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surgical research
anesthetist
| Question | Answer |
|---|---|
| dexter | right side |
| alb | white |
| levo | left side |
| year Paracelsus makes ether | 1540 |
| 1800 Sir David discovers | nitrous oxide |
| 1831 Liebig discovers | chloroform |
| 1842 ether first used for | human anesthesia |
| 1847 chloroform first used for | human anesthesia by Dr. Simpson |
| 1975 | American College of Vet Anesthesiologists formed |
| loss of sensation to the entire or part of the body | anesthesia |
| loss of sensation in a defined body area | local anesthesia |
| loss of sensation to a larger though limited body area than with local anesthesia | regional anesthesia |
| Drug induced unconsciousness that is characterized by controlled reversible depression of the CNS and analgesia | General anesthesia |
| induced by a multiple drug approach in which drugs are targeted to specifically attenuate individual components of the anesthetic state (consciousness, analgesia, muscle relaxation and autonomic reflexes. | Balanced anesthesia |
| Induced by drugs that dissociate the thalamocortic and limbic systems and which is characterized by a cataleptoid state in which the eyes remain open and swallowing reflexes remain functional | Dissociative anesthesia |
| Unless a sedative or muscle relaxant has been given | skeletal muscle hypertonus persists |
| The plane/stage of general anesthesia that provides unconsciousness, muscular relaxation, and analgesia sufficient for painless surgery | Surgical anesthesia |
| A state of behavioral change wherein anxiety is relieved and the patient is relaxed although aware of his surroundings | Tranquilization |
| State characterized by central depression accompanied with drowsiness where the patient is unaware of its surroundings | Sedation |
| Drug induced state of deep sleep from which the patient cannot be easily aroused | Narcosis |
| condition of artificially induced sleep, or a trance resembling sleep resulting from moderate depression of the CNS from which the patient is readily aroused | Hypnosis |
| Type of anesthesia where anesthetic gasses or vapors are inhaled in combination with oxygen | inhalation |
| type of anesthesia where anesthetic agents are administered IV, IM, SC, IP and IT | injectable |
| Type of anesthesia where anesthetic agents are administered into the openings of the GI tract | Oral and/or Rectal |
| Type of anesthesia where anesthetic agents are topically or locally injected into or around a surgical site or a large nerve trunk supplying a specific region | Local and Conduction |
| Passing an electric current through the cerebrum to induce deep narcosis is called | electronarcosis |
| When local analgesia is induced with low intensity high frequency electric stimulation of the skin via surface electrodes it is called | Transcutaneous Electric Nerve Stimulation or TENS |
| an ancient chinese system of analgesia using fine needles at predetermined locations is called | acupuncture |
| When the local or general body temperature is lowered to supplement anesthesia and decrease analgesic drug administration in neonate and cardiovascular procedures it is called | Hypothermia |
| true or false: anesthesia is a reversible process | True |
| True or false: anesthetic dosed are based on the "average" animal although there is no true "average" animal | True |
| true or false: The anesthetist does not need to modify the regimen based on experience and the individual animals' responses. | False |
| true or false: response to anesthetic agents relies on metabolism, uptake and distribution of the anesthetic, and pre-existing disease or pathology | true |
| true or false: General anesthesia results from interaction of the drug and the CNS | true |
| what type of anesthesia: Enters the blood stream for transport to target tissues, requires redistribution, detoxified in the liver and is excreted by the kidneys and gives less control of the elimination process | injectable |
| what type of anesthesia enters the blood stream from the lungs, is eliminated via the lungs, gives more control over the process | inhalation |
| What is Minimum Alveolar Concentration?(MAC) | the amount of inhaled anesthetic required to keep 50% of dogs from gross movement in reaction to a painful stimulus |
| true or false: small animals have a higher basal metabolism rate (BMR) per unit of surface area than larger animals | true |
| true or false: small animals require smaller doses of anesthetic and analgesic agents per kg of body weight | false |
| yes or no: Does BMR rate increase with activity? | Yes |
| does disease or pathology lower metabolic rate? | yes |
| do adult and geriatric animals have higher BMR's than adolescent and young adults? | no |
| newborns have lower BMR's than adolescent and young adults | true |
| Is the BMR of the male or female ~7% higher? | male |
| do fatter animals have slower BMR's and require less anesthetic? | yes |
| anesthetic agent absorption in adipose tissue may result in less anesthetic agent freely available in the bloodstream | true |
| adipose tissue may require more anesthetic early on due to absorption into fat but may result in longer recovery times due to prolonged discharge of anesthetic agents back into the bloodstream from fat | true |
