laryngeal mask airway (LMA) inserted?

A

By pressing the mask against the hard palate and advancing it into the pharynx

68
Q

What is the Simplified Airway Risk Index (SARI) designed to assess?

A

Risk factors for difficult intubation

69
Q

What is the main use of supraglottic airway devices during positive pressure ventilation?

A

To maintain a high airway seal pressure

70
Q

What is the main function of a nasopharyngeal airway?

A

To maintain airway patency through the nasal cavity

71
Q

What is the most severe consequence of bilateral recurrent laryngeal nerve injury?

A

Stridor and respiratory distress

72
Q

What happens with unilateral vagus nerve injury?

A

Hoarseness

73
Q

What technique is used for bag and mask ventilation when a single operator is present?

A

One-handed face mask technique

74
Q

Who introduced videolaryngoscopy classification?

A

Healy et al., in 2012

AAA-ANESTHESIOLOGY (14 decks)

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