RUSVM Anesthesia 2016 for exam 1 – Flashcards
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What does general anesthesia include?
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Muscle relaxation Narcosis Analgesia
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Define anesthesia
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loss of sensation to the entire part of the body
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define analgesia
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loss of sensitivity to pain
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define nociception
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the neural process of encoding noxious stimuli -doesn't require consciousness
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define tranquilization
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a state of behavioral change, wherein anxiety is relieved ; the pt is relaxed, although aware of its surroundings
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define sedation
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a state characterized by CNS depression accompanied by drowsiness -Pt likely unaware of its surroundings
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what are the 3 types of sedation?
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mild, moderate, profound
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what level sedation does this represent?
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mild
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what level sedation does this represent?
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moderate
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what level sedation does this represent?
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profound
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define local anesthesia
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loss of sensation in a circumscribed body area
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define regional anesthesia
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loss of sensation in a larger, though limited, body area
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define narcosis
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drug induced state of deep sleep from which a pt can't be easily aroused may or may not be accompanied by antinociception
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define General anesthesia
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drug induced UNCONSCIOUSNESS characterized by controlled, reversible depression of the CNS & perception in this state pt is NOT arousable by noxious stimulation Sensory, motor, & autonommic reflex functions are attenduated to varying degrees
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how is dissociative anesthesia induced? what is it characterized by? what are 2 drugs produce dissociative anesthesia?
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induced by drugs that dissociate the thalabocortical & limbic systems characterized by a CATATONIC state where eyes remain open & swallowing reflexes remain functional skeletal muscle rigidity is common unless a muscle relaxing drug is given in conjucntion produced by "dissociative anesthestics" e.g: ketamine & tiletamine (Telazol)
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what is this picture represent?
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catatonic kitty
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define surgical anesthesia
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the stage/plane of general anesthesia that provides unconsciousness, muscle relaxation & analgesia sufficient for painless surgery
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what is balanced anesthesia
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is induced by a multiple rug approach drugs are targeted to attenuate individual components of the anesthetic state: unconsciousness, analgesia, muscle relaxation
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what are 3 routes of admin of anesthetics
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inhalation -anesthetic gases or vapors are inhaled in combination with oxygen injectable -anesthetic solutions are injected intravenously, intramuscularly or subcutaneously oral, transmucosal or intranasal -routes infrequently used with liquids or gels in anesthesia
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what is flow from O? cylinder to pt?
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Cylinder?press. reduct. valve?flowmeter?vaporizer?pt. breathing circuit
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what is starting volume of O? in E cylinder
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660 L
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what is starting volume of O? in H cylinder
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6600 L
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what is starting pressure of gas in medical cylinders
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2200 psi
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what is the formula to calculate for remaining volume of 0? in cylinder?
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660 L/2200 psi = X L/psi remaining in cylinder solve for X
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what is formula to calculate minutes remaining of O? in cylinder?
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X L/ L/min flow
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what is minimum O?% acceptable for people & SA
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30-35% O? (FiO? = 0.30-0.35) minimum
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what is the metabolic requirement for oxygen What does this # represent?
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5-10 mL/kg/min the minimum O? flow!
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what are the possible adverse pt. effects caused by routine use or mishaps
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hypoxia - d/t inadequate O? delivery pneumothorax - d/t ? pressure in lungs (quick flush valve)
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Advantages of rebreathing system
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? fresh gas flow rate req. -pt breathes warm, humidified gases -saves $ -? environ. pollution
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disadvantages of rebreathing system
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? resistance to breathing ?d/t valves ? in anes. gas conc. occur slowly d/t ? fresh gas flow more components? ? potential for leaks
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types of rebreathing systems
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circle universal F -coaxial setup
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types of non-rebreathing systems
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Bain (modified Mapleson D) Mapleson F
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advantages of non-rebreathing system
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light minimal dead space minimal resist. to ventilation ? in anes. gas conc. occur rapidly d/t ? fresh gas flow fewer components? ? potential for leaks
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when to use non-rebreathing system
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small pt < 3kg
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disadvantages of non-rebreathing system
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requires ? gas flow rate pt breathes cold/dry gas ? $ ? environ pollution
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types of common ET tubes
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Murphy-most common type cuffed or uncuffed Cole- common for avian pt uncuffed w/ shoulder Wire reinforced (armored)
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What has largest effect on resistance to gas flow in ET tube
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Radius Poiseuille's Law
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types of scavenging systems for waste gases
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Passive -exhaust directly to atmosphere -F-air canister --absorbs halogenated agents --not N?O Active -piped vacuum
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what type of absorbent is used with rebreathing system
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Soda lime = calcium hydroxide/ sm amt sodium hydroxide ethyl violet color indicator when exhausted