| ataxic means | loss of coordination |
| tachypnea means | rapid breathing |
| hyperventilation is | faster deeper breathing |
| uncontrolled tightening of vocal cords is | laryngeal spasm |
| voluntary movement, tachycardia, irregular respiration, pupils dilate, some analgesic effects present in what stage of anesthesia? | stage one |
| delirium, cns depressed, loss of voluntary control, relexes exaggerated, struggling, cardiac arrythmias, palpebral reflex present, vocalization, salivation, perhaps a laryngeal spasm is in what stage of anesthesia? | stage two |
| surgical anesthesia, pulse rate returns to normal, muscles relax, swallowing and vomiting reflex lost, | stage three |
| lowered heart rate, cyanosis, dilated pupil unresponsive to light, flaccid muscle tone jaw tone and sphincter control lost | overdose |
| begin to die, slow respirations, all reflexes and tone lost, heart begins to stop etc | stage four |
| what is the carrier for all anesthetic agents to the CNS not administered directly into the CSF? | blood plasma |
| partial pressure gradients | molecules are always in motion moving in random directions |
| both sides have an equal number of molecules with both sides having some moving to the other in equal amounts is called | equilibrium |
| true or false: IV anesthesia allows quick onset of anesthesia | true |
| what is hypocarbia? | low co2 levels in blood |
| what is hypercarbia? | hight co2 levels in blood |
| the four most important systems to be considered before anesthesia are: | nervous, cardiopulmonary, hepatic and renal |
| fasting is generally done for how many hours? | 12 |
| fasting is not advised for : | small mammals, birds, neonates rabbits |
| hypoglycemic | low blood sugar |
| why is fasting not recommended in ruminants and horses? | due to possible rumen shutdown |
| what should be withheld from horses to reduce the chance of rupture and distension? and for how long? | water for 12-24 hours |
| surgical procedures and procedures may lead to what problem with fluids? | dehydration |
| what is necessary for cell metabolism, intra and extra cellular transport and life itself? | Fluid in body |
| what four ways can fluids be administered? | IV, SQ, IO (intraosseous) and orally |
| should iv fluids be warmed? why? | yes, to 37c to prevent hypothermia. |
| what is IO administration used for? | severely dehydrated or traumatized patients with poor or inaccessible veins/arteries that need rapid fluid absorption into the blood. |
| what is the common maintenance rate for LRS/Isotonic saline ? | 10 to 20 mL/kg/hr |
| procedures that involve opening a major body cavity due to dehydration while the organs are exposed should receive how much fluid? | 20 to 30 mL/kg/hr |
| which solution is isotonic so that it does not induce fluid shifts? | Lactated Ringers Solution |
| what is the word for rapid sodium replenishment | hyponatremia |
| what is essential for successful anesthesia? | an open airway |
| what happens when the airway is blocked? | death |
| what if the airway is partly occluded? | a decrease in available oxygen to the lungs |
| what is the easiest method to maintain a patent airway? | animal positioning |
| Laryngoscopes have two main styles of blade.They are: Miller, and Bizarri-Guiffrida. Which is straight and which is curved? | Miller is straightBizzari-Guiffrida is curved. |
| atelectasis means | lack of gas exchange in the alveoli |
| true or false: Most anesthetic agents depress the thermoregulatory centers and metabolism which leads to accelerated heat loss. | True |
| True or false: Most preanesthetic agents cause CV depression. | True |
| Most preanesthetic and anesthetic agents do or do not cause pulmonary depression. | do |
| Care should be taken in using Nitrous Oxide due to it's effect on the | pneumothorax |
| Pneumothorax means | collapsed lung |
| ICP stands for | intracranial pressure |
| CBF stands for | cerebral blood flow |
| renal disease affects the | kidneys |
| hepatic disease afftects the | liver |
| obtund | dull or deaden or make less intense |
| atropine sulfate should not be used in | ruminants (because of bloat) and rodents (because of their rapid HR) |
| atropine sulfate and glycopyrrolate are | anticholinergics |
| anticholinergics | reduce secretions and helps bradycardia |
| relieve anxiety, reduce vomiting, smoother anesthesia recovery is due to use of | tranquilizers |
| acepromazine maleate is a | tranquilizer |
| droperidol is a | tranquilizer primarily used with fentanyl (InnovarVet) |
| Diazapam (Valium) is a | tranquilizer (should not be mixed with other agents, painful IM, not for injection in artery (venous thrombosis) |
| Midazolam is | tranquilizer,can be given IM, can be mixed with other agents, may cause behavioral changes in dogs and cats, |
| Flumazenil | reverses valium and midazolam |
| Opioids | depress CNS, addictive, DEA controlled |
| Morphine sulfate | opioid |
| Meperidine hydrochloride | opioid(Demerol, Pethidine) used 30 minutes before anesthesia. one tenth the effect of morphine, does not cause vomiting. |
| Methadone hydrochloride | synthetic opioid unrelated to morphine, lasts 2 to 6 hours, stimulates respiration rate (Methadone, Dolophine) |
