Mosier Test 2

Question 1

When upper motor neurons are injured, that can cause ________ ________ not associated with _________ ________ and causes _________

Answer 1

Spastic paralysis; muscle atrophy; hyperreflexia

Question 2

Lower Motor neuron injuries cause __________ ________and are associated with _________ ________ and causes ____________

Answer 2

Flaccid Paralysis; muscle atrophy; hyporeflexia

Question 3

When upper motor neurons have been around long enough they can eventually cause _________ ________, but the board answer is that they do not.

Answer 3

Muscle atrophy

Question 4

Injuries above ___ can cause __________ _________
and ___________ ___________, especially when ___ and ____ levels are damaged, and will cause paralysis below the level of the injury

Answer 4

T6; autonomic Dysreflexia; Neurogenic shock; T1-T4

Question 5

Dysreflexia and hyperreflexia are _____________

Answer 5

Synonymous

Question 6

Autonomic Hyperreflexia can lead to dangerously ______ blood pressure, and can be caused by ___ and above spinal cord injuries, and can be precipitated by ________ _______ below the level of the injury

Answer 6

high; T6; noxious stimuli

Question 7

Spinal nerves ___ through ___ innervate the diagram,

Answer 7

C3; C5

Question 8

__ thru __ injuries can cause quadriplegia and need for __________ _________

Answer 8

C1; C4

Question 9

Injuries to ___ and above will cause difficulty with clearing _________

Answer 9

C5

Question 10

_________ __________ _________ prepares body to rest and digest, originates in the ________ ________ of the spinal cord and brainstem, and uses _____ as its neurotransmitter

Answer 10

Parasympathetic nervous system; Cranial sacral; ACH

Question 11

________ _________ _________ prepares the body for flight and fight, ___________ heart rate and contractility and __________ smooth muscles of the airways

Answer 11

Sympathetic Nervous System; increases; relaxes

Question 12

Except for glands, viscera, and the adrenal medulla, the receptors of the ________ nervous system are ____ receptors, ____ receptors, and are referred to as _________ receptors

Answer 12

Sympathetic; Alpha; Beta; Adrenergic

Question 13

The receptor of the PNS are the _________ receptors, and are referred to as the _________, and use ____ as their neurotransmitter

Answer 13

Muscarinic; Cholinergic, ACH

Question 14

___ receptors cause vasoconstriction and ____________

Answer 14

A1; bronchoconstriction

Question 15

___ activation inhibits the release of NE. What two medications are an example of an A2 agonist?

Answer 15

A2; Clonidine and Precedex

Question 16

___ receptors are present in the heart. They ________ HR and contractility and can _________ AV nodal conduction

Answer 16

B1; increase; increase

Question 17

B2 receptors cause vaso______ and broncho_______ and cause __________ ___________ _________

Answer 17

dilation; dilation; uterine muscle relaxation (terbutaline)

Question 18

Activation of __________ __________ Decreases HR, contractility, and causes broncho_________ and vaso_______

Answer 18

muscarinic receptors; constriction; dilation

Question 19

The __________ is the “captain” of the ____

Answer 19

Hypothalamus; ANS

Question 20

Brainstem has control over __________ and ____________ ____________

Answer 20

Cardiovascular; pulmonary

Question 21

Autonomic Reflexes will suppress _ branch of the ANS, whether it be the ____ or ____, while activating the other

Answer 21

1; SNS or PNS;

Question 22

__________ __________ causes loss of vasomotor tone. Loss of vasomotor tone leads to __________

Answer 22

Neurogenic shock; hypotension

Question 23

Neurogenic Shock cause diminished sympathetic innervation of the heart, which leads to __________

Answer 23

Bradycardia

Question 24

ICP is normally __ to __ mmhg and is usually treated when it is above ___ mmhg.

Answer 24

5 to 15 (textbook answer); 20

Question 25

ICP can be affected by anesthetic __________ and _________

Answer 25

administration and technique

Question 26

CSF accounts for approximately ___ to ___ percent of intracranial volume

Answer 26

10 to 15%

Question 27

The __________ _________ produces approximately 500cc of CSF per day. The total volume of CSF is approximately ____cc

Answer 27

Choroid Plexus; 150

Question 28

Cerebral Edema can be caused by ________ _______, __________, and disruption of the _________ ________ ________

Answer 28

Ischemic Stroke, Meningitis, Blood Brain Barrier

Question 29

Cerebral blood flow accounts for approximately ___ percent of cardiac output, is tightly coupled to _______, and is autoregulated to MAP of ____ to ____

Answer 29

14; CMR02; 60 to 160

Question 30

Autoregulation of CBF can be lost to ________, ________, and _________ __________.

