Unit 1 Flashcards
Which events fulfill the definition of a failed laryngoscope intubation? Name Two.
- Airway not successfully intubated within 5-10 minutes
- Glottis not intubated after 4 attempts
What percentage of anesthesia induced atelectasis occurs in anesthetized patients?
90%
What is the only anesthetic not associated with anesthetic induced atelectasis?
Ketamine
What percentage of the lung is atelectatic during uneventful general anesthesia?
15-20%
How does stimulating noradrenergic, noncholinergic mechanisms affect bronchiolar smooth muscle tone?
Leads to bronchoconstriction through the release of tachykinins, vasoactive intestinal peptide, adenosine, and calcitonin gene-related peptide
What does agonizing the acetylcholine M3 receptors lead to?
Bronchoconstriction
How does an influx of calcium into the bronchial smooth muscle affect the tone?
It increases the tone (Bronchoconstriction)
How does the stimulation of a2-receptors affect bronchial smooth muscle?
Relaxes the smooth muscle
Which nerve is most likely injured following the placement of an LMA? Which cranial nerve? Which others?
- Hypoglossal (CN12)
Also - the lingual and RLN
What is most likely to cause a nerve injury with an LMA?
Overinflation of the cuff
Which type of patients are at higher risk of difficult extubating?
- Abnormal or complicated airway issues like dental damage during intubation
- Surgical issues create airway issues like cervical fusion
- General risk factors such as OSA or neuromuscular weakness
Does a supine patient create an increased risk of difficult extubation?
No
What is the recommended time that a patient stops smoking before surgery?
8 weeks
When does the Hgb P50 return to normal after smoking cessation?
12 weeks
What is the P50 of Hgb? What is normal ?
When 50% of hgb is saturated with oxygen.
Normal is approximately 27 mmHg
Carbon monoxide binds to Hgb at what rate compared to oxygen?
240 times - this reduces the amount of available O2 to tissues
What type of shift does smoking / carbon monoxide cause?
A leftward shift because it forces the Hgb to hold onto the oxygen
Smoking cessation causes which shift on the P50?
A right shift
-Allows O2 onto the Hgb which is released to the body to improve oxygenation
What is seen at the 48–72-hour mark of smoking cessation?
Increased secretions and a more reactive airway
What is seen at the 2–4-week mark of smoking cessation?
Decreased secretions and less reactive airway
What is seen at the 4-6-week mark of smoking cessation?
Immune system and metabolism normalize
Return of pulmonary function
What is seen at the 8-12-week mark of smoking cessation?
Improved mucociliary transport and small airway function
Carotid bodies are linked to? Carotid sinuses are linked to?
Bodies - chemoreceptors
Sinuses - baroreceptors
What is the pathway of from peripheral chemoreceptors to the brain?
- Carotid bodies >
Carotid sinus n. (Hering’s) >
Glossopharyngeal n. (CN9) >
Dorsal center of medulla
2.
Transverse aortic arch >
Vagus n. (CN10)>
Dorsal center of medulla
