Term
The brain consumes what percentage of total body oxygen |
|
Definition
|
|
Term
How much of the O2 consumed by the brain is used to make ATP |
|
Definition
|
|
Term
CMRO2 is greater in white or grey matter? |
|
Definition
|
|
Term
Average cerebral metabolic rate for oxygen |
|
Definition
|
|
Term
If you lose O2 to the brain, how long will it take to go unconscious |
|
Definition
|
|
Term
If you lose O2 to the brain, how long will it take to have irreversible damage |
|
Definition
|
|
Term
|
Definition
750 ml/min (15% of total CO) or 50 ml/100g/min |
|
|
Term
CBF of <25ml/100g/min causes what? |
|
Definition
cerebral impairment and EEG slowing |
|
|
Term
CBF of <10ml/100g/min causes what? |
|
Definition
irreversible damage and isoelectric EEG (flat line) |
|
|
Term
What is the most important extrinsic factor on CBF |
|
Definition
|
|
Term
PaCO2 is _____ proportional to SVR |
|
Definition
|
|
Term
CBF is _______ proportional to PaCO2 |
|
Definition
|
|
Term
CBF changes ______ for every 1 mmHG change in PaCO2 (between PaCO2 20-80 mmHg), how long does this effect last? |
|
Definition
1-2ml/100g/min, lasts 6-8 hours |
|
|
Term
PaO2 effects CBF when it reaches what level? |
|
Definition
<50mmHg, then CBF increases |
|
|
Term
CBF is _____ proportional to temperature |
|
Definition
directly (it follows a change in CMRO2 in the same direction) |
|
|
Term
CBF changes _____ for every ___ change in temperature |
|
Definition
|
|
Term
Autoregulation occurs independently when MAP is what? |
|
Definition
|
|
Term
|
Definition
|
|
Term
CPP must be what (minimun)? |
|
Definition
|
|
Term
|
Definition
CPP= MAP- ICP or CPP= MAP- CVP (if CP > ICP) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
% of cranial vault that contains brain, blood, CSF respectively |
|
Definition
|
|
Term
|
Definition
|
|
Term
Focal ischemia (localized) occurs at what ICP |
|
Definition
|
|
Term
Global ischemia occurs at what ICP |
|
Definition
|
|
Term
|
Definition
Irregular Respirations MAP increased (HTN) Bradycardia (I'M Bad) |
|
|
Term
A patient has n/v and altered LOC, what is their ICP |
|
Definition
|
|
Term
|
Definition
|
|
Term
Total CSF volume (at any given time) |
|
Definition
|
|
Term
Dural sinus pressure in flat position |
|
Definition
|
|
Term
Dural sinus pressure in sitting 25 degrees |
|
Definition
|
|
Term
Dural sinus pressure in sitting 60 degrees |
|
Definition
|
|
Term
Dural sinus pressure in sitting 90 deg. |
|
Definition
|
|
Term
Dural sinus pressure in sitting 20 deg. |
|
Definition
|
|
Term
Dural sinus pressure in prone |
|
Definition
|
|
Term
Hyperventilation includes what range of PaCO2? |
|
Definition
|
|
Term
Inverse Steal (robinhood effect) |
|
Definition
Occurs with Hypocarbia, normal vessels contrict, shunting blood to ischemic areas and potentially causing ischemia in normal tissue |
|
|
Term
|
Definition
Hypercarbia causes non-ischemic vessels to dilate and pull blood away from ischemic areas. |
|
|
Term
|
Definition
|
|
Term
Goal serum osmolality with mannitol treatment |
|
Definition
|
|
Term
|
Definition
0.5-1 mg/kg, with mannitol 0.15-0.3 mg/kg |
|
|
Term
Halothane reduces CBF by how much? |
|
Definition
200% and reduces autoregulation the most |
|
|
Term
|
Definition
increases CBF the least, and reduces CMRO2 the most, also reduces CSF |
|
|
Term
Don't use nitrous because... |
|
Definition
increases CBF and ICP, incresases intracranial air, VAE and pneumothorax size |
|
|
Term
Ketamine increases CBF by how much? |
|
Definition
50-60% and blocks CSF absorption |
|
|
Term
Avoid opioids because they do what? |
|
Definition
Hypoventilation= increased CO2= cerebral vasodilation= increased CBF= increased ICP |
|
|
Term
|
Definition
|
|
Term
Demerol metabolite promotes what? |
|
Definition
|
|
Term
Dilantin dose for seizures |
|
Definition
15mg/kg over 20 minutes, must mix with 0.9 NS |
|
|
Term
Midazolam dose for seizures |
|
Definition
|
|
Term
Pentothal dose for seizures |
|
Definition
|
|
Term
Diazapam dose for seizures |
|
Definition
|
|
Term
most effective therapy for atherosclerosis |
|
Definition
|
|
Term
What percentage of CVAs are preceded by TIAs? |
|
Definition
|
|
Term
Is a patient more at risk for an MI or stroke post CAE? |
|
Definition
|
|
Term
What is the single most important cause of morbidity and mortality in vascular surgery? |
|
Definition
|
|
Term
What is the major goal of anesthesia for vascular surgery? |
|
Definition
To preserve myocardial function |
|
|
Term
What are the major goals for vascular surgery? |
|
Definition
Restore normal perfusion to prevent stroke, improve functional status, or prevent death |
|
|
Term
