Neurophysiologic Effects Flashcards Preview

Apex 4 - 5 Volatile Anesthetics II: Pharmacodynamics (11) > Neurophysiologic Effects > Flashcards

Flashcards in Neurophysiologic Effects Deck (41)
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1

Sevoflurane at 1.5 MAC increases:

Study on!!!

2

The Neurophysiologic Effects of Volatile agents include:

 

CMRO2, CBF, Cerebral blood volume, Autoregulation, and CSF dynamics

3

How do Volatile agents affect Cerebral Metabolic Rate (CMRO2)?

????

4

60 percent of CMRO2 is dependent on:

Electrical activity

5

40 percent of CMRO2 is dependent on:

Cellular homeostasis

6

Volatile anesthetics ----- CMRO2

 

"reduce"

7

Volatile anesthetics reduce CMRO2, but only to the extent that they reduce ----- activity

Electrical activity

8

Volatile anesthetics reduce CMRO2, but only to the extent that they reduce electrical activity. Once the brain is -----, volatile agents cannot reduce CMRO2 any further

"isoelectric"

9

--- to --- MAC is required to produce an isoelectric state

1.5 - 2.0 MAC

10

Sevoflurane in high concentrations (--- MAC) can produce seizure activity

2.0 MAC

11

Sevoflurane in high concentrations (2.0 MAC) can produce seizure activity. This is exacerbated by -----.

 

 

Hypocapnia (low PaCO2)

12

Sevoflurane in high concentrations (2.0 MAC) can produce seizure activity. This is exacerbated by hypocapnia and is more common with ----- inhalation induction

Pediatric inhalation induction

13

How do Volatile agents affect Cerebral Blood Flow?

???

14

The brain ----- its blood flow with its metabolic requirement

"matches"

15

When metabolic demand increases, the blood vessels -----.
 

"dilate"

16

When metabolic demand increases, the blood vessels dilate. Cerebrovascular resistance -----.

"decreases"

17

When metabolic demand decreases, the blood vessels -----.
 

"constrict"

18

When metabolic demand decreases, the blood vessels constrict. Cerebrovascular resistance -----.

"increases"

19

We've already established that volatile anesthetics are cerebral vaso-----.
 

vasodilators

20

We've already established that volatile anesthetics are cerebral vasodilators. They ----- cerebrovascular resistance (CVR)

"decrease"

21

Therefore, there are two competing factors at play: vasoconstriction from the reduction in CRMO2 and vasodilation from the anesthetic agent

True

22

Therefore, there are two competing factors at play: vasoconstriction from the reduction in CRM02 and vasodilation from the anesthetic agent. The net effect is a dose-dependent ----- in cerebral blood flow, cerebral blood volume, and ICP

"increase"

23

Which ventilatory intervention partially offset the vasodilatory effects from Volatile anesthetics?

 

Mild hyperventilation

24

Mild hyperventilation and/or concurrent administration of which drugs partially offset the vasodilatory effects Volatile anesthetics

Propofol, Opioids, or Barbiturates

25

Nitrous oxide is different. It ----- CMR02 and cerebral blood flow

"increases"

26

How do Volatile agents affect Cerebral Autoregulation?

?????

27

The cerebral vasculature continuously adjusts vessel diameter to maintain a constant cerebral blood flow between cerebral perfusion pressure of --- to --- mmHg

50 - 150 mmHg

28

Volatile anesthetics ----- autoregulation in a dose-dependent fashion.

"disrupt"

29

Volatile anesthetics disrupt autoregulation in a dose-dependent fashion. Cerebral blood flow becomes increasingly dependent on ----- as the concentration of the volatile agent is increased

Blood pressure

30

How do Volatile agents affect Cerebrospinal Fluid Volume?

?????