Abducens Nerve

Cambridge University Press 978-1-107-65223-1 - Primary FRCA: OSCEs in Anaesthesia William Simpson, Peter Frank, Andrew Davies and Simon Maguire Index More information

Index

abducens nerve (VI) 156, 158 aortic sinuses 146 brachial artery 10 ABO blood grouping 132 aortic stenosis 150, 166 brachial plexus 3–5 accessory nerve (XI) 156 aortocaval compression, gravid brachial plexus block 3, 4–5 acute limb ischaemia 166 uterus 174 brachiocephalic artery 2 adrenaline arrhythmias, cardiac 239–243 bradyarrhythmia 172 regional blocks 13, 211, 212 history taking 43, 44, 47, 48 breaking bad news 63–64, 68 resuscitation 188, 198 resuscitation 195–196 breathing circuits 95–97 adult respiratory distress arterial waveforms, abnormal bronchospasm, acute 191, 192 syndrome (ARDS) 116, 117 166 burns, diathermy 76 air embolism 217, 218 artery of Adamkiewicz 26 BURP manoeuvre 180 airway arthritis 40 assessment 48, 53, 167–170, asthma 39–40, 59–61 caesarean section 228 asystole, risk factors 172 Jehovah’s witness 72–73 difficult see difficult airway atelectasis 154 obstetric haemorrhage effects of drying 114 atlanto-axial instability 52, 53, 199–201 fires 124 141–143 perimortem 174 surgical, procedure 215–216 atlanto-occipital distance 170 preoperative assessment airway devices 99–101 atrial fibrillation (AF) 44, 48, 196 55–57, 159–162 alcohol thermometers 287 atrial flutter 239–240 regional vs general Allen’s test 30 auscultation 148, 152, 164 anaesthesia 162 allergies 37, 43, 44 awake fibre-optic nasal tracheal cancelled surgery 70 alternating current (AC) shock intubation 86–87 capacitative coupling 76 120, 121 axillary artery 4 capacitor 78 amiodarone 188, 196 axis, ECG 242 capnography 233 anaesthesia specific questions, Ayre’s T-Piece, Jackson-Rees carbimazole 48 history 38, 44 modification 96 carbon dioxide, end-tidal – anaesthetic hazards 119 133 (ETCO2) 233 anaphylaxis 197–198 Beer’s law 278 cardiac veins 20 anatomy 1 β blockers 48 Cardiff Aldasorber 108 angiogram 145–146 biceps tendon 10 cardiopulmonary resuscitation angry patients 70, 71 bimetallic strips 105, 288 (CPR) ankle block 11–13 blood pressure obstetric patient 174 ankle-brachial pressure index invasive monitoring 249 paediatric patient 188–189 166 non-invasive (NIBP) cardiovascular disease antecubital fossa 9–10 monitoring 261–263 history taking 37, 38–39 anterior jugular vein 7, 8 blood transfusion 131–133 rheumatoid arthritis 52 anterior spinal artery 26 obstetric haemorrhage 200 cardiovascular examination 160 anterior spinal artery syndrome reactions 132–133 cardioversion, DC 196 26 refusal, Jehovah’s witness carotid arteries, auscultation antibiotics 72–73 164 history of allergy 43, 44 bloody tap 213 carotid pulse 147, 150, long-term medication 59, 60 Bochdalek hernia 24 236–237 patients with pacemakers 138 body mass index (BMI), raised cell salvage 72 anxiety 47, 48, 67, 68–69 46, 57 Celsius scale 286 aorta, branches 20 bone-cement implantation central nervous system (CNS) aortic regurgitation 150, 166 syndrome 129 disorders 37, 40

