Clinical Questions Flashcards
List the cranial nerves
I - Olfactory nerve: Sense of smell.
II - Optic nerve: Ability to see.
III - Oculomotor nerve: Ability to move and blink your eyes.
IV - Trochlear nerve: Ability to move your eyes up and down or back and forth.
V - Trigeminal nerve: Sensations in your face and cheeks, taste and jaw movements.
VI - Abducens nerve: Ability to move your eyes.
VII - Facial nerve: Facial expressions and sense of taste.
VIII - Auditory/vestibular nerve: Sense of hearing and balance.
IX - Glossopharyngeal nerve: Ability to taste and swallow.
X - Vagus nerve: Digestion and heart rate.
XI - Accessory nerve (or spinal accessory nerve): Shoulder and neck muscle movement.
XII - Hypoglossal nerve: Ability to move your tongue
What is the difference between hypoxia and hypoxemia?
HypoxEMIA is low blood O2
Hypoxia is low cellular tissue O2
What is normal ICP and Cerebral PP?
ICP: 15-20 mmHg (invasive inside skull)
CPP: 60-100 mmHg (MAP - ICP)
Cardiac index formula
CO / BSA (normal is > 2.5)
SVR formula
(MAP - CVP) / CO
800-1200
Pulmonary vascular resistance formula
Mean PAP - WEDGE / CO
Normal is 100-250
MAP Formula
(Diastolic x2) + SBP / 3
What are Mu1 and Mu2 receptors?
Mu1 (μ1) receptors: These receptors are associated with the analgesic effects of opioids. Activation of mu1 receptors can lead to pain relief and euphoria.
Mu2 (μ2) receptors: Mu2 receptors are primarily involved in the negative side effects of opioid medications, such as respiratory depression, sedation, and constipation. They are also associated with the development of tolerance and dependence.
What are Kappa receptors?
Kappa (κ) receptors: Kappa receptors are also involved in pain modulation. Activation of kappa receptors can produce analgesic effects but is typically associated with a different quality of analgesia compared to mu receptors. Kappa receptor activation may lead to dysphoria or an unpleasant feeling.
What are Delta receptors?
Delta (δ) receptors: Delta receptors are involved in the modulation of pain transmission. They contribute to the analgesic effects, but their specific role is less well understood compared to the mu and kappa receptors.
What pain receptors does Morphine work on?
Morphine, a naturally occurring opiate alkaloid derived from the opium poppy, has a high affinity for mu receptors. It is commonly used for the management of moderate to severe pain, such as postoperative pain or pain associated with cancer
What receptor does Fentanyl work on?
Fentanyl, a synthetic opioid, is also a potent mu receptor agonist. It is more potent than morphine and is often used in cases where stronger analgesia is required, such as during anesthesia or in severe, chronic pain situations
Tell me about spinal anesthesia
Spinal analgesia refers to the reduction or blocking of pain signals at the level of the spinal cord. This can be achieved through various methods, such as epidural analgesia or spinal anesthesia. These interventions primarily target the transmission of pain signals through the spinal nerves, affecting the processing and perception of pain at that level.
Tell me about supraspinal anesthesia
Supraspinal Anesthesia: Supraspinal anesthesia refers to the inhibition of pain perception at higher levels of the central nervous system, particularly within the brain and brainstem. This can be achieved through the administration of certain medications, such as general anesthetics or centrally acting analgesics, that act on receptors and pathways in the brain to induce a state of unconsciousness or reduce pain perception.
How much more potent is fentanyl in comparison to morphine?
100X