| oxymorphone hydrochloride | (Numorphan) semisynthetic opioid ten times more potent than morphine effective epidural analgesia |
| Fentanyl citrate | opioid, 250 more potent than morphine, rapid onset, short duration, depresses respiration, exaggerates response to loud noises |
| Carfentanil citrate | opioid, 10,000 times more potent than Morphine, used for capture of wild animals, can be administered by applying to buccal or nasal mucosa. |
| Sufentanil | 5 to 10 times as potent as Fentanyl |
| Alfentanyl | 1/5th to 1/10th as potent as fentanyl, 80 to 100 times more potent than morphine, used to capture wild animals primarily |
| Butorphanol tartrate (Torbugesic) | synthetic opioid, 3 to 5 times as potent as morphine, less resp depression than morphine, excellent analgesic when combined with xylazine or detomidine for cattle/horses |
| buprenorphine (Buprenex) | 25 to 30 times as potent as morphine, slow onset, IM lasts 6 to 8 hours |
| Pentazocine lactate (Talwin) | one third as effective as morphine |
| Alpha 2 Andrenergic Agonist | non-addictive, anticonvulsant, produce sedation, muscle relaxation and analgesia. |
| example of alpha 2 andrenergic agonist is | guaifenesin (glyceryl guaiacolate) |
| Neuromuscular (Blocking) paralytic agents | interfere with transmission of signal from motor neuron to muscle |
| Depolarizing Neuromuscular Paralytic Agents | keeps the motor neuron from repolarizing and firing again |
| succinylcholine | must be refrigerated, rapid onset, excellent relaxation, twitch for 30 minutes |
| fasciculation means | twitching |
| nondepolarizing blocks may not be | reversible |
| xylazine hydrochloride (Rompun) | sedative, analgesic, not for swine, causes emesis in dogs and cats, wide margin of safety |
| mydriasis | dilation of pupils |
| Detomidine | developed for horses and cattle, may be used as a pre-anesthetic or combined with ketamine for anesthesia |
| Medetomidine | more potent and longer lasting than other alpha 2 adrenergic agonists |
| alpha 2 andrenergic antagonists used for | reversal agent for injectable anesthetics |
| Yohimbine | reverses xylazine, ketamine |
| tolazoline | reverses xylazine |
| atipamezole | selectivity ratio 200 to 300 times higher than yohimbine; rapid IV dose may cause death |
| paralytic (Muscle relaxants) | provide superior muscle relaxation as an adjunct to general anesthesia, allows easier intubation, less muscle tension |
| muscle relaxants do not provide | analgesia or unconsciousness |
| steroid analogs | pancuronium,vecuronium,pepecuronium,rocuronium |
| benzylisoquinoliniums | curare, tubocurarine, motocurine, gallamine, atracurium, doxacurium and mivacurium |
| reversal agents are most effective when | spontaneous recovery of muscle strength has begun |
| injectable anesthesia generally requires | a combination of drugs to affect all necessary bodily systems adequately |
| inhalant anesthesia | increase or decrease all components of anesthesia at the same time |
| what type of barbituates are used for clinical anesthesia? | short or ultra short duration |
| Used for fish and amphibians anesthesia | Tricaine Methanesulfonate (MS222) |
| name two dissociative anesthetics | Ketamine, Telazol |
| physical methods of anesthesia include: | hypothermia, electronarcosis,acupuncture |
| examples of local and regional anesthesia to be used on topical mucous membranes are | lidocaine, benzocaine, tetracaine butacaine |
| injected into muscles that will be cut, separated or subject to extensive manipulation during surgery | general muscle block |
| the most common type of anesthesia machine is | VOC (Vaporizer out of circuit) |
| system that does not allow precise control of the agent concentration is the | VIC (Vaporizer in Circuit)(no longer produced in the USA |
| movement of gas in and out of the alveoli in the lungs | ventilation |
| the total process whereby oxygen is supplied to and utilized by body cells and co2 is eliminated by means of concentration gradients | respiration |
| ordinary quiet breathing | eupnea |
| dyspnea | labored breathing |
| tachypnea | increased breathing rate |
| hyperpnea | fast and deep breathing |
| polypnea | rapid and shallow panting breathing |
| hypopnea | slow and shallow breathing |
| apnea | transient or longer cessation of breathing |
| cheyne-stokes respirations | initial increase in rate and depth, followed by slowing followed by brief periods of apnea. |
| Biot's respirations | sequence of gasping, apnea, and several deep gasps |
| kussmaul's respirations | regular deep respirations without pause |
| apneustic respirations | long, gasping respirations with several ineffective exhalations |
| Tidal volume (VT) | volume of air inspired or expired in a single breath |
| inspiratory reserve volume (IRV) | volume of air that can be inspired over and above the normal tidal volume |
| Expiratory reserve volume (ERV) | amount of air that can be expired by forceful expiration after a normal expiration |
| residual volume (RV) | air remaining in the lungs after the most forceful expiration |
| Minute respiratory volume or minute ventilation | tidal volume times respiratory frequency |
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