Anesthesia exam 3

When intermittent mandatory manual ventilation is applied to a patient that is connected to a circle system with a precision vaporizer, it is customary to: - increase the vaporizer setting - decrease the vaporizer setting - disconnect the patient from the circle system before starting manual ventilation - the lungs of patients that are connected to a circle system should not be manually ventilated

decrease the vaporizer setting

When an animal is given a ___ neuromuscular blocking drug, an initial surge of muscle activity may be seen before there is paralysis of the muscles - depolarizing - nondepolarizing

depolarizing

The maximum subcutaneous dose of lidocaine for a dog is ___mg/kg: - 1 - 4 - 10 - 15

10

the normal VT in an awake animal is ___mL/kg

10 to 15

In healthy awake animal, exhalation lasts at least__ times as long as inhaltaion

2

Patients that have undergone major surgery should have their pain assessed how frequently? - every 60 seconds - every 2 minutes - every 60 minutes - at shift changes

60 minutes

The effects that could result from an epidural anesthetic if the drug reached the thoracic and cervical spinal cord include: (can be multiple answers) A. sympathetic blockade B. paralysis of intercostal muscles C. paralysis of the diaphragm D. hypertension

A, B, C

Clinical signs of systemic toxicity from a local anesthetic agent may include: (can be multiple answers) A. sedation B. convulsions C. multiple twitching D. respiratory depression

A, B, C, D

Factors that may interfere with the action of local anesthetic agents include: (can be multiple answers) A. fat B. scar tissue C. rapid heart rate D. hemorrhage

A, B, D

nonpharmacologic analgesic therapies that can be used to manage both acute and chronic pain include: - massage therapy - topical anesthetics - NSAIDs - NMDA agonists

massage therapy

Int he spinal cord, pain impulses can be altered by neurons that either suppress or amplify nerve impulses. This process is known as: A. perception B. modulation C. transduction D. transmission

modulation

Local anesthetic agents such as lidocaine or proparacaine work well when applied (can be multiple answers) A. topically on the epidermis B. Topically on mucous membranes C. topically on the cornea D. through injection

B, C, D

The anesthetist's delivery of all of the air and/or anesthetic gasses required by the patient is termed: - assisted ventilation - controlled ventilation - positive pressure ventilation - bagging

controlled ventilation

A 14-month-old Boston Terrier dog is brought for evaluation. One eye has discharge, conjunctivitis, and a prolapsed gland of the third eyelid . Which of the following is the most appropriate treatment? - morgan pocket technique - Holtz-celsus procedure - Entropion repair - eyelid tacking

morgan pocket technique

Which one of the following analgesic plans targets three different pain receptor mechanisms? A. Morphine IM, Fetanyl CRI, Lidocaine nerve block B. Morphine IM, fentanyl CRI, Bupivacine nerve block C. Morphine IM, Ketamine CRI, lidocaine nerve block D. ketamine CRI, lidocaine and bupivacine nerve block

morphine IM, ketamine CRI, lidocaine nerve block

The concept of utilization of pain management therapies to target two or more receptors is: - primary hyperalgesia - mediators - secondary hyperalgesia -multimodal therapy

multimodal therapy

Nondepolazing neuromusclar blocking agents may be reversed by

neostigmine or edrophonium (anticholinesterase)

Do reversal agents have effect on depolarizing neuromuscular blocking agents?

no

Gallamine, pancuronium, atracurium besylate, and cisatracurium are examples are

nondepolarzing agents

Which of the following drug combinations is an example of multimodal analgesic therapy? A. Dexmedetomidine, sevoflurane B. Acepromazine, ketamine, isoflurane C. Acepromazine, morphine, isoflurane D. Dexmedetomidine, morphine, ketamine

Dexmedetomidine, morphine, ketamine

pain that occurs at the site of tissue injury due to the release of chemical mediators such as prostaglandin and histamine. This is:

Inflammatory pain

Same as manual ventilation, but bagging is throughout the anesthetic period. This is achieved by gently squeezing the reservoir bag at a rate of 6 to 12 breaths/min and a pressure of 15 to 20 cm H2O for small animal patients.Inspiration time should be 1 to 1.5 seconds, and expiration time should be at least 2 to 3 seconds. What type of ventilation is this?

Intermittent mandatory ventilation

provide significant analgesia when injected into the joint at the conclusion of arthroscopy and surgery. what type of block is this?

Intraarticular

used to provide short-term (less than 1 hour) local anesthesia to an extremity. Most common for surgery of the lower extremity, including amputation of a digit. What type of block is this?

Intravenous Regional anesthesia (Bier block)

The following are clinical situations for a type of block Used extensively in food animal and equine surgery, particularly in cattle. Teat and wound repair. L-block used for laparotomy in ruminants. This type of block can be placed in the subcutaneous or subcuticular tissues immediately proximal to the target area. What type of block is this?

Line block

The following are a list of clinical situations: dental blocks in dogs and cats (infraorbital, mental, and mandibular nerve blocks). A. Infraorbital: desensitizes the upper lip, the nose, the roof of the nasal cavity, and the skin overlying these structures, up to the level of the infraorbital foramen. B. Mental (alveolar mandibular): analgesia of the lower lip alone. C. Mandibular: anesthetize the teeth, skin, and mucosa of the lower jaw and lip. Intercostal nerve blocks in animals undergoing chest surgery. Infiltration of nerves during amputation of a limb. To provide analgesia for declawing cats. What type of block would be used for these clinical situations?

Nerve blocks

Patients that require mechanical ventilation (thoracic or diaphragmatic surgery). Prevents spontaneous inspiratory efforts by the patient and allows more rapid and complete control of ventilation. Orthopedic surgery. Provide excellent muscle relaxation. Ophthalmic surgery. Prevent movement of the eyeball and cause it to remain in a central rather than ventral position, which facilitates intraocular surgery. Cesarean section. These do not cross the placenta to the fetus and provide abdominal muscle relaxation, allowing easier access to the uterus. Facilitating difficult intubation. Can be used in "balanced anesthesia". These are all indications for what type of block?

Neuromuscular blocking agents

detection by the nervous system of the potential for or actual tissue injury is

Nociception

The use of NSAIDs that results in renal toxicity is most likely due to the blockage of: -PGE2 - COX-1 - COX-2 - misoprostol

PGE2

Periodic "sighs" are:

Periodic bagging (one to two breathes every 2 to 10 mins) is adequate to expand the lungs and reduce atelectasis. (still doing manual ventilation)

The protective sensation of pain that normally occurs when there is a possibility of or actual tissue injury. This is adaptive because it promotes survival by preventing and by promoting healing of the injured body part. This is:

Physiologic pain

When performing an epidural, one must be aware that the spinal cord in a cat may extend as far caudally as: - T13 - L6 - L7 - S1 - the coccygeal vertebrae

S1

to reduce the dose of general anesthetic or analgesic required for painful operations and to prevent cardiac arrhythmias. What type of block is this?

Systemic (IV)

Cauda equina is:

a group of nerves located at the caudal termination of the spinal cord in the spinal canal

Local anesthesia is:

a loss of sensation in a small area of the body produced by administration of a local anesthetic agent in proximity to the area of interest

Motor neuron is

a neuron that conveys impulses from the brain to muscle fibers and is responsible for initiating and controlling voluntary movements.

Sensory neuron is

a neuron that conveys sensation (i.e. pain, heat, cold, and pressure) from the skin, muscles, and other peripheral tissues to the brain.

Controlled ventilation is:

a type of ventilation in which the anesthetist controls the respiratory rate, the tidal volume, and the peak inspiratory pressure. In this type of ventilation, the patient does not make spontaneous respiratory efforts.

problems that may result from excessive controlled ventilation may include (Can be multiple answers) A. a decreased cardiac output B. muscle twitching C. a state of respiratory alkalosis D. ruptured alevoli

a, c, d

One neonate that was just delivered has not started to breathe on her own even after being towel dried and briskly rubbed by the technician for 30 seconds. Which of the following is the most appropriate next step the technician should take? - administer positive-pressure ventilation by mask - administer epinephrine under the tongue - begin chest compression immediately - ligate and transect the umbilical cord

administer positive-pressure ventilation by mask

A 6-year-old Irish Setter dog is brought to the emergency clinic after being struck by a vehicle. Radiographs show a fractured left tibia. Which of the following is the most appropriate first step in treatment? - external coaptation - fiberglass cast fixation - administration of analgesics - application of Robert jones bandage

administration of analgesics

After gastric surgery on a dog before closure of the abdomen, which of the following is most appropriate for the scrub team to do? - do a sponge count - do an instrument count - change gloves and instrument packs - all of the above

all of the above

In the anesthestized animal that is breathing room air, the anesthetist may expect to see: - an increase in the Paco2 and a decrease in the Pao2 - A decrease in the Paco2 and an increase in the Pao2 - a decrease in the Paco2 and a decrease in the Pao2 - an increase in the Paco2 and an increase in the Pao2

an increase in the Paco2 and a decrease in the Pao2

Where are local anesthetics deposited in the epiurdal space?

between the dura mater and the vertebrae

Where are epidurals placed in dogs

between the last lumbar vertebra (L7) and teh sacrum

An ovariohysterectomy, which involves surgically incising the skin and the abdominal wall and the excising the uterus and ovaries, has the followoing components of pain: A. Somatic pain only B. Visceral pain only C. Both somatic and visceral pain D. Neither somatic nor visceral pain

both somatic and visceral pain

Opioid agonist drugs act in which of the following ways? - peripherally: in the spinal cord and joints - centrally: to inhibit perception in the brain and sensitization in the spinal cord - centrally: to increase perception in the brain and spinal cord - peripherally: in the brain and spinal cord on the opioid receptors

centrally: to inhibit perception in the brain and sensitization in the spinal cord

Perception of pain takes place in the: - spinal cord - cerebral cortex - sensory nerves - nociceptors

cerebral cortex

The term atelectasis refers to: - excess fluid in the respiratory system - the absence of breathing - collapse of the alveoli - bronchial constriction

collapse of the alveoli

Which of the following is a true statement regarding complications form an epidural? - the animal should be tilted slightly downward to ensure that the anesthetic reaches as far cranially as possible. - diffusion of the anesthetic into the cervical and thoracic spinal cord can result in bradycardia, decreased cardiac output, and hypotension. - epidurals rarely cause trauma, so placing them in an awake patient is acceptable. - it is recommended to use agents with preservatives in epidurals

diffusion of the anesthetic into the cervical and thoracic spinal cord can result in bradycardia, decreased cardiac output, and hypotension.

When is direction injection into a nerve okay

during amputation

tail amputation, anal sac removal, perianal surgery, urethrostomies, obstetric manipulations, cesarean sections, and some hind limb operations. These type of procedures need what type of block?

epidural

In healthy awake animal, the main stimulus to breathe is the result of:

excess carbon dioxide concentration in the blood

A dog is brought to the emergency clinic after being struck by a motorcycle. The surgeon is set to perform abdominal surgery on this dog. Which of the following should NOT be done before surgery? - clip the abdomen from xiphoid process to pubis - place the dog in dorsal recumbency - perform abdominal radiographs - express the dog's bladder

express the dog's bladder

T/F A gastropexy is a procedure used to prevent GDV's

false

T/F a neuromuscular blocking agent will not only paralyze skeletal muscle, but also provide some analgesia

false

T/F both depolarizing and nondepolarizing drugs can be reversed

false

T/F treating pain dose not improve wound healing

false

Manual ventilation is:

forced delivery of oxygen and anesthetic gases by squeezing of the reservoir bag of the anesthetic machine. May be used to provide periodic or intermittent mandatory ventilation.

Anesthetic depth can be difficult to monitor in animals given a neuromuscular blocking agent. What is the most reliable indication of anesthetic depth in these patients? - jaw tone - palpebral reflex - anal tone - heart rate

heart rate

Which of the following can be used to monitor anesthetic depth in a patient that has been given a neuromuscular blocking agent? - heart rate - jaw tone - palpebral reflex - pedal reflex

heart rate

Caution should be taken with rapid IV injection of morphine in canine patients due to the potential for: - histamine release - locomotor activity - dysphoria - restlessness

histamine release

This type of block is used to provide analgesia for surgery involving superficial tissues, including skin biopsies, removal of small skin tumors, and repair of minor lacerations. Surgical preparation of the area is necessary before injection of a local anesthetic. Epinephrine is commonly added to lidocaine to delay absorption of the local anesthetic agent from the site, but epinephrine must not be used at peripheral locations, where blood supply may be compromised. What type of block is this?

infiltration

When a local anesthetic is injected around a single major nerve, the procedure is referred to as a(n): - line block - epidural block - infiltration nerve block - intravenous anesthesia

infiltration nerve block

Chemical mediators, such as prostaglandin and histamine, are responsible for: - inflammatory pain - neuropathic pain - idiopathic pain - pathologic pain

inflammatory pain

Line block is:

injection of a continuous line of local anesthetic in the subcutaneous or subcuticular tissues immediately proximal to the target area.

Which of the following complications should the technician be most aware of after an animal has been spayed and is in the recovery cage? - cardiac arrhythmias - intra-abdominal hemorrhage - gastritis with mucoasal ischemia - gastric necrosis and perforation

intra-abdominal hemorrhage

Which anesthetic agent can be administered intravenously by using a constant rate infusion to a healthy anesthetized patient, and what is the the advantage of doing so? - bupivacaine: to reduce the dose of general anesthetic required - bupivacaine: to increase the level of analgesia during a painful operation - lidocaine: to reduce the dose of general anesthetic required for a painful operation to prevent cardiac arrhythmias - procaine: to reduce the risk of cardiac arrhythmias

lidocaine: to reduce the dose of general anesthetic required for a painful operation and to prevent cardiac arrhythmias

Splash block is:

local anesthesia produced by direct application of local anesthetic to a wound or open surgical site. Most often applied as a spray or with a soaked gauze sponge.

Which type of agent will affect the neurons but will allow the animal to be fully conscious? - local anesthetics - inhalant anesthetics - sedatives - general anesthetic

local anesthetics

Sympathetic blockade is:

loss of function of sympathetic nerves supplying the heart and blood vessels resulting from diffusion of local anesthetic into the thoracic spinal cord. Signs include bradycardia, decreased cardiac output, and hypotension. Blockade of the caudal sympathetic nerves results in less sever hypotension and tachycardia.

Nerve block is:

loss of sensation in a particular anatomic site, produced by injection of local anesthetic in proximity to a nerve.

An aversive sensory and emotional experience that elicits protective motor actions, results in learned avoidance, and may modify species-specific behavior is

pain

Pathologic pain is defined as

pain that is prolonged and exaggerated

Idiopathic pain is

paint that is of unknown cause

when used in a line block, a local anesthetic agent will have a direct effect on the: - peripheral nervous system - central nervous system - peripheral and central nervous systems - autonomic nervous system

peripheral nervous system

Known as "ouch" pain, which of the following protective sensations of pain occurs when there is a possibility or actual tissue injury? - nociception - physiologic pain - adaptive pain - pathologic pain

physiologic pain

Administering analgesics before tissue injury is known as: A. permedication B. local analgesia C. multimodal analgesia D. preemptive analgesia

preemptive analgesia

blockage of nerve impulses to and from a relatively large area, such as an entire limb or the caudal portion of the body is what type of block?

regional

Epidural anesthesia is:

regional anesthesia produced by injection of a local anesthetic or analgesic into the epidural space surrounding the spinal cord.

Which of the following is not a potential side effect of opioid administration in cats and dogs? A. vomiting B. dysphoria C. renal failure D. respiratory depression

renal failure

Waht is the most common acid-base abnormality in anesthetized patients - respiratory alkalosis - metabolic alkalosis - respiratory acidosis - metabolic acidosis

respiratory acidosis

Which of the following is NOT a potential side effect of NSAID administration? A. Liver damage B. kidney damage C. GI ulcers D. respiratory depression

respiratory depression

Local anesthetics block transmission of nerve impulses from: - sensory neurons only - motor neurons only - sensory and motor neurons only - sensory, motor, and autonomic neurons

sensory, motor, and autonomic neurons

Depolarzing neuromuscular blocking agents cause:

single surge of activity at the neuromusclar junction, which is followed by a period in which the muscle is refractory to further stimulation.

The muscle type that is most affected by neuromuscular blocking agent is: - cardiac - smooth muscle - skeletal muscle - all types are equally affected

skeletal muscle

Where in the pain pathway does secondary sensitization or "windup" occur? A. Brain B. spinal cord C. visceral pain receptors D. peripheral pain receptors

spinal cord

A 6-year-old female Persian cat in the recovery cage after undergoing a resection and anastomosis is vomiting and depressed. She is febrile, and palpation of the abdomen elicits pain. The technician notices discharge from the cat's wound site. Which of the following is the most likely cause of these findings? - suture dehiscence - short-bowel syndrome - leakage of the surgical site - stenosis of the intestinal lumen

suture dehiscence

Which of the following statements regarding multimodal analgesic therapy is true? A. the dose of each drug is decreased when several drugs are used B. multiple pain receptor mechanisms are targeted by one drug C. one pain receptor mechanism is targeted by several drugs D. side effects are increased by using several drugs.

the dose of each drug is decreased when several drugs are used

Nondepolarizing agents act by blocking

the receptors at the endplates

What is the mechanism of action of nonsteroidal antiinflammatory drugs? A. they block sodium channels B. they are alpha2-receptor agonists C. they inhibit prostaglandin synthese D. they are mu-opioid receptor agonists

they inhibit prostaglandin synthesis

Local anesthetics agents work because: - they mechanically block nerve impulse transmission - they interfere with the movement of sodium ions - they block all impulses at the spinal cord level - they affect neurotransmission within the brain

they interfere with the movement of sodium ions

Corticosteroids are ineffective in the nociceptive pathway in all areas except: - transduction - transmission - modulation - perception

transduction

The process by which thermal, mechanical, or chemical noxious stimuli are converted into electrical signals called action potentials is: A. perception B. modulation C. transduction D. transmission

transduction

T/F a pain scale can be used to assess pain as as well as response to analgesic therapy

true

T/F epinephrine may be mixed with a local anesthetic agent to prolong the effects of the drug

true

Ring block is:

type of line block that completely encircles an anatomic part, such as a digit or teat

Assisted ventilation is:

type of ventilation in which the anesthetist ensures that an adequate volume of air is delivered to the patient, although the patient initiates each inspiration.

The use of morphine administered through an epidural route is most likely to illicit which adverse effect? - urine retention - sedation - motor loss - respiratory depression

urine retention

When performing intravenous regional anesthesia (Bier block), one should use lidocaine: - with epinephrine - without epinephrine - either with or without epinephrine - lidocaine should not be used for this technique

without epinephrine