Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Advanced Anesthesia 2 > Eye Surgery - Quiz 4 > Flashcards

Eye Surgery - Quiz 4 Flashcards

(74 cards)

Start Studying
1
Q

What are the 3 Layers of the Eye?

A

Sclera - Outermost

Uveal Tract - middle

Retina - Innermost

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

Where does the most Focus Power of the eye come from?

A

Curvature of Cornea

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

What is the Uveal Tract made of?

A

Choroid

Ciliary Body

Iris

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

What is the Choroid?

A

Layer of Blood Vessels in the back of the Uveal Tract that supplies oxygen to the eye

Detachment = Vision Loss

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

What does the Ciliary Body do?

A

Sits behind Iris

Makes Aqueous Humor & Adjusts Focus by reducing tension on the Lens

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

What does the Retina contain?

A

Photoreceptors - neural signal

Pars Plana

NO Capillaries

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

Where is the Pars Plana of the Retina located?

A

Between Limbus of Cornea & End of Retina

(Area of Entry for Vitrectomies)

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

What is the Center of the Eye filled with?

A

Vitreous Gel

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

What does the Center of the Eye attach to?

A

Blood Vessels & Optic Nerve

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

What happens when there is Traction of the Vitreous on the Retina?

A

Detachment

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

What does the Superior Oblique muscle of the Eye do?

A

Rotates & Depresses Eye

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

What does the Inferior Oblique muscle of the Eye do?

A

Rotates Eye on Horizontal Axis

Extorts & Elevates Eyeball

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where do all Muscles of the Eye originate from with the exception of the Inferior Oblique?

A

Annulus of Zinn

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

What is the Ocular Cardiac Reflex (Five & Dime)?

A

Trigeminovagal Reflex that happens w/ Eye Manipulation (Especially Medial Rectus)

Bradycardia

AV Block

Ventricular Ectopy

Asystole

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

How does the Trigeminovagal Reflex work?

A

Afferent Impulses from Eyes –> Ciliary Ganglion –> Ophthalmic Trigeminal Nerve @ 4th Ventricle –> Trigeminal Sensory Nucleus –> Visceral Motor Neclei of Vagus –> Efferent Vagus –> Heart

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

With what type of Anesthesia does the Ocular Cardiac Reflex Occur?

A

Topical & General > Retrobulbar Blocks

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

What worsens the Ocular Cardiac Reflex?

A

Hypoxemia

&

Hypercarbia

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

How is Ocular Cardiac Reflex treated?

A

Stop Manipulation

Lidocaine Localization

Deepen Anesthetic

Atropine

Robinul

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is Intraocular Perfusion Pressure calculated?

A

MAP - IOP

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

What is the Normal IntraOcular Pressure?

A

10 - 22 mmHg

(> 25 mmHg is BAD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

The Globe is ________ with a _____ volume

A

The Globe is NON-COMPLIANT with a FIXED volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What regulates IntraOcular Pressure?

A

Amount of Aqueous & Blood Volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Production of Aqueous Humor is constant and is faciliated by _______

A

Production of Aqueous Humor is constant and is faciliated by CARBONIC ANHYDRASE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What can Increased IOP lead to?

