Test 1: Definitions Flashcards by Preeti Gulve

A loss of sensitivity to pain

Analgesia

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The neural process of encoding noxious stimuli;

does not require consciousness

Nociception

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A state of behavior change where anxiety is relieved and the patient is relaxed, but also aware of its surroundings

Tranquilization

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A state characterized by CNS depression accompanied by drowsiness. Patient is likely unaware of its surroundings

Sedation

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A drug induced state of deep sleep from which a patient cannot be easily aroused; may or may not be accompanied by antinociception

Narcosis

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Induced by drugs that dissociate the thalamocortical and limbic systems. Characterized by a catatonic state:

Swallowing reflexes are functional

Eyes remain open

Skeletal muscle rigidity is common unless a muscle relaxant is given in conjunction

Dissociative Anesthesia

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Dissociative Anesthesia

is induced by which 2 drugs?

Ketamine

Tiletamine

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Stage/plane of general anesthesia that provides unconsciousness, muscle relaxation, and analgesia sufficient for painless surgery

Surgical Anesthesia

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Air without gas exchange

Dead Space

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Gas that is a liquid at ambient temperature and pressure

Vapor

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Exists as a gas at both ambient temp and pressure

GAS

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Pressure exerted by molecules when liquid and vapor

phases are at equilibrium

Vapor Pressure

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Solubility Concept:

At equilibrium, in the 3 compartments (gas,oil,water),

The # of anesthetic molecules

in the compartments _______,

but the pressure exerted by the anesthetic molecules

in the compartments ________.

At equilibrium, in the 3 compartments (gas,oil,water),

The # of anesthetic molecules

in the compartments DIFFERS

but the pressure exerted by the anesthetic molecules

in the compartments IS THE SAME!

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The concentration ratio of an anesthetic in the solvent

and gas phases, which describes the capacity of a given

solvent to dissolve the anesthetic gas

Partition Coefficient

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The most clinically useful number,

describes the amount of anesthetic in the blood vs. alveolar gas

at equal partial pressures

Blood-Gas Partition Coefficient

The anesthetic in the alveolar gas represents the concentration in the brain!

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The ________ the blood-gas partition coefficient,

the more soluble the agent

higher

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Order the major gas anesthetics in order of

decreasing solubility

Halo>Iso>Sevo>Des

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The lower the blood-gas partition coefficient,

the _______ the time of induction and recovery

shorter

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Which gas anesthetic is most potent

and has the longest induction and recovery?

HALOTHANE

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What does F_A stand for?

What does F_I stand for?

F_{A =}Alveolar concentration

F_I = Inspired Concentration

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In regards to rate of rise of F_A to F_I:

The less soluble the gas, the _____ the rise

The more soluble the gas, the ______ the rise

less soluble = FASTER rise (i.e. N20)

more soluble = SLOWER rise (i.e. Halothane)

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Increasing anesthetic delivery and

decreasing removal from the alveoli

will do what to PA

INCREASE P_A

P_A = Anesthetic delivery to alveoli

P_I = Inspired anesthetic concentration

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A ______ P_I is required at the start of anesthesia to

rapidly increase P_A

HIGH

_{PA = Anesthetic delivery to alveoli}

_{PI = Inspired anesthetic concentration}

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In regards to Hepatic Metabolism,

List the common anesthetic gases in order of

most metabolized to least metabolized

Halo > Sevo > Iso > Des

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The minimum concentration of anesthetic in the alveoli that *prevents movement* in 50% of patients *exposed to a noxious stimuli*

Minimum Alveolar Concentration (MAC)

MAC allows comparison of ______ between agents

_Potency_

The _______ the MAC, the lower the potency

_HIGHER_

T/F: Halothane has the highest MAC and is therefore the most potent

FALSE! Halothane has the **LOWEST MAC** and is therefore the most potent

List the anesthetic gases in order of Lowest MAC to Highest MAC

Halo \< Iso \< Sevo \< Des \< Nitrous Oxide

List the anesthetic gases in order of potency from most potent to least potent

Halo \> Iso \> Sevo \> Des \> Nitrous Oxide

Used to describe dose of gas in relation to effect

MAC Multiples

1.2 to 1.4 times MAC ensures immobility in \_\_\_\_% of patients

_95%_

Inotropy

Cardiac CONTRACTILITY

Chronotropy

HEART RATE

Anesthesia effects: Contractility (Inotropy) will \_\_\_\_\_\_\_ and HR (Chronotropy) will _______ or \_\_\_\_\_\_

Contractility (Inotropy) will _DECREASE_ and HR (Chronotropy) will _NOT CHANGE_ or _INCREASE_

