Final Thoughts Flashcards

1
Q

What is organ least likely to withstand hypoxia?

A

Brain

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2
Q

What are MEP?

A

Motor evoked potentials

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3
Q

What are SSEP?

A

Somatosensory evoked potentials

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4
Q

What does EEG stand for?

A

Electroencephalography

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5
Q

What does EEG measure?

A

Brain ischemia
Seizure activity
Brain metabolic activity

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6
Q

What does MEP measure?

A

Motor nerve ischemia / Spinal cord ischemia

Spinal cord injury / Motor nerve injury

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7
Q

What does SSEP measure?

A

Stroke
Spinal cord injury / Sensory nerve injury
Sensory nerve ischemia / Spinal cord ischemia

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8
Q

When using ECoG (electrocorticogram), what is the symbol given for midline ?

A

z

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9
Q

Where are the even numbers on ECoG?

A

RIght side

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10
Q

Where are odd numbers on ECoG?

A

Left side

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11
Q

What waves are indicative of sleep?

A

Spindle waves

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12
Q

Are the waves in synchrony when you are asleep or awake?

A

Asleep

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13
Q

What frequency range is sleep?

What are those waves called?

A

0-7 Hz

4-7 Hz = Theta ( Light anesthesia)
0-4 Hz = Delta (Deep anesthesia)

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14
Q

What frequency range is quiet wakefulness?

What are those waves called?

A
8-12 Hz
Alpha waves (resting or eyes closed)
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15
Q

What kind of technique does the BIS monitor use?

A

Averaging

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16
Q

What waves are indicated by a >12 Hz and what do they indicate?

A

Beta waves

Indicates sedation / Stage 2 excitation

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17
Q

What is normal cerebral blood flow?

A

50mL / (100 g x min)

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18
Q

When does EEG become abnormal?

A

CBF of 20-25 mL / (100 g x min)

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19
Q

T or F: Deep anesthesia and ischemia produce the same EEG patterns?

20
Q

How much does normal brain weigh?

A

1500 g or 3 lbs

21
Q

Which 2 IV drugs and what 1 class of drugs can cause burst suppression on EEG?

A

Etomidate
Propofol
Barbiturates

22
Q

When patient gets sleepier, what happens to f and what happens to amplitude?

A

f gets lower

Amplitude gets larger

23
Q

List intracranial contents:

A

Brain parenchyma : 1200-1600 mL
ECF : 100 - 150 mL
Blood: 100 - 150 mL
CSF: 100 - 150 mL

24
Q

What factors causes acidosis and vasodilation on cerebral vessels ultimately increasing ICP?

A

Increased PaCO2
Decreased Bicarb
Increased metabolic activity ( lactic , pyruvic)

25
What factors causes alkalosis and vasoconstriction on cerebral vessels ultimately decreasing ICP?
Decreased PaCO2 | Increased Bicarb
26
Cerebral O2 consumption is what ?
20% of total body O2 consumption ~ 3.5 mL / 100 g / min or ~ 50 mL / min
27
How much of CO is CBF?
15% of CO
28
What is TCD and how many MHz does the probes use?
Transcranial doppler | 2- MHz probes
29
What kind of waveform does TCD look like?
Arterial
30
What does TCD look at?
Looks at middle cerebral artery perfusion
31
What is cerebral blood flow autoregulation range?
50 - 150 mmHg
32
How to calculate perfusion pressure?
PP = MAP - ICP | or MAP - CVP (if CVP is higher than ICP)
33
What drugs for most part increase ICP?
- - Succinycholine - - Ketamine - - Nitroprusside - - Hydralazine - - Nitroglycerin - - Nicardipine ++
34
What drugs decrease ICP?
- - Etomidate - - Mannitol - - Furosemide - - Barbiturates - - Propofol - - Benzo's
35
What do the inhaled anesthetics do to ICP?
All increase (iso increases it the least)
36
What is only IV drug to increase CBF?
Ketamine
37
On the glasco coma scale, what do the numbers indicate?
- - Small #'s mean more obtunded | - - Large #'s mean the better they are
38
What is the best most sensitive way to detect venous air embolism?
Transesophageal echocardiography | Precordial doppler
39
What is the standard way for ICP measuring and CSF drainage?
Ventriculostomy
40
What does a intracranial hemorrhage present with?
- - Hypervolemic - - Hypertension - - Hemodilution
41
What is a homunculus?
A diminutive human being without any deformity of physiology
42
T or F: the motor area of the brain is slightly more frontal than the sensory area?
TRUE
43
Can you NMB block when doing SSEP?
Yes, NMB does not affect
44
What is the SSEP pathway? | What is MEP pathway?
Dorsal (posterior horns) = sensory | Ventral (anterior) horns = motor
45
T or F: the larger the amplitude on the evoked potential waveform, the closer (nearness) to the electrical stimulus the electrode is
TRUE
46
What does latency equal?
TIME