The House Don't Fall If The Bones Are Good
How many mmHg above the SBP should a tourniquet be inflated for a total knee arthroplasty
100 mmHG
Name 1 thing A-delta fibers sense?
Pain, Cold, Pressure
A pneumoperitoneum during abdoming insufflation causes an ________ in SVR and a _________ in CO
increase, decrease
PLT's adehere to collage via which 2 receptors
GP 1a/2a and GP 6
A patient has eaten half a bowl of cheerios with skim milk before realizing he has surgery today, how long will his new fasting time need to be from the moment of his last bite? (In hours)
6 hours
Name 2 perioperative events that may trigger delirium in older patients undergoing orthopedic surgery
Hypoxemia, hypotension, hypervolemia, abnormal electrolytes, infection, sleep deprivation, pain, benzos/anticholinergics
Name 1 place deep somatic pain is felt
muscles, tendons, joints, bones
What is the most common peripheral nerve damaged in the lithotomy position
Common Peroneal
All mediatorys (pro or anti inflammatory) are released from the intima and effect the _________
Adventitia
Which NORA site has the highest rate of complications and mortality? (name 1 of 2)
Cardiology and radiology suites
Which 2 Cardiac risk score scale take into account ASA classification and functional status
Gupta Score and Geriatric Sensitive Cardiac Risk Index (GSCRI)
What is one effect of pain on the endocrine system
sodium & water retention, hyperglycemia
What type of heat loss happens when an abdomen is insufflated with CO2
Convection
What are the 2 clotting factors not produced in the liver?
3 and 4
What is the federal guideline for max annual dose of radiation in Sv?
50 mSv
What are 2 anesthetic considerations associated with rheumatoid arthritis
Limited TMJ movement, narrow glottic opening, A/O instability, pericarditis, cardiac tamponade, Sjogren's syndrome, diffuse interstitial fibrosis, susceptibility to skin tears and bruising
What part of the brain or spinal cord activates and transmits endogenous opioid signals
Rostral Ventral Medulla
Name 2 cardiac consequences of hypercarbia related to CO2 insufflation
myocardial depression, dysrthythims, peripheral vasodilation, myocardial sensitization, pulmonary HTN --> RV failure
Calcium is needed in which 4 stages of the clotting cascade
IX to IXa
X to Xa
II to IIa
Formation of Fibrin
Explain what happens when you quench an MRI magnet (aka why is there no more magnetic field)
The quench heats up the MRI which turns the helium from liquid into gas --> this disables the magnetic field
Name 1 major FES feature and 4 minor to diagnose a fatty embolism
Major: Respiratory insufficiency, petechial rash, hypoxemia, drowsy, confusion, obtunded
Minor: Pyrexia, tachycardia, retinal changes, jaundice, renal changes
Enkephalines bind to ________ opioid receptors
Dynorphins bind to ________ Kappa opioid receptors
Endorphines bind to _______ Mu opioid receptors
Delta, Kappa, Mu
What EKG waveform change is seen with a venous air embolism
QRS widening
What are the 2 main proteins that ensure PLT's stay inactivated when there is no injury
Protein kinase A and G
Steroid (Prednisone or dexamethasone), Famotidine, Benadryl