Intro Anesthesia Exam 1: Practice 1

Greek origin of 'anesthesia'

Loss of sensation

4 components of general anesthesia

Amnesia, Analgesia, Muscle Relaxation, Loss of Consciousness

First demonstrated ether anesthesia publicly in 1846

William T.G. Morton

Significance of Public Ether Day

Marks the first successful public surgical demonstration using ether

Anesthetic agent used by James Simpson in obstetrics

Chloroform

Humphry Davy's contribution to anesthesia

Identified nitrous oxide's analgesic properties

Developer of the hypodermic needle in 1855

Alexander Wood

Two types of early anesthetic agents used before 1800

Alcohol, Opium

John Snow's contribution to anesthesiology

Pioneered dosage control and ether/chloroform use

First ether anesthetic performed but not published until later

Crawford Long

Decade when the AA profession was founded

1960s

Two universities that launched the first AA programs

Emory University and Case Western Reserve

Organization that certifies Anesthesiologist Assistants

NCCAA

CME credits required every 2 years for recertification

40 credits

CAAHEP

Commission on Accreditation of Allied Health Education Programs

Delegatory authority in anesthesia practice

Physician delegates tasks under supervision

Difference in supervision between AAs and CRNAs

AAs require anesthesiologist supervision; CRNAs may not

Year the AAAA was founded

1975

Minimum oxygen concentration allowed under the Link-25 system

25%

National organizations that recognize AAs

ASA, AMA, NCCAA, CAAHEP

Continuation of the right main bronchus

Right lower lobe bronchus

Region that includes the nasal cavity, pharynx, and larynx

Upper respiratory tract

LEMON mnemonic

Used to evaluate airway difficulty

Ideal interincisor gap for intubation

Greater than 3 cm

Mallampati class showing only the hard palate

Class IV

Indication for intubation under the 5 P's

Protection of airway

Yankauer device

Suction secretions from the mouth and throat

'Sniffing position'

Used to align airway axes for intubation

Definitive method to confirm ETT placement

End-tidal CO₂ monitoring

Signs of esophageal intubation

No chest rise; absent EtCO₂

Most important muscle in quiet inspiration

Diaphragm

Pressure that keeps the lungs expanded

Intrapleural pressure

Tidal volume

Air moved in or out during normal breathing

Bohr effect

Decreased hemoglobin O₂ affinity at low pH

Region of the lung with high ventilation but poor perfusion

Zone 1

Effect of pH drop on hemoglobin's oxygen affinity

Decreases oxygen affinity

Medulla oblongata

The primary control center for automatic breathing.

EtCO₂ normal range

35-45 mmHg on capnography.

Alveolar plateau

Represents CO₂ from alveoli on a capnogram.

Flat capnogram

Indicates no CO₂ detected (e.g., apnea).

SA node

The heart node with the fastest Phase 4 depolarization.

Ventricular systole

The phase of the cardiac cycle that involves aortic valve opening.

QRS complex

Represents ventricular depolarization in an ECG.

Stroke volume

Amount of blood pumped per heartbeat.

Poiseuille's Law

Describes the relationship between radius and resistance.

Digitalis mechanism

Works by inhibiting Na⁺/K⁺ ATPase.

S1

Marks the closure of the AV valves.

S2

Represents closure of aortic and pulmonary valves.

Preload

Stretch on ventricles before contraction.

Sympathetic stimulation effect

Increases heart rate.

0.9% Normal Saline

The only IV fluid compatible with blood products.

Lactated Ringer's

An isotonic crystalloid fluid.

Trauma catheter gauge

Typically 18 gauge or larger.

Infiltration

IV fluid leaks into surrounding tissue.

Microdrip tubing drop factor

60 gtt/mL.

4-2-1 rule

Used for calculating maintenance fluids.

Total maintenance rate for 70 kg patient

110 mL/hr.

Allowable blood loss (ABL) calculation

(EBV × [Hct_i - Hct_f])/Hct_i.

EBV for adult female

65 mL/kg.

Packed red blood cells

Increases hemoglobin by ~1 g/dL per unit.

Anesthesia machine pressure systems

High, intermediate, low pressure systems.

Oxygen flush valve function

Bypasses vaporizers and delivers 100% O₂.

Pin Index Safety System

Prevents cylinder misconnection.

APL valve function

Controls pressure during manual ventilation.

Common gas outlet location

Between vaporizer and breathing circuit.

Fail-safe device in intermediate-pressure system

Oxygen failure cutoff valve.

Hypoxic mixture delivery factor

N₂O alone (not affected by O₂ proportion).

Sevoflurane vaporizer type

Variable bypass vaporizer.

CO₂ rebreathing prevention component

CO₂ absorber in the circle system.

Circle breathing system advantage

Conserves heat and humidity.

ASA standard I

Requires continuous presence of anesthesia personnel.

Deoxyhemoglobin absorption in pulse oximetry

Absorbs more red light.

False readings in pulse oximetry causes

Nail polish, motion, CO poisoning.

Acceptable MAP value for organ perfusion

≥ 65 mmHg.

Core temperature monitoring site

Esophageal or bladder.