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SRNA3AnesthesiaMgt > FINAL EXAM REVIEW > Flashcards

FINAL EXAM REVIEW Flashcards

(108 cards)

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1
Q

Non-cutting

A

Sprotte
Whitacre
Pencan

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2
Q

Definition – Chronic pain is a

A

physical and emotional response to tissue damage that

lasts longer than the expected duration of pain.

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3
Q

pain following a distribution of a nerve or group of nerves

A

Neuralgia –

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4
Q

perception of pain in an area that lacks sensation

A

Anesthesia dolorosa –

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5
Q

perception of a non‐painful stimulus as painful

A

Allodynia

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6
Q

Lack of all sensation, painful or otherwise

A

Anesthesia –

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7
Q

The presence of an unpleasant sensation whether or not a causitive stimulus is present

A

Dysesthesia –

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8
Q

– Diminished response to painful stimuli

A

Hypoalgesia

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9
Q

– Increased or aggravated response to painful stimuli

A

Hyperalgesia

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10
Q

– Exaggerated response to a mild stimus.

A

Hyperesthesia

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11
Q

Name layers of spinal

A

SIFEDASP

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12
Q

Reduced ability to sense cutaneous

stimuli such as light touch, pressure, or temperature

A

Hypoesthesia –

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13
Q

Abnormal sensation that occurs without

stimuli (numbness, tingling, pins &needles)

A

Paresthesia –

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14
Q

Functional abnormality associated with at least one nerve root

A

Radiculopathy

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15
Q

Complex interaction between peripheral and central pain mechanisms associated with lesions of peripheral nerves, nerve roots, ganglions, or spinal structures

A

Neuropathic pain

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16
Q

Sensation of pain in a limb that has been amputated

A

• Phantom pain

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17
Q

Lack of pain perception

A

Analgesia

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18
Q

Combined disorder consisting of hyperesthesthia, allodynia, and hyperalgesia

A

Hyperpathia

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19
Q

What former name for CRPS Type I?

A

Reflex sympathetic dystrophy

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20
Q

What former name for CRPS Type II?

A

Causalgia

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21
Q

CRPS – There are

two types. Type I and Type II.

A

Complex regional pain syndrome.

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22
Q

CRPS Characterized by

A

spontaneous pain, allodynia, hyperalgesia, sudomotor

and vasomotor dysfunction

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23
Q

Opioids receptors location in the SC

A

substantia Gelatinosa

Brain–: Periaqueductal gray, and the , Locus coeruleus

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24
Q

Liphophillic opioids

A

Fentanyl
sufentanyl
Methadone.

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25
Depth of epidural Catheter
11-12 cm
26
Each black line
5 cm
27
Nerve stimulator lead placement
Orbicularis ocularis Adductor policis Posterial tibial
28
Action of SUCC
Binds to ACH
29
Metabolism of succ
Plasma pseudocholinesterase
30
TOF 1/4 Receptor blocked
90%
31
TOF 2/4 Receptor blocked
85%
32
TOF 3/4 Receptor blocked
80%
33
TOF 4/4 Receptor blocked
75%
34
Contraindications of SUCC
MD Hx of MH Old CVA Increase ICP
35
Succinylcholine and M
2x dose MG
36
NDNMB and Asthma
Histamine release with Atracurium, hoffman and esters h
37
Treatment of Laryngospasm Dosing of succ for laryngospasm________ then give ______
``` Call for help 0.1mg/kg 100% FiO2 Lidocaine 1.5mg/kg Sedate patient ```
38
Phase I block
FADE
39
Phase II Block
NO fade
40
Local anesthetics spread | B DGBA C
From OUTER TO INNER B fibers, Adelta, Agamma , Abeta, Aalpha, C fibers Block the conduction of impulses Block Na channels
41
PA catheter cm RA
20-25cm
42
PA Catheter cm RV
30-35cm
43
PA catheter cm PA
40-45cm
44
Wedge site cm PA catheter
45-50cm
45
a waver
Atrial contractio
46
C wave
Tricuspid buldging in ventricle
47
v wave
systolic filling of the atrium
48
Most common used DLT
left
49
Tracheal cuff; how many ml of air
20 ml
50
Bronchial cuff how many mls of air
3 ml
51
Fire triad
Fuel Oxygen Heat
52
NORA
Oxygen supplies Suction Scavenger Full tanks
53
Dexmetomidine (precedex)
Alpha 2 agonist Produce both SEDATION and analgesia 1600:1 alpha 2 to alpha 1 ratio
54
Precedex class
Alpha 2 agonist
55
Sentinel
sentinel event as an unanticipated death or loss of function unrelated to the natural course of the patient's illness or underlying condition or wrong-site, wrong-procedure, wrong-patient surgery. Such an event is called sentinel because it signals a need for an immediate investigation and response.
56
Monitored Anesthesia Care vs Sedate
MAC: Twillight sleep, potential for a deeper level of sedation than that provided by sedation/analgesia and is always administered by anesthesia professional Sedation is performed by ICU nurses, non anesthesia personnel, with training sedation principles.
57
When performingthe laryngoscopy for the placement of a DLT, the stylet should be removed when?
AS soon as the tracheal cuff passes the vocal cords | you inflate the cuff
58
When performing the laryngoscope
AS soon as the tracheal cuff passes the vocal cords | you inflate the cuff
59
Spinal Anesthesia ASA contraindications
None
60
Spinal Anesthesia contraindications Antiplatelets: Clopidogrel
Stop for 7 days prior to neuraxial block ; if considered between 5-7 days, check platelet function
61
Spinal Anesthesia contraindications Antiplatelets: Prasugrel
Stop for 7-10 days prior to neuraxial block , wait 9 hours
62
Spinal Anesthesia contraindications Antiplatelets: Ticagrelor
Stop for 5-7 days prior to neuraxial block , wait 10 hours
63
Spinal Anesthesia contraindications Antiplatelets: Ticlopidine
Stop 14 days prior
64
Spinal Anesthesia contraindications: WARFARIN
stop 4-5 days ,
65
When catheter removed for warfarin, INR
INR <1.5
66
Warfarin held when INR is
INR> 3
67
For heparin prophylaxis dose wait
10-12 hours
68
For heparin treatment dose wait
24 hours
69
To restart heparin therapy , catheter should have been out for at least______prior to initiation of therapy. Single dose therapy , wait how long
2 hours; 10-12 hours
70
Thrombin and Xa inhibitors restart
DAR (dabigatran, Apixaban, Rivaroxaban) 56 Wait 5 days, then 6 hour after 37 wait 3 days, then 6 hour after 38 wait 3 days then 8 hour
71
Tetany with Fade
Non-depolarizing
72
Tetany no FADE
Depolarizing
73
The entry of this ion facilitates the release of the neurotransmitter at the NMJ end plate
CALCIUM
74
The last to be paralyzed but the first to recover among the different muscles of the body from nondepolarizers are the muscles of the
DIAPHRAGM
75
TOF use to determine
NM blockade.
76
No problem to give SUCC TO those patients
Parkinson's Disease Epilepsy Acute CVA
77
Do not give SUCC
Spinal cord injry > 1 wk
78
Dose of succinylcholine with fasciculation
1-2 mg /kg
79
AANA standard regarding infection
One needle, one patient, one syringe
80
PPE
OR masks eye protection OR hats
81
2 principles that violate infection control recommendations
Monitoring cable should be wiped down once a day | Anesthesia machine should be wiped down once a day
82
Review fibers blocked first and last
``` B fibers A Delta A Gamma A Beta A Alpha C fibers ```
83
Fast impulses for sharp pain is mediated by what specific nerve fiber
A delta fibers
84
Recurarization in the PACU definite signs | AID
Appears uncoordinated Increase resp effort Declining O2 saturation
85
Maximal duration of tourniquet time is not well defined, although
2 hours is generally considered safe to avoid distal tissue ischemia.
86
Max tourniquet pressure.
The inflation pressure should not exceed 100 mm Hg above the systolic pressure for the upper extremity or above 150 mm Hg for the lower extremity. However, higher pressure may be needed in morbidly obese patients to prevent arterial inflow.
87
Signs and symptoms recurarization in the PACU
O2 sats drop, unresponsive pt, floppy, ineffective abdominal and intercostal activity. Feeling of suffocation
88
Treatment recurarization in the PACU
Resedate the patients | Give reversal
89
Entry of PA
35-45 cm
90
Proper sizing of the DLT is baed off of
HEIGHT
91
Proper depth of ETT For MALE
20-22
92
Proper depth of ETT for FEMALE
22-24
93
Hockey stick correlates
Height
94
A line transducer higher then bed
Underestimate BP
95
A line transducer lower then bed
Overestimate BP
96
A line transducer at PHLEBOTAXIS AXIS
Accurate BP
97
MAC involves the administration of drugs with
Anxiolytic Amnestic Hypnotic Analgesia.
98
What 2 drugs can be used to help sedate the patient for the block as well as for positioning on the OR table prior to THA
Propofol/Ketamine
99
Anatomy of the spine for SPINAL Anesthesia
``` IP SADEL SIST Intervertebral disc Pia mater Spinal nerve Arachnoid Matter Dura matter Epidural Fat Ligamentum Flavum Spinous process Interspinous Ligament Supraspinous Ligament Transverse process. ```
100
The meaning of underdampened
Systolic overestimated | Diastolic underestimated
101
The meaning of Overdampened
Systolic underestimated | Diastolic overestimated.
102
CVP measures and should be measured at
Filling pressure of the Right side of the heart | END EXPIRATION
103
Ease of cannulation
IJ better than subclavian
104
Complications IJ vs Subclavian
IJ better than subclavian
105
PAC indications
``` evaluation of response to fluid administration Valvular heart disease ARDS Recent MI Massive trauma ```
106
Zone lungs
Zone 1 PA> Pa> Pv Zone 2 Pa> PA> Pv Zone 3 Pa>Pv> PA
107
The Tip of PAC must lie in
ZOne 3 for accurate measurements of PAWP
108
Supine position favors
Zone 3

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