Exam 1 Review Questions PDF

1. Which prep solution results in fewer incidences of nerve injuries because it creates a durable bacterial barrier? CHG 2. What is the gold standard treatment for a postdural puncture headache? Epidural blood patch 3. Which local anesthetic is associated with TENS and CES when injected...

1. Which prep solution results in fewer incidences of nerve injuries because it creates a durable bacterial barrier? CHG 2. What is the gold standard treatment for a postdural puncture headache? Epidural blood patch 3. Which local anesthetic is associated with TENS and CES when injected intrathecally via a microcatheter? Lidocaine 4. What are two qualities of needles that cause a PDPH? Cutting needle and larger size needle e.g. Quincke-Babcock needles 5. What nerves innervate the diaphragm and comprise of the phrenic nerve? C3-C5 6. What respiratory muscles are impaired from a high thoracic epidural? Internal intercostals, external intercostals, abdominal muscles 7. What are the first signs that neuraxial anesthesia is positioned appropriately? Hypotension due to sympathectomy 8. What are the 3 meningeal layers from superficial to deep? Dura, arachnoid, pia 9. What meningeal layer adheres to the spinal cord? Pia 10. What meningeal layer limits movement of drugs in and out of the CSF? Arachnoid 11. Why does autonomic blockade occur in neuraxial anesthesia? Due to blocked transmission of B fibers 12. What causes nausea and vomiting after neuraxial anesthesia? Hypotension, opioid stimulation of CTZ, unopposed activity of parasympathetic nervous system, anxiety 13. What are two factors that increase the spread of epidural anesthesia? Pregnancy due to engorged veins and old age due to decreased compliance 14. What medication can cause delayed respiratory depression when administered neuraxially? Morphine and other hydrophilic opioids 15. What factors determine the spread of local anesthetics in spinal anesthesia? Patient position and baricity 16. What is a characteristic of a patient that contraindicates neuraxial techniques? Taking long-acting antithrombic or antiplatelets e.g. Plavix 17. What are absolute contraindications to neuraxial anesthesia? Patient refusal, infection at the site of injection, increased ICP 18. What are relative contraindications to neuraxial anesthesia? Spine surgery 19. What is the first line medication to administer when a patient codes after administration of a local anesthetic? Epi 20. What type of local anesthetics are more ionized in acidic environments? Basic drugs 21. What types of channels do local anesthetics affect? Na, K, Ca, and GPCR 22. How do nerve bundles appear in the periphery on ultrasound? hyperechoic due to increased connective tissue 23. What are risk factors for nerve injuries associated with regional anesthesia? Diabetes, hypertension, obesity, cigarette smokers, male gender 24. What innervates the lateral rectus muscle? Abducens/cranial nerve 6 25. What innervates the superior oblique muscle? Trochlear/cranial nerve 4 26. What are the efferent and afferent branches of the oculocardiac reflex? Efferent = vagus, afferent = ophthalmic division of the trigeminal nerve 27. What type of eye protection are used for argon lasers? Orange 28. What type of eye protection are used for Nd:Yag lasers? Green 29. What type of eye protection are used for CO2 lasers? Clear 30. What types of masks should be used whenever lasers are used in the OR? N-95 31. What are the standard OR fire precautions? Let prep dry for at least 3 mins 32. What are the high risk OR fire precautions? Use high flow low FiO2, stop supplemental O2 at least 1 min before and while using electrocautery with an open oxygen system, use wet sponges, have sterile water or saline available 33. When should a tonsillectomy or BMT be postponed? When the patient has active chest symptoms e.g. fever and rhonchi 34. When should you preoxygenate with FiO2 less than 30% during a tracheostomy procedure? If surgeon is using electrocautery to enter the trachea 35. When should you remove the ETT during a tracheostomy procedure? After the surgeon connects the tracheostomy to the anesthesia circuit 36. When should the ETT cuff be deflated during a tracheostomy? Prior to tracheal transection 37. When would you extubate deep? When you want to avoid bucking but has risk of aspiration