1. Provide general information on neuroanesthesia.

a. Name the most potent cerebral vaso dilator.

CO₂

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b. Effect of hyperventilation on

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     i. PaCO₂

reduces

     ii. CBV

decreases

     iii. CBF

decreases

     iv. Goal is end tidal CO₂ of (ETCO₂) _____

25 to 30 mm Hg

     v. Correlates with a PCO₂ of _____

30 to 35 mm Hg

c. For every_____ degree change in temperature

1

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d. there is a change in cerebral metabolic rate of oxygen by_____%.

7%

e. The effect that hyperglycemia has on ischemic deficits is to make them _____.

worse

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f. Elevating the patient’s head will have the following effect on:

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     i. arterial blood flow

decreases

     ii. ICP

reduces

     iii. venous blood outflow

improves

2. Inhalation anesthesia agents have the following effects:

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a. cerebral vessels_____

dilate

b. auto-regulation is_____

disturbed

c. cerebral blood volume is_____

increased

d. CSF volume is_____

increased

e. Reactivity of vessels to CO₂ is_____

increased

3. What anesthetic drug may come out of solution and aggravate pneumocephalus?

nitrous oxide

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4. To reduce the risk of tension pneumocephalus you would

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a. fill any space with_____

fluid

b. and turn off_____

agent

c. _____ minutes before closing the dura.

10

5. Complete the following regarding barbiturates:

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a. Most are anticonvulsants but there is an exception that actually lowers the seizure threshold called B_____.

Brevital

b. They cause peripheral vaso_____

dilatation

c. which may cause_____

hypotension

d. and_____ the CPP.

reduce

6. True or False. Morphine and Demoral

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a. release histamine

true

b. produce hypotension

true

c. cause vasodilation

true

d. increase ICP

true

e. compromise CPP

true

f. Demoral can cause seizures.

true

7. Characterize synthetic narcotics.

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a. Have the advantage that they don’t cause h_____ r_____.

histamine release

b. An example is f_____.

fentanyl

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8. Benzodiazepines are_____agonists.

GABA

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9. Characterize pancuronium (Pavulon).

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a. Potentially,_____ minutes are necessary for full reversal of pancuronium (Pavulon).

20

b. True or false. Due to its long action it is indicated for intubation.

false

10. Answer the following questions concerning anesthesia requirements for evoked potential monitoring:

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a. What technique is preferred?

total IV anesthesia

b. Second best is_____.

nitrous/narcotic

c. Are muscle relaxants permitted?

yes

d. How should fentanyl be infused?

continuously as opposed to intermittent injections

11. The antiepileptic drugs that do not effect SSEP are

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a. c_____

carbamazepine

b. p_____

phenytoin

c. p_____

phenobarbital