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© in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-107-65223-1 - Primary FRCA: OSCEs in Anaesthesia William Simpson, Peter Frank, Andrew Davies and Simon Maguire Index More information Index central venous cannulation cricothyroid membrane 215, endocrine disorders 41 217–219, 236 216 endotracheal intubation central venous pressure (CVP) cricothyroid muscle 32 awake fibre-optic 86–87 235–237 cricothyroidotomy 215–216 blind nasal 87 measurement 236, 237 cuffs, blood pressure collapsed obstetric patient waveform 235, 236 monitoring 262 174 central venous pulse 236–237 CURB-65 score 154 difficult see difficult airway cerebral blood flow 16 current density 76 failed 179–181 cerebrospinal fluid (CSF) 16 limited mouth opening 84, cervical spine X-rays 141–143, damping, arterial pressure 86–87 170 waveform 250 obstetric haemorrhage 200 chest drain 136, 207–209 dantrolene 176, 177 risks 92 chest examination 147, 148, Datex-Ohmeda Aladin Cassette tooth damage 71 151–152 vaporiser 104, 105 endotracheal tubes 89–93 chest pain 51, 52 deep peroneal nerve 12 cuffs 92, 93 chest wall compliance 260 block 12 laser hazards 124 chest X-rays 170 defibrillation 174, 188 uncuffed 92 choking algorithm, paediatric defibrillators 77–78 epidural analgesia 189 dental extractions 167–170 catheter insertion 210–213 cholecystectomy, laparoscopic desaturation, intraoperative complications 212, 213 45–46, 191–193 191–193 labour 162, 211, 212 chronic obstructive pulmonary desflurane vaporiser 104, 105 epidural space 211, 212 disease (COPD) 39–40, 43, dew point 246 epilepsy 40 44, 152, 154, 256 diabetes mellitus 41, 45, 46, 56 equipment 75–117 circle of Willis 15–16 diaphragm 23–24 external jugular vein 7, 8 circuit breakers, current- diathermy 75–76, 138 eyes operated earth-leakage 120 difficult airway anaesthesia 223–224 circumflex coronary artery 146 history taking 51, 53 examination 147, 151 Clark electrode 265, 266, 267, management 179, 180 268 prediction 167–170, 228 face, examination 147, 151 collapsed obstetric patient Difficult Airway Society (DAS) facemasks 173–174 guidelines 180 components 100 collapsing pulse 163, 166 DINAMAP 263 fear of 67 common mode rejection ratio direct current (DC) electric ventilation, failed intubation 240 shock 120 180 common peroneal nerve 274 double burst stimulation 274 facial nerve (VII) 22, 156, 274 communication 73 draw-over vaporisers 104 factor VII, recombinant compliance 257, 259–260 drug history 37, 56 (NovoSeven) 132, 133 computed tomography (CT), failed intubation 179–181 head 139–140 ear, nose and throat (ENT) family history 38 consent 65–66, 72–73 surgery 59–61 FAST1 system 222 continuous mandatory electrical hazards 119–121 feet, examination 147, 152, 163 ventilation (CMV) 116 electrocardiogram (ECG) femoral pulses 163 – Cormack and Lehane grading 239 243 FEV1 256 fi system 86 differential ampli ers 240 FEV1:FVC ratio 256 coronary angiogram 145–146 electrodes 240 fibrillated coronal-charged coronary blood flow 146 electrostatic filters 114 filters 114 coronary circulation 17–20 emergency surgery 68–69, filling ratio 110 coronary sinus 20 137–138 filters 113–114 cranial base, anatomy 21–22 emphysema, surgical 136 fires, laser-related 124 cranial nerve examination end-tidal carbon dioxide flow-time curves 115, 116 – fl 155 158 (ETCO2) 233 ow volume loops 257, 258, 259 cricoid pressure 67, 226 endobronchial blockers 92, 93 foramina, cranial base 22