Answer 30

Acidosis, hypoxia, and volatile anesthetics

Question 31

PAC02 is a potent _________ _________, and has a proximate __________ relationship to CBF, and is a potent determinant of _____

Answer 31

cerebral vasodilator; linear; CBF

Question 32

Once _____ drops below 50mmhg the is an _________ in CBF, even in the presence of ____________

Answer 32

PA02; increase; hypocapnia

Question 33

A PA02 of ___ equates to an approximate oxygen saturation in the low 80's

Answer 33

50

Question 34

Volatile anesthetics generally _________ CBF, _________ CMR02, and have a profound effect on _________ evoked potentials

Answer 34

increase; decrease; motor

Question 35

Propofol and Etomidate __________ CBF and __________ CMR02

Answer 35

Decrease; decrease

Question 36

Ketamine __________ CBF and __________ CMR02

Answer 36

Increases; increases

Question 37

Opioids have no direct affect on ____ and Benzodiazepine have _________ effect on CBF. Studies have shown that there is no clinically significant ________ in CBF after Succs administration

Answer 37

CBF; minimal; increase

Question 38

___________ ___________ ___________ are sensitive to Inhaled anesthetics. They require the patient not to be paralyzed for the entire case, but it is okay at the

Answer 38

Motor Evoked Potentials; beggining

Question 39

Regarding evoked potentials, Ketamine and Etomidate have been reported to __________ the quality of _______ signals

Answer 39

enhance; SSEP

Question 40

Propofol and Thiopental ___________ the amplitude of all modalities of EP monitoring, but do not ___________ them

Answer 40

attenuate; obliterate

Question 41

Opioids, Benzos, and Precedex have __________ effects on the recording of _________ _________

Answer 41

negligible; Evoked potentials

Question 42

Inhalation agents, including N02 generally have a more ___________ effect on evoked potential monitoring than ___ agents

Answer 42

depressant;IV

Question 43

Volatile anesthetic can have a profound effect on the ________ and ________ of evoked potentials

Answer 43

amplitude; latency

Question 44

Signal are obtainable under __________ _________ but the anesthetic is usually kept at ____ _____ doses

Answer 44

Volatile anesthetics; Sub MAC

Question 45

_________ ________ can be used in any circumstance where there may be vascular compromise to the brain or restriction of blood flow

Answer 45

Cerebral Oximetry

Question 46

A decrease in ____ percent from baseline is significant in cerebral oximetry

Answer 46

20

Question 47

Cerebral oximetry can be used in any procedure where there can be compromise in CBF from patient _________

Answer 47

positioning

Question 48

Regarding heart transplant patients, a spinal anesthetic will _____ SVR, and despite activation of _______ ________ and increased ________ _________ being sent to the brain via cranial nerves __ and __, the ________ _________ being sent to the heart have been lost, thus a __________ _________ in CO will be absent

Answer 48

decrease; baroreceptors Afferent signals; 9 and 10; efferent signals; reflexive increase

Question 49

If treating a Heart transplant patient for hypotension after spinal, than an __ _______ should be used to increase SVR, and a __ ________ should be readily available to increase CO

Answer 49

A1 agonist; B1 agonist

Question 50

Heart transplant patient becomes bradycardic and hypotensive after induction, you going to give what drug?

Answer 50

Epi

Question 51

ER burn patient comes in and you need to urgently intubate them, what NMB is safe to use? Because when will Hyperkalemia become a problem? Burn patient comes in 3 Years later with Bowel obstructions and hypokalemia, what NMB would you use?

Answer 51

Succs; 48 hours after injury; Succs

Question 52

Succs vs large dose Roc in RSI, which is better?

Answer 52

Succs

Question 53

Chemical warfare, Serin being used (Acetylcholinesterase Inhibitor) - soldier has pinpoint pupils, shaking, frothing at the mouth, wheezing, nd confusion. What is the first drug your going to give?

Answer 53

Atropine