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Fall 2020 - Physiology 3 - Neuro > Quiz 2 Review > Flashcards

Quiz 2 Review Flashcards

(60 cards)

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1
Q

What do Upper Motor Neuron Injuries cause?

A

Spastic Paralysis & Hyperreflexia

No Muscle Atrophy til Later

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2
Q

What do Lower Motor Neuron injuries cause?

A

Flaccid Paralysis & Hyporeflexia w/ Muscle Atrophy

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3
Q

What do injuries above T6 cause?

A

Autonomic Dysreflexia

&

Neurogenic Shock

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4
Q

What happens with T1-T4 damage?

A

Paralysis below level of Injury

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5
Q

What is a main sign of Autonomic Hyperreflexia?

A

Dangerously High BP precipitated by Noxious Stimuli below the Injury Level

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6
Q

Which patients are infamous for Autonomic Hyperreflexia?

A

Cysto Patients

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7
Q

What does C3-C5 Innervate?

A

Phrenic Nerve - Diaphragm

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8
Q

What do C1-C4 injuries cause?

A

Quadriplegia requiring Mechanical Ventilation

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9
Q

Injuries at what level would cause Difficulty Clearing Secretions?

A

C5 & Above Injuries - Indicates Intubation

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10
Q

What is the Neurotransmitter of the Parasympathetic Nervous System?

A

Acetylcholine

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11
Q

Where does the Parasympathetic Nervous System orginate from?

A

Cranial & Sacral Areas of Spinal Cord & Brainstem

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12
Q

What does the Sympathetic Nervous System do?

A

Increase HR & Contractility

+

Relax Airway Smooth Muscles

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13
Q

Which adrenergic receptors are stimulated by the Sympathetic Nervous System?

A

Alpha & Beta Receptors

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14
Q

How do Alpha & Beta receptors affect the Airway?

A

Alpha: Minor - Contraction & Bronchconstriction

Beta: Major - Bronchodilation

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15
Q

What is not included in regards to Sympathetic Nervous System receptors?

A

Glands

Viscera

Adrenal Medulla

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16
Q

What are the receptors of the Parasympathetic Nervous System?

A

Cholinergic / Muscarinic Receptors

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17
Q

What are the effects of Alpha-1 Receptors?

A

Vasoconstriction & Bronchoconstriction

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18
Q

What happens when Alpha-2 Receptors are activated?

A

Inhibition of Norepi Release

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19
Q

What are examples of Alpha-2 Agonists?

A

Clonidine & Precedex

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20
Q

Where are Beta-1 Receptors located and what do they do?

A

Increase HR, Contractility, & AV Node Conduction in the Heart

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21
Q

What does Beta-2 Stimulation do?

A

Vasodilation, Bronchodilation, & Uterus Relaxation

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22
Q

What happens when Muscarinic receptors are activated?

A

Decrease HR & Contractility

Bronchoconstriction

Vasodilation

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23
Q

What controls the Autonomic Nervous System?

A

Hypothalamus - Captain of the ANS

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24
Q

What does the Brainstem control?

A

CV & Pulmonary Function

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25
How do Autonomic Reflexes affect the SNS & PNS?
Activates one while supressing the other
26
What does Neurogenic Shock cause?
Loss of Vasomotor Tone Diminished SNS Hypotension Bradycardia
27
What is the normal ICP?
5-15 mmHg
28
When should the ICP be treated?
20 mmHg or Higher
29
What can affect ICP?
Anesthetic Meds & Techniques
30
How much of the Intracranial volume is CSF?
10-15 %
31
How much CSF does the Choroid Plexus produce a day?
~500 mL/day
32
How much total CSF is there at any one time?
150 mL
33
What can cause Cerebral Edema?
Ishemic Stroke Meningitis BBB Disruption
34
How much Cardiac Output goes to Cerebral Blood Flow?
~14 %
35
Cerebral Blood Flow is tightly coupled to \_\_\_\_\_\_\_
Cerebral Blood Flow is tightly coupled to **CMRO2**
36
At what MAP is Cerebral Blood Flow autoregulated?
MAP of 60-160 mmHg
37
What can cause of loss of Cerebral Blood Flow autoregulation?
Acidosis Hypoxia Volatile Anesthetics
38
What is a potent Cerebral Vasodilator & has a linear relationship to CBF?
PaCO2
39
What level of PaO2 will cause an increase in Cerebral Blood Flow, even with Hypocapnia?
PaO2 \< 50 mmHg
40
PaO2 of 50 mmHg = ? SaO2
PaO2 of 50 mmHg = **~80%** SaO2
41
How should O2 Saturation be managed for patients w/ Increased ICP?
Dont let O2 Saturation go below 80%
42
What are the Neuro Effects of Volatile Anesthetics?
↑CBF ↓CMRO2 Profoundly affects Motor EPs
43
What are the Neuro Effects of Propofol & Etomidate?
↓CBF & ↓CMRO2
44
What are the Neuro Effects of Ketamine?
↑CBF & ↑CMRO2
45
How do Opioids affect Cerebral Blood Flow?
**No Direct Effect**, but respiratory depression can ↑CO2 & ↑ICP
46
How do Benzos affect Cerebral Blood Flow?
Minimal Effect
47
How does Succinylcholine affect Cerebral Blood Flow?
No Significant Increase
48
What is required to be able to monitor Motor Evoked Potentials (MEPs)?
Patient CANNOT be paralyzed for entire case, only the beginning of case is OK
49
How do Ketamine & Etomidate affect Evoked Potentials?
Enhances SSEP
50
How do Propofol & Thiopental affect Evoked Potentials?
Attenuates Amplitude without Obliteration
51
How do Opioids, Benzos, and Precedex affect Evoked Potentials?
Negligible Effects
52
How do N2O & Inhalation agents compare to IV Agents regarding Evoked Potentials?
N2O & Inhalation Agents have more Depressant Effects
53
How do Volatile Agents affect Evoked Potentials?
Profound influence on Amplitude & Latency - Sensory & Motor
54
How should Inhalation Agents be managed in order to obtain Evoked Potential signals?
Keep below full MAC
55
When should Cerebral Oximetry be used?
Any case where Vascular Compromise to Brain d/t from blood flow restriction is possible
56
A decrease of Cerebral Blood Flow of ______ is considered Significant
A decrease of Cerebral Blood Flow of **20%** is considered Significant
57
True/False: Acute Burns is a contraindication for Succinylcholine?
False - only contraindicated if it has been 2-3 days since burn
58
What meds will NOT work for patients who have had a Heart Transplant?
Vagolytics & Sympathomimetics such as Atropine or Ephedrine
59
Which meds should be used to for patients who have had a Heart Transplant?
Direct Acting Agents - Epinephrine
60
What is the antidote for Seron, an Aerosolized Neostigmine?
Atropine - Antimuscarinic

Fall 2020 - Physiology 3 - Neuro (2 decks)

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