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Neuroscience Anesthesia Review
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Neuroscience Anesthesia Review
Neuroscience Anesthesia Review
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1
Question
What primarily determines cerebral blood flow (CBF)?
Answer
Cerebral perfusion pressure (CPP) and autoregulation
2
Question
How does temperature affect CMRO2?
Answer
Each 1°C decrease reduces CMRO2 by 6-7%
3
Question
Which anesthetics increase CMR and CBF?
Answer
Ketamine and nitrous oxide
4
Question
What formula represents cerebral perfusion pressure?
Answer
MAP minus ICP or CVP, whichever is higher
5
Question
What disrupts cerebral autoregulation?
Answer
Cerebral vasodilators, chronic hypertension, ischemia
6
Question
What is the relationship between CBF and PaCO2?
Answer
Direct; increased PaCO2 increases CBF, decreased PaCO2 decreases CBF
7
Question
Describe the relationship between CBF and ICP.
Answer
Inversely proportional; increased ICP decreases CBF significantly
8
Question
Where do most brain tumors originate from?
Answer
Glial cells
9
Question
Function of glial cells?
Answer
Maintain ionic environment, modulate conduction, NT reuptake, repair neurons
10
Question
Which area is responsible for understanding speech?
Answer
Wernicke's area in the temporal lobe
11
Question
What type of aphasia results from frontal lesion?
Answer
Expressive aphasia (Broca's area affected)
12
Question
Which structures are included in the diencephalon?
Answer
Thalamus and hypothalamus
13
Question
Preop management for seizure prevention?
Answer
Anticonvulsants like levetiracetam (Keppra)
14
Question
Ideal head position to promote venous drainage?
Answer
15-20 degrees head-up
15
Question
Position used for microvascular decompression of CN V?
Answer
Jannetta position (semilateral)
16
Question
What is the primary monitoring method of CNS function intraoperatively?
Answer
Neurological exam of an awake patient
17
Question
What does EEG assess?
Answer
Cortical activity, anesthesia depth, ICP, sleep, coma
18
Question
Purpose of evoked potentials (EP)?
Answer
Monitor neural pathway integrity during surgery
19
Question
What change in SSEP amplitude indicates significant deterioration?
Answer
50% reduction
20
Question
Which evoked potential monitors CN VIII?
Answer
Brain auditory evoked potentials (BAEP)
21
Question
What is the main application of intraoperative MEP?
Answer
Assess corticospinal and corticobulbar tract integrity
22
Question
Monitoring for posterior fossa surgery?
Answer
SSEPs, BAEPs, cranial nerve EMG
23
Question
Preferred position for posterior fossa surgery?
Answer
Sitting position
24
Question
VAE detection gold standard?
Answer
Transesophageal echocardiography (TEE)
25
Question
What triggers paradoxical air embolism during neurosurgery?
Answer
VAE crossing via PFO due to >5mm RA pressure
26
Question
Best noninvasive VAE monitor?
Answer
Precordial Doppler
27
Question
What is cerebral oximetry used for?
Answer
Measure cerebral oxygenation and perfusion
28
Question
Treat intraoperative hypertension with?
Answer
Beta-blockers, vasodilators, or BB agents
29
Question
Most common symptom of ruptured saccular aneurysm?
Answer
Headache
30
Question
Intraoperative BP goal for aneurysm clipping?
Answer
120-150 mmHg