What are the five other causes of morbidity and mortality in vascular surgery (aside from myocardial dysfunction)? |
|
Definition
Pulmonary infections, renal insufficieny/failure, hepatic failure, CVAs, spinal cord ischemia |
|
|
Term
What stump pressure reflects neurological hypoperfusion and is a criterion for shunt placement? |
|
Definition
|
|
Term
If there is a pulse felt on the distal end of the clamped carotid artery, then what is the stump pressure? |
|
Definition
|
|
Term
|
Definition
|
|
Term
What is the most important predictor of subsequent aneurysm rupture and mortality? |
|
Definition
|
|
Term
Aneurysms ____ have a 20% incidence of rupture within 6 years |
|
Definition
|
|
Term
Mortality after aneurysm rupture |
|
Definition
|
|
Term
Traditional repair of AAA is associated with what percentage of mortality? |
|
Definition
|
|
Term
What are the only definitive methods to prevent spinal cord ischemia with an aortic cross clamp? |
|
Definition
-fast surgery and maintenance of normal cardiac function |
|
|
Term
Suprarenal clamping decreases renal blood flow by how much? |
|
Definition
|
|
Term
Infrarenal clamping is associated with what percentage of renal failure? |
|
Definition
|
|
Term
What are the most important determinants of post op renal function? |
|
Definition
maintaining intravascular volume and normal myocardial function |
|
|
Term
Cross clamp time should be limited to... |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Recurrent productive cough for 3 months for 2 consecutive years |
|
|
Term
Examination findings of pulmonary hypretension include |
|
Definition
1) Split 2nd heart sound 2) RV hypertrophy 3) RA hypertrophy |
|
|
Term
What things will worsen pulmonary hypertension? |
|
Definition
Hypoxemia, acidosis, sepsis, and peep |
|
|
Term
ECG features of RV/RA strain |
|
Definition
Low voltage QRS, Poor R wave progression (precordial leads), enlarged or biphasic P wave in lead II is diagnostic of RA hypertrophy |
|
|
Term
|
Definition
-ID risk of morbidity and mortality -who will need vent postop -who will benefit from bronchodilators |
|
|
Term
Vital Capacity of ____% or ____L idicates increased postoperative risk |
|
Definition
|
|
Term
Spirometry cannot measure |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
FEV1/FVC in obstructive disease |
|
Definition
|
|
Term
FEV1/FVC in restrictive disease |
|
Definition
> or = to 0.8, both are reduced |
|
|
Term
Severe risk is FEV! < _____L and FEV1/FVC < |
|
Definition
|
|
Term
Cyclic AMP action in lungs |
|
Definition
|
|
Term
Cyclic GMP action in lungs |
|
Definition
|
|
Term
Beta 2 specific drugs (albuterol) do what |
|
Definition
Stimulate beta receptors and increase cyclic AMP |
|
|
Term
|
Definition
prevent breakdown of cyclic AMP, aminophylline, also improve diaphragm contractility |
|
|
Term
|
Definition
Stabilizes mast cells, inhibits degranulization and histmaine release |
|
|
Term
Atropine/ipratropium (parasympatholytics) |
|
Definition
block formation of cyclic GMP |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
high risk residual volume ___- |
|
Definition
|
|
Term
|
Definition
|
|
Term
arrythmias occur during one lung ventilation due to |
|
Definition
hypoxemia, hypercarbia, cardiac manipulation (SVT) |
|
|
Term
What lead detects the p wave and is good for arrhythmia detection |
|
Definition
|
|
Term
What lead detects anterlateral wall ischemia |
|
Definition
|
|
Term
What should you consider adding to assist with ventilation of the lower lung in an anesthetized, lateral, paralyzed, chest closed patient? |
|
Definition
|
|
Term
Drugs that do not effect hypoxic pulmonary vasoconstriction |
|
Definition
-fentanyl, propofol, pentothal, ketamine |
|
|
Term
|
Definition
Left side DLT with carinal hook |
|
|
Term
|
Definition
Right side DLT (carlens tube) with carinal hook |
|
|
Term
|
Definition
Right side tube with no hook, slotted cuff |
|
|
Term
|
Definition
|
|
Term
|
Definition
41 (6.5 mm), 39 (6.0), 37 (5.5), 35 (5.0), 28 (4.5). |
|
|
Term
Size ETT needed to accomodate an Arndt Endobronchial blocker |
|
Definition
|
|
Term
|
Definition
|
|
Term
Cricoid cartilage is at what vertebral level? |
|
Definition
|
|
Term
Trachea bifurcates at what vertebral level? |
|
Definition
|
|
Term
|
Definition
|
|
Term
Tracheal cuff color and amount of air that can be inserted |
|
Definition
|
|
Term
Bronchial cuff color and amount of air that can be inserted |
|
Definition
|
|
Term
The right upper lobe is how far from the carina? |
|
Definition
|
|
Term
thoracic epidural catheters need to be placed at what level for postop analgesia for thoracic surgery? |
|
Definition
|
|