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what nerves originate in the intermediolateral horn of the spinal cord
sympathetic preganglionic neurons
what nerves pass through the gray rami communicans
sympathetic postganglionic neurons
somatic sensory neuron are
afferent and enter the cord via the dorsal horn
anterior to the ligamentum flavum is the
epidural space
what spinal cord tract modulate pain?
what area of the brain is responsbile for keep the individual awake?
Reticular Activating System
the pt undergoing surgery on the cervical spine is prepared for somatosensory evoked potensial monitoring.  what change in the somatosensory evoked potential suggest that the cord is being damage
latency: increased
Amplitude: decreased
If somatosensory evoked potential monitoring suggests spinal cord damage, what segment of cord is iinvolved
which of the following evoked potentials is least sensitive to anesthetics:
visual, somatosensory, brainstem auditory
Brainstem Auditory evoked potential
Are C fibers myelinated?
C fibers synapse in what layers of the dorsal horn?
Rexed's Lamina II and III
pain afferent nerve fibers enter the dorsal cord and ascend or descend 1-3 segments in what tract before enetering and synapsing in the dorsal horn
Tract of Lissauer
pain transmitted form the periphery by A-delta fibers terminate primarily in Rexed's Lamina ____
I and V
Identify the neurotransmitters released form the A-dleta and C fibers
A delta: Glutamate
C fibers: Substance P
Early depression of ventialtion (within 2 hours) after intrathecal or spinal injection of opioids results from______
systemic absorption of opioid
When a lipophilic opioid is used for intrathecal or epidural anesthesia
onset is fast and duration is short
late depressionof venitlation after intrathecal or epidural placemnt of opioid requires_______
Hydrophilic opioid and significant rostral spread
Delayed depression of venitlation (6-12 hours) occurs after neuraxial  injection of which opioid?
sufentanil, fentanyl, alfentanil, morphine
spinal analgesia is mediated mostly by which opioid receptor?
Mu2 receptors cause: pruritis, supraspinal analgesia, dyphoria, or respiratory depression
respiratory depression
Naloxone is an opioid_____
the pt is emerging from high dose sufentanil anesthesia.  If nalbuphine were given t the this pt, you would see:
reversal of respiratory depression and maintenance of analgesia
after CSF passes through the foramen of munro, it enters:
thrid ventricle
If the right lateral spinothalamic tract is severed at C4, what sensations are lost?
pain and temperature are lost on the left side fo the body
the umbilicus is found in that dermatone
what substance decrease the release of substance P in the spinal cord?
where does epidural morphine work?
in the substantia gelatinosa
what brain region controls events in the substantia gelatinosa
periventricular/periquaductal gray of brainstem
what area of the brain mediates spinal analgesia after administration of an IV opioid
periventricularperiaquaductal gray of brainstem
the major vessels supplying the circle of willlis are the
basilar and internal carotids
the minimum stump pressure demonstrating that hte brain will be adequately perfused during carotid endarterectomy is
the gland is found in the sell turcica?
the brainstem and cerebellum are found in the
posterior cranial fossa
which fontanelle closes at about 2 yrs of age
the pt exhibits deverebrate rigidity. the pt_______
requires a ventilator and has arms extended
the pt with an intracranial pressure that suddenly has risen to 30 mmHg will exhibit:
Hypertension and bradycardia
which of the folllowing agents decreases both cerebral blood flow and cerebral metabolism in the normocarbic pt:
halothane, ketamine, nitrous, propofol
which of the following agents increased CBF and decreases cerebral metabolism in th enormocarbic pt: enflurane, ketamine, thipental,, nitrous oxide
which cranial nerve controls the musculature of the tongue?
which cranial nerve controls the lateral rectus muscle?
another name for cerebral steal is
luxury perfusion
what could cause the Robin Hood Effect?
what happens to blood flow and blood vessel diameter in an ischemic region of brain if the pt is  hypoventilated?
blood flow decreases and blood vessel diameter does not change
muscles for chewing are controlled by CN#____
which CN controls motor activty of the larynx and pharynx?
there are 4 fontanells at birth:
anterior, posterior, anterolateral and posterolateral.  when does each close?
Anterior: 18 months
Posterior and anterolateral: 2 months
Posterolateral: 2yrs
stimulation of the presynaptic and postsnaptic nicotinic receptors at the skeletal neuromuscular junction leads to what (in terms of release of Ach and motor end plate potential)?
Release of Acetycholine: Increased
Motor end plate potential: Decreased (depolarized)
sodium, Ca, and K ions diffuse in which directions wehn the channels of the motor end plate of sekeletal muscle are stimulated to open?
Na: In
Ca: In
K: Out
the release of Ach from the neuromuscular junction will be increased inchich of the following conditions:
which agent has antimuscarinic actions;
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