Respiratory arrest occurs at this range of MAC

1.5 - 3X MAC

ICP increases at \> \_\_\_\_X MAC

_1X MAC_

The substance produced by **s****evoflurane** breakdown in the CO2 absorbent which causes **renal toxicity.** Higher concentrations are formed during prolonged anesthesia

COMPOUND A

This anesthetic gas can cause **hepatic toxicity**

HALOTHANE "Halothane Hepatitis"

A myopathy caused by exposure to inhalant, especially Halothane, the results in uncontrolled muscle contraction, severe hyperthermia and then death (very likely despite treatment)

Malignant Hyperthermia

The first sign of Malignant Hyperthermia is a rapid increase in

EtCO2

What drug is administered if a rapid rise in EtCO2 is seen, indicative of malignant hyperthermia?

DANTROLENE | (muscle relaxant!)

What is the solubility of Nitrous Oxide?

0.47 | (low solubility)

What is the max % administration of Nitrous oxide and why?

75% max because need at least 25% oxygen

The major concern when stopping N2O administration is

Diffusion Hypoxia | (Give 100% oxygen)

A condition caused by opioids resulting in unpleasant body sensations, nervousness, and anxiety.

Opioid DYSPHORIA

How do you differentiate between pain and dysphoria?

Administer a short-acting opioid (FENTANYL) If patient calms, it was pain If patient is more distressed, it is dysphoria

This category of drugs treats Dysphoria AND Pain

Alpha-2 Agonists

Muscle injury secondary to hypoperfusion seen in horses in recovery

Rhabdomyolysis

The active process of retching

Vomiting

The passive process of expelling material from the esophagus or stomach into the oral cavity

Regurgitation

T/F: Fasting decreases incidence of vomiting, regurg, and reflux

FALSE!! Fasting only decreases incidence of vomiting! (not regurg or reflux- passive processes)

Increased parasympathetic tone (vagal stimulation) causes

Bradycardia

The volume of blood ejected by the heart

Cardiac output

The amount of blood ejected by the left ventricle in one contraction

Stroke Volume

The average arterial pressure during a single cardiac cycle

MAP (Mean Arterial Pressure)

the resistance to blood flow offered by all of the systemic vasculature, excluding the pulmonary vasculature. This is sometimes referred as total peripheral resistance (TPR)

Systemic Vascular Resistance (SVR)

partial pressure of carbon dioxide in arterial blood

PaCO2

The partial pressure or maximal concentration of carbon dioxide (CO2) at the end of an exhaled breath Expressed as a percentage of CO2 or mmHg. The normal values are 5% to 6% CO2, which is equivalent to 35-45 mmHg.

End Tidal CO2

The slope of the intrapleural pressure-volume curve

Compliance

Non-invasive breath by breath technique used to measure CO2, where EtCO2 closely approximates PaCO2

Capnography

Inconsistency between the amount of air and the amount of blood in the lungs

ventilation/perfusion (V/Q) mismatch.

An estimate of arterial oxygen saturation which refers to the amount of oxygenated hemoglobin in the blood

SPO2 (saturation of peripheral capillary oxygen)

the inspired concentration of oxygen breathed

FiO2

The ratio of partial pressure arterial oxygen and fraction of inspired oxygen; the comparison between the oxygen level in the blood and the oxygen concentration that is breathed.

PaO2:FiO2 Ratio

A disorder defined by the initial change in HCO3- or PaCO2

Primary Acid-Base Disorder

A change in HCO3- or PaCO2 in the opposite direction to the primary disorder

Compensation

Refers to an increase or decrease in the amount of base present in the blood, and defines the metabolic component of acid-base disturbances

Base Excess

The partial pressure of CO2 (mmHg) in the arterial blood

PaCO2

The partial pressure of oxygen in the arterial blood

PaO2

PAO2

Partial pressure of oxygen in the Alveolar space

PaO2 vs. PAO2

PaO2 = partial pressure in *arterial blood* PAO2 = partial pressure in *Alveolar space*

The upper limit of ______ is the PAO2

_PaO2_ * The upper limit of the partial pressure of oxygen in arterial blod* * is the partial pressure of oxygen in the Alveolar space!* _{(if gas exchange was ideal, the #s would be equal. In real life, pp of oxygen in} _{arterial blood is always LOWER than the pp of oxygen in the Alveolar space!)}

The insufficient oxygenation of arterial blood

Hypox**emia**

The insufficient oxygenation of tissues

Hypox**ia**

The ratio of inspiratory and expiratory times

I:E Ratio

Test 1: Definitions Flashcards

(76 cards)