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fuel cell 267–268 implantable cardioverter laryngeal mask airway (LMA) functional residual capacity defibrillators (ICDs) 78 99, 100–101, 180 Index (FRC) 253, 256 inferior laryngeal artery 32 laryngectomy 183, 184 FVC (forced vital capacity) 256 inferior thyroid vessels 2 laryngoscopes 79–87 infrared thermometers 288 cleaning 86, 87 gastro-oesophageal reflux 45, inspired gases, humidification rigid fibre-optic 84, 86, 87 46, 57 114, 246–247 straight vs curved blades 86, gastrointestinal system review insulin-treated diabetes 46 87 37 inter-incisor distance 170 laryngoscopy general anaesthesia (GA) interarytenoid muscles 32 Cormack and Lehane caesarean section 162 intercostobrachial nerve 5 grading system 86 family history 38, 47, 48–49 intermittent positive pressure difficult 179, 180 past history 38, 44, 51 ventilation (IPPV) 96 larynx 31 genitourinary system review 37 internal carotid artery 16 lasers 123–125 glossopharyngeal nerve (IX) internal jugular vein latent heat 246 156 anatomy 7, 8, 217, 218 lateral cricoarytenoid muscle 32 great veins of the neck 7–8 cannulation 217, 218 left anterior descending (LAD) intracranial pressure (ICP), coronary artery 146 Hagen–Poiseuille equation 249, minimising 140 left brachiocephalic vein 2 251 Intralipid 213 left coronary artery 20 hands, examination 147, 151, intraosseous (IO) access left lateral tilt, obstetric patient 163 221–222 174 headache, post-dural puncture introducing yourself (to the light reflexes 155, 158 204, 212 patient) 36 limb ischaemia, acute 166 hearing, assessment 156 intubation see endotracheal lithotomy position 128 heart, innervation 20 intubation local anaesthetic toxicity 213 heart block 241–243 ischaemic heart disease 39, 51 lumbar puncture (LP) 140 heart disease 39 risk factors 146 lung compliance 259–260 heart sounds, additional 166 isobestic point 278 lung function tests 253–260 heat and moisture exchangers (HME) 113–114, 247 Jehovah’s witness 72–73 Macintosh laryngoscope blade heat loss, routes of 288 jet ventilation 93 86, 87 Heliox21 110, 111 jugular venous pulse (JVP) 147, malignant hyperthermia (MH) history of presenting complaint 150, 151 49, 175–177 36 Mallampati classification 170, history taking 35–61 Kelvin scale 286 228 Horner’s syndrome 158 ketamine 140 Mapleson F breathing circuit 96 human factors (in clinical Korotkoff sounds 262 masks see facemasks errors) 129 mean arterial pressure 262 humidification, inspired gases labour, epidural analgesia for measured flow vaporisers 104, 114, 246–247 162, 211, 212 105 humidity 245–247 Lambert’s law 278 measurement and monitoring absolute 245, 246 laminar flow 288 measurement 246, 247 factors affecting 251 median nerve 10 relative 246 rotameters 282, 283 median nerve blocks 9, 10, 30 hygrometers 246, 247 landmark technique, internal medical gases 109–111 hypertension 38–39, 45, 46, 162 jugular vein cannulation medical history, past 36, 56 hyperthyroidism 41, 48 217, 218 mercury thermometers 285, hypoglossal nerve (XII) 156 laparoscopic cholecystectomy 287 hypothermia, induced 188 45–46, 191–193 methotrexate 52–53 hypothyroidism 41, 48 laparoscopic surgery microshock 120 hypoxia 191–193, 279 causes of hypoxia 193 mixed venous oxygen hysteresis 260 diathermy risks 76 saturation (SvO2) 270

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© in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-107-65223-1 - Primary FRCA: OSCEs in Anaesthesia William Simpson, Peter Frank, Andrew Davies and Simon Maguire Index More information Index Mobitz type I heart block 242, obstetric patient, collapsed Papworth Bivent tube 93 243 173–174 parents, communication with Mobitz type II heart block 242, obstetric pre-operative 68–69 243 assessment 159–162 Parkinson’s disease 40 monitoring and measurement obstructive lung disease 254, Patil’s test 168 288 256, 258 PDEQ checks 4, 180–181 Montandon tube 92 obstructive sleep apnoea 46 peak expiratory flow rate mouth oculocardiac reflex 224 (PEFR) 257, 259 examination 167–168 oculomotor nerve (III) 155 Penaz technique 262 opening, limited 84, 86–87 palsy, complete 158 percussion, chest 152 Murphy eye 93 oesophagus 2 perforated viscus 137–138 musculoskeletal disorders 40 olfactory nerve (I) 155 peribulbar block 224 musculoskeletal system review optic nerve (II) 155 peripheral circulation 37 damage 158 examination 163–166 myocardial infarction (MI) 146, oropharyngeal airways 100 phrenic nerve 24 242 oscillometry, blood pressure physical examination 170 measurement 262, 263 pin-index system 110–110 narrow complex tachycardia osteoarthritis (OA) 40, 43, 44 placenta praevia 162 195, 196 overbite 168 plenum vaporisers 104 nasopharyngeal airways 100, oxygen pneumonia, community 225 cylinders 110, 111 acquired 154 neck rotameters 282, 283 pneumoperitoneum 137–138 examination 147, 151, 168 vacuum insulated evaporator pneumothorax 136 extension, assessment 168, (VIE) 111 chest drains 136, 208 228 oxygen measurement 265–268 tension 136, 191, 192 great veins 7–8 Clark electrode 265, 266 polarographic (Clark) electrode problems, rheumatoid fuel cell 267–268 265, 266, 267, 268 arthritis 51, 52, 53 methods 266 popliteal pulses 163 swelling/lump 47, 48 see also pulse oximetry Portex Ivory nasal tube 93 needle phobia 65–66 oxygen saturation, mixed positioning, patient 127–129 – nerve stimulators 273 276 venous (SvO2) 270 positive end-expiratory percutaneous 273, 275–276 oxygen therapy, long-term 154 pressure (PEEP) 96, 116 peripheral 273–276 oxyhaemoglobin dissociation post-dural puncture headache neuromuscular block, assessing curve 279 204, 212 depth 273, 274, 275 post-tetanic count 275 nitrous oxide P-R interval 240 posterior cricoarytenoid muscle contraindications 136, 138 pacemakers 32 cuffed endotracheal tubes anaesthetic considerations posterior interosseous nerve 10 and 93 243 posterior primary rami 26 cylinders 110 chest X-ray 137–138 posterior spinal artery 26 scavenging 108 diathermy use with 76, 138 posterior tibial nerve 12 non-invasive blood pressure history taking 39 pre-eclampsia 162 (NIBP) monitoring indications for insertion 242 pre-oxygenation 67, 228 261–263 pacing, transcutaneous 172 pressure controlled ventilation non-steroidal anti-inflammatory packed red cells 132, 133 116 drugs (NSAIDs) paediatric patients pressure support ventilation 51, 52 breathing circuits 96 116, 117 nose, examination 168 emergency scenario 187–189 pressure-time curves 115, 116 endotracheal tubes 92 pressure-volume curve obesity 45, 46 Macintosh laryngoscope 257, 259 obstetric haemorrhage blades 87 procedures 229 199–201 weight estimation 188 prone positioning 128–129 obstetric history, past 56, 159 palpitations 48 propylthiouracil 48

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prothrombin complex rheumatoid arthritis (RA) 40, supraglottic airway devices concentrate 132, 133 51–53, 142 (SADs) 100–101 Index pulmonary artery (PA) right coronary artery 20, 146 supramaximal stimulus 275 catheters 269–271 Rinne’s test 156 sural nerve 12 pulmonary artery pressure 270, rotameters 281–283 surgical history, past 271 36–37, 56 pulmonary capillary wedge salbutamol 192 suxamethonium apnoea 38, 49, pressure (PCWP) 270, 271 saphenous nerve 12 68–69 pulmonary hypertension 150, saturated vapour pressure Swan–Ganz catheters 270, 271 (SVP) 104, 105 269–271 pulse oximetry 277–279 scavenging 107–108 swinging light test 155, 158 pulseless electrical activity Schrader valves 111 synchronised intermittent (PEA) 174 Seebeck effect 286 mandatory ventilation pulsus alternans 166 Sellick’s manoeuvre 226, 228 (SIMV) 116 pulsus paradoxus 166 sevoflurane vaporiser 104 systems review 37 pumping effect 104 SHOT (Serious Hazards of Transfusion) 133 tachyarrhythmia 195–196 radial nerve 9, 10, 30 shoulder replacement surgery temperature iatrogenic injury 262 51–53 compensation 104, 105 radial pulses 147, 151 sickle cell disease 60 core body 286 radicular arteries 26 sickle cell test 65–66 critical 104 radiology 146 simulation 201 measurement 285–288 RAE tubes 92, 93 sinus bradycardia 172 resistance vs. 285, 287 rapid sequence induction (RSI) sinuses of Valsalva 146 thermistors 285, 287, 288 difficult laryngoscopy 179, skull base 21–22 thermocouples 285, 286, 288 180 smoking 38, 47, 154 thermometers 285, 287, 288 emergency laparotomy 137, social history 38 third nerve see oculomotor 138 specific latent heat of nerve patient communication 67 vaporisation 246 thymol 105 procedure 225–229 spinal anaesthesia 43, 44 thyroarytenoid 32 vomiting during 226, cranial nerve examination thyroid disease 41, 48 228–229 after 155–158 thyroid notch 32 recurrent laryngeal nerve 2, 32 total 213 thyroid surgery 47–49 damage 32–33, 48 see also epidural analgesia thyromental distance 168, 228 Regnault’s hygrometer 247 spinal cord 25–27, 204 tooth damage 71 relative afferent pupillary defect spinal nerves 26 trachea 1–2 (RAPD) 155, 158 spinal shock 26–27 tracheostomy 93 resistance thermometers 285, spinothalamic tracts 26 complications 184–185 288 spirometry 253–256, displaced 183–185 resonance, arterial pressure 257–260 train of four 273, 274 waveform 250 splenectomy 59 transducers, arterial pressure respiratory disease sterno-mental distance 170 monitoring 250 history taking 37, 39–40 steroid-treated patients 53 transformers, isolating 120, 121 rheumatoid arthritis 52 sub-Tenon block 223–224 transfusion reactions 132–133 respiratory examination subarachnoid haemorrhage transurethral resection of 151–154 139–140 prostate (TURP) 43–44 respiratory function tests subdural catheter insertion, tribocharged electrostatic filters 253–260 inadvertent 213 114 restrictive lung disease 254, 256, superficial peroneal nerve 12 tricuspid regurgitation 236 258 superior laryngeal artery 32 trigeminal nerve (V) 22, 156 resuscitation 201 superior laryngeal nerve 32 triple point of water 286 retrobulbar block 224 supraclavicular nerve blocks trochlear nerve (IV) 155, 158 Reynolds number 282 3, 5 tuberculosis (TB) 136

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© in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-107-65223-1 - Primary FRCA: OSCEs in Anaesthesia William Simpson, Peter Frank, Andrew Davies and Simon Maguire Index More information Index turbulent ﬂow, rotameters 282, vacuum insulated evaporator visual assessment 155 283 (VIE) 111 vocalis muscle 32 tympanic membrane vagal stimulation, interventions voice changes 33, 47, thermometers 288 causing 172 48, 151 vagus nerve (X) 156 volume controlled ventilation ulnar nerve 9, 10, 30 valvular heart disease 39 116 iatrogenic injury 262 vaporisers 103–105 von Recklinghausen’s nerve stimulator 274 vapour 104 oscillotonometer ulnar nerve block, at wrist 30 variable bypass vaporisers 104 261, 263 ultrasound guidance VBM Ravussin 13 G needle 216 central venous cannulation venepuncture 66 water bath humidiﬁers 247 217, 218 ventilators 115–117 Weber’s test 156 regional blocks 4, 5 ventricular tachycardia (VT) Wenckebach phenomenon 242, universal donors/recipients 132 195, 196 243 urological surgery 43–44 vertebral artery 16 WET–FAG acronym 189 uterus, displacement of gravid vestibulocochlear nerve (VIII) wrist 29–30 174 156 wrist blocks 30

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