NMB Lecture 7 - Neuromuscular Monitoring

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NMB Lecture 7 - Neuromuscular Monitoring


 
  
Created Apr 25, 2012
by
abbyas2003

 

 
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1
Succ - Phase I Block1. single twitch?2. response to continuous stimulus3. TOF ratio4. anti...
 
1. decreased2. no FADE - decreased bu sustained response to continual stimulus3. greater than...
2
Succ - Phase II Block1. resembles what?Non-depolarizers2. twitch response?3. continual stimulus?4....
 
1. non-depolarizer blockade characteristics2. decreased twitch response to single stimulus3....
3
1. once Wednesky inhibition and post-tetanic facilitation disappear during reversal, what conclusion...
 
1. absence of residual curarization - dcrs risk of post-op resp depression2. induction - eyesemergence...
4
4 reasons muscles are relaxed/ paralyzed
 
1. to obtain adequate intubating conditions2. to facilitate surgical exposure3. to improve...
5
Muscles = sensitivity to NDMR's7 in order
 
Upper airwayMasseterAbdominalLimbLarynxE (face)Diaphragm
6
Clinical Assessment of Recovery1. 4 reliable indicators2. 4 unreliable indicators
 
1. ** sustained head lift for 5 sec- sustained tongue depressor test- sustained leg lift- max...
7
Nerve Monitoring1. single twitch = strength?2. TOF = strength and timing3. tetanus= strength...
 
1. 0.1 - 0.15Hz2. 2Hz - 0.5sec apart3. can be 50Hz or 100Hz (5 sec apart)4. 50Hz each 0.2ms;...
8
1. tetanusa. normal responseb. NDNMB responsec. depol. response2. double burst = use?
 
1a. sustained contraction with no changes in post-tetanic stimulationb. will see fade as Ach...
9
1. post-tetanic facilitation = will occur only in what situation?-- what does no change indicate?
 
1. if TOF after tetanus is stronger --> indication that tetanus displaced NMB's and there...
10
1. impulse duration2. purpose of nerve monitoring3. TOF seen at baseline, with phase I depol...
 
1. 0.2sec2. to evaluate degree of muscle paralysis or recovery from paralysis3. baseline -...
11
1. how many receptors r blocked?a. 4 twitchesb. 3 twitchesc. 2 twitchesd. 1 twitch2. therefore,...
 
1a. 0-70% (R4 decreases at 75% blocked)b. R3 decreases at 85% receptors blockedc. R2 decreases...
12
1. 3 most frequently used nerves 2. __ is stimulated to observe a __ response
 
1. ulnar = adductor pollicis-- thumb adducts= correct nerve stimulation-- fingers adduct= incorrect...
13
1. 5 branches of cranial nerve 7 (facial nerve)2. posterior tibial nerve monitoringa. placementb....
 
1. temporal, zygomatic, maxillary, mandibular, buccal2a. behind medial malleolusb. flexion...
14
1. corrugator supercilli has similar resistance to which muscle?2. which nerve is best to monitor...
 
1. diaphragm2. facial nerve3. easy4. -- ease of placement/ access-- contralateral innervation...
15
Residual Muscle Paralysis Evaluation-- give % of receptors occupied1. normal TV2. holds tetanus...
 
1. 0-80% may be blocked2. 0 to 75-80%3. 0 to 75-80%4. 0-50%5. 0-33%
16
Meaning of following Modes1. single twitch2. TOF3. DBS
 
1. allows continual evaluation of depolarizing block (must know baseline)2. allows estimation...
17
1. neuro monitoring tools that eval shallow &/or moderate block2. methods that monitor...
 
1. twitch, TOF, DBS, tetanus2. post-tetanic count and post-tetanic facilitation3. shallow =...

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