A

Optic Disc Atrophy

Nerve Atrophy

Optic Artery Occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What can Decreased IOP lead to?
Fluid Accumulation in the Eye
26
What happens to IOP with a Sudden BP Decrease of \< 90 mmHg?
↓IOP Los of Autoregulation
27
How does a Sudden BP Increase affect IOP
↑IOP, but normalizes d/t Drainage System
28
An Increase in CVP has a ______ effect than an Increase in BP regarding IntraOcular Pressure
An Increase in CVP has a **GREATER** effect than an Increase in BP regarding IntraOcular Pressure
29
How much can coughing increase IOP?
40x d/t Drainage Obstruction
30
How does Decreased PaCO2 affect IOP?
_FAST_ drop in IOP d/t Choroidal Vasoconstriction
31
How does Increased PaCO2 affect IOP?
_SLOW_ increase in IOP
32
How does Fast Breathing affect IOP?
INCREASE IOP d/t Insufficient Venous Drainage
33
How does Metabolic Acidosis / Alkalosis affect IOP?
Alkalosis = ↑Choroid Volume & IOP Acidosis = ↓Choroid Volume & IOP
34
Blinking, Squinting, and Forced Lid Squeeze can increase IOP by \_\_\_\_\_, \_\_\_\_\_, and _____ respectively
Blinking, Squinting, and Forced Lid Squeeze can increase IOP by **5 mmHg**, **25 mmHg**, and **50 mmHg** respectively
35
Which muscle relaxant increases IOP?
Succinylcholine
36
Which IV drugs can be given to Decrease IOP?
**Acetazolamide** - Carbonic Anyhydrase Inhibitor - Depletes Lytes & **Mannitol** - Osmotic Diuretic - Lasts 30-45 min, returning to baseline 5-6 hrs.
37
What is Echothiophate?
Topical Anti-Cholinesterase used to maintain Miosis & treat Gluacoma
38
What can happen if Echothiophate is systemically absorbed?
Total Cholinesterase Inhibition & Prolonged Post-Sux Paralysis
39
What drug is used to Dilate the Pupil?
Phenylephrine
40
What drugs are used to Constrict the Pupil?
Pilocarpine & Acetylcholine May cause Bradycardia & Brochospasm
41
What is Timolol used for?
Beta Blocker used to treat Glaucoma
42
What can occur if Timolol is Systemically Absorbed?
Bradycardia Bronchospasm CHF
43
How does Flomax affect Cataract Surgery?
Binds Iris Dilator Muscles & Makes Iris Floppy 7-28 days off therapy
44
How should Pre-Op Severe HTN (Stage 3 \> 180/110) be handled before Eye Surgery?
Reschedule surgery until two weeks of Anti-HTN Treatment
45
What is the Blood Glucose goal for diabetics regarding Eye Surgery?
BS: 150-250
46
What Urea Nitrogen level is considered Critical for eye surgery?
\> 104 mg/dL
47
What should be done if a patient came in for Cataract Surgery and was on Coumadin?
Continue with Surgery - safe to do w/ patient on warfarin
48
What are Eye Surgery Requirements?
Eye Immobility & Lots of Anesthetic at the Site
49
When should Versed & Fentanyl be avoided for Eye Surgery?
In patients w/ limited cognitive reserve
50
What kind of Facial Nerve Blocks are typically used prevent eyes from Squeezing & Squinting?
Van Lint Atkinson O'Brien
51
What is a Major Complication from Van Lint, Atkinson, or O'Brien blocks?
Subcantaneous Hemorrhage
52
What kind of block affects the entire trunk of Facial Nerve and causes Lower Facial Droop for hours post-op?
Nadbath Rehman Block
53
What are complications related to Nadbath Rehman Blocks?
Vocal Cord Paralysis Laryngospasm Dysphagia Respiratory Distress
54
How is a Retrobulbar Block done?
Inject 1:1 Bupiv 0.75% + Lidocaine 2% at the Inferior Temporal Margi of the Orbit
55
What are the effects of a Retrobulbar Block?
Anesthesia of the Globe Extraocular Akinesia Hypotony - ↓IOP & ↓Aqueous Humor
56
What indicates that the Superior Rectus muscle is not affected by the Retrobulbar Block since its outside the muscle cone?
Intorsion on Downward Gaze
57
What are the complications from a Retrobulbar Block?
Hemorrhage Proptosis (Downward Displacement) Subconjuctival Ecchymosis Optic Nerve Damage Ocular Perf Post-Op Strabismus (Cross Eyed)
58
What happens with Intravascular Injection during a Retrobulbar Block?
**Intravenous:** Nothing **Arterial:** CNS Excitation & Seizure
59
What can happen when local is injected into the Optic Nerve Sheath/Subarachnoid during a Retrobulbar Block?
Contralateral Amaurosis (Vision Loss) Obtundation Respiratory Arrest w/in 20 min Total Spinal & Vascular Collapse
60
What are contraindications to a Retrobulbar Block?
Bleeding Disorders Extreme Myopia (Nearsightedness) Open Eye Injury
61
How does a Peribulbar Block compare to a Retrobulbar Block?
Safer Multiple Injections around Eye Doesn't Enter Muscle Cone Longer Onset Less Complete Akinesia Increased Risk of Ecchymosis
62
What makes a Sub-Tenon's Block safer than a Peri/Retrobulbar Block?
No sharp needle & Less complications
63
When is Topical appropriate for Eye Surgery?
Small Incision Surgeries & Phacoemulsion
64
What are the Disadvantages to using Topical?
Patient Movement Increased Pt. Anxiety & Discomfort
65
What is used in Topicals for Eye Surgery?
Tetracaine 0.5% & Lidocaine 4%
66
What meds can be given to limit IOP response to Intubation?
Lidocaine & Opioids
67
What symptom may indicate IO Hypertension, Corneal Abrasion, or other complications?
Severe Pain
68
What is done to tamponade a detached retina to the globe during certain vitreoretinal procedures?
Inject air bubble into eye
69
When should N2O be stopped when air bubbles are use to tamponade detacehd retinas?
15 min before Sulfur Hexaflouride & avoid for 7-10 days after to avoid increased IOP
70
How long should N2O be avoided after the use of Perfluoropropane (C3F6)?
1 Month
71
How is Lacrimal Surgery done for kids?
Probe & Irrigation - suction well
72
How is Lacrimal surgery done for Adults?
Dacrocystorhinostomy - Suction well
73
Which anesthetic is avoided d/t nystagmus?
Ketamine
74
What type of Anesthesia is used for Retinal Detachment & Vitreal Surgery?
General or Retrobulbar BLock

Advanced Anesthesia 2 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions