Flashcards in Surg 102 Chapter 12 (Fuller) Deck (54):
What is a polarizing agent?
cause muscle paralysis by stimulating involuntary muscles, which is followed by muscle fatigue
What drugs are commonly used as polarizing agents?
succinylcholine and decamethonium
What is a nondepolarizing agent?
prevent muscle contraction by binding to the muscle's cholinergic receptor
What drugs are commonly used as nondepolarizing agents?
-mivacurium (short acting)
-atracurium (intermediate duration)
-cistatracurium (intermediate duration)
-vecuronium (intermediate duration)
-rocuronium/Zemuron (intermediate duration)
-tubocurarine (long duration)
-gallamine (long duration)
-metocurine (long duration)
-pancuronium (long duration)
-pipecuronium (long duration)
Regional anesthesia provides reversible loss of sensation in a specific area of the body without _____.
The most common uses of regional anesthesia are :
1. limb surgery in which complete nerve block is possible
2. procedures in which consciousness is desirable or required
3. minor superficial procedures
4. patients for whom general anesthesia poses a significant risk
What are the different types of regional anesthesia?
1. topical anesthesia
2. local infiltration
3. nerve block
4. spinal, caudal, and epidural anesthesia
What is topical anesthesia?
an anesthetic is applied directly to the eye, skin, or mucous membrane
What is local infiltration?
a small amount of drug is introduced through multiple injections into the skin and subcutaneous tissue
What is a nerve block?
a single nerve or nerve plexus (group) is anesthetized, blocking sensory stimuli to the tissue enervated by that nerve or group
What are spinal, caudal, and epidural anesthesia?
specific techniques for blocking transmission to the middle and lower body
Monitored anesthesia care (MAC) is _____ provided during regional anesthesia.
continuous patient monitoring
Topical anesthesia is used on _____ and _____ during ophthalmic procedures.
mucous membranes and superficial eye tissue
Topical anesthetics are used before insertion of _____ and _____devices and also before _____ and _____to prevent reflexive gagging.
endotracheal and LMA
laryngoscopy and bronchoscopy
Local infiltration is injection of an anesthetic into _____ to produce a small area of anesthesia.
During a nerve block, the anesthetic agent is injected into the _____.
adjacent tissue, not into the nerve itself
During an intravenous (Bier) block, blood is temporary displaced from a _____.
limb and replaced by a regional anesthetic agent
Spinal anesthesia is injection of anesthetic into the _____.
During spinal anesthesia, two positions are used--_____ or _____.
lateral (side-lying) or sitting
A _____ position is used with patient lying on his side and the knees drawn up.
Epidural anesthesia is produced when the anesthetic agent is injected into the epidural space that surrounds the _____.
What are the risks associated with spinal anesthesia?
hypotension, postspinal headache, total spinal anesthesia
Caudal and epidural anesthesia target the _____.
In the epidural anesthesia the approach is through the _____.
In caudal anesthesia the approach is through the _____.
All health care worker must maintain current certification in _____ and be able to respond in case of a cardiac or respiratory arrest
The signs and symptoms of cardiac arrest vary according to whether the patient is _____.
fully conscious at the time or sedated
During cardiopulmonary arrest a conscious patient may feel _____.
nausea, shortness of breath, chest pain or pressure, or pain radiating from the jaw, neck, or shoulder
It is important to remember that resuscitative efforts must begin _____ to prevent neurological damage from lack of oxygen to the brain.
Brain damage may occur as quickly as _____ after circulatory collapse.
A _____ is autonomic spasming of the laryngeal muscles.
A laryngospasm is usually associated with _____ or _____ of the laryngeal nerve during intubation or extubation.
airway secretions or stimulation
Laryngospasms are treated with positive-pressure administration of oxygen or, in severe cases, administration of _____.
succinylcholine to paralyze the muscles
Anaphylaxis is a _____ to a material or drug that can lead to shock.
true allergic reaction
Sign and symptoms of anaphylaxis include _____.
rash, abnormal lung sounds detected during auscultation, wheezing, and difficulty breathing.
During severe shock, the supply of _____ and _____ to all body tissues is inadequate.
oxygen and nutrients
What are the different types of shock?
1. circulatory shock
2. cardiogenic shock
3. anaphylactic shock
4. neurogenic shock
5. septic shock
Circulatory shock is a state of _____ for supplying the whole body.
inadequate blood volume
(can be caused by hemorrhage, burns, severe diuresis)
Cardiogenic shock is caused by heart failure, which disables the _____ because blood cannot be pumped adequately throughout the body.
Anaphylactic shock is caused by true allergy, resulting in _____, which slows or halts normal circulation.
vasodilation and pooling of blood
Neurogenic shock is caused by _____ to maintain vascular tone.
failure of the autonomic nervous system
Septic shock is caused by _____, which results in hypovolemia.
Treatment of shock is targeted at restoring _____, _____, and _____.
circulatory function, electrolyte balance, and oxygenation of tissues
Malignant hypothermia (MH) is a rare physiological response to all _____ and _____.
volatile anesthetic agents and succinylcholine
Malignant hypothermia causes a severe immediate or delayed _____.
During malignant hypothermia the patient exhibits an extremely _____, _____, _____, and _____.
high core temperature, tachychardia, tachypnea, and increased muscle rigidity
Emergency drugs for MH treatment include _____ and agents to treat specific metabolic disorders.
_____ is the rupture of red blood cells.
Hemolysis is associated with _____ during blood transfusion.
ABO factor incompatibility
Patients under _____ do not show signs and symptoms of hemolytic reaction.
ABO mismatch symptoms outside of surgery include:
1. back pain
What is analgesia?
the absence of pain, produced by specific drugs
What is anesthesia?
the absence of sensory awareness or medically induced unconsciousness