推 ftsymoon:辛苦了 12/09 12:44
推 gsddya:推樓上~ 12/09 13:12
推 cclittlebaby:辛苦囉～小柯柯真的很詐～都考沒教的耶… 12/09 13:39
※ 編輯: tabo0 來自: 220.140.7.156 (12/09 15:02)
*洪維德主任 <全人麻醉照護>:1-2題
沒有考訊 看考古題
*柯玟如醫師 <Patient monitors>:6題
1.關於EEG用途的描述 共筆P20
2. pulse oximeter判讀 受到哪些因素影響? 共筆P17有原理 以下是網路補充
用來量度的肢體不停震動
有不正常的血紅素存在，如 Fetal Hb 、COHb、MetHb（變性血紅素）
血液中有染劑存在時，如：甲基藍、顯影劑
皮膚有色素或有指甲油
血循環差，如：低血容性休克 (hypovolemic shock)、週邊組織灌流低
測量的時候，暴露在額外的光源下
SpO2值＜70％時，就失去其客觀性，需以動脈血氧測量 (ABG) 的PaO2為參考標準。
高膽紅素血症 (bilirubin) 可影響SpO2正確的判讀。
3. pulmonary artery catheterization 相關問題 共筆P12:
cardiac output 測量 共筆P15, mixed venous blood的基本觀念
4. a-line相關問題: colateral circulation 的什麼test的基本觀念>>Allen’s test ,
a-line的注意事項(隨堂考那一題)共筆P8上
5. CVP技術相關問題 共筆P9-10 : 打完後的確認動作 共筆P10表格最下方
6. 跟眼睛有關的signs 如何判斷麻醉深度?
例如 cornea reflex消失(Stage III plane II)
eyelash reflex喪失(Stage II), pupil light reflex(Stage III plane III)
老師沒上 以下是補充
根據Guedel’s classification分四期:
Stage I (Stage of Analgesia or the stage of Disorientation):
from beginning of induction of anesthesia to loss of consciousness.
Stage II (Stage of Excitement or the stage of Delirium):
from loss of consciousness to onset of automatic breathing. Eyelash reflex
disappear but other reflexes remain intact and coughing, vomiting and
struggling may occur; respiration can be irregular with breath-holding
Stage III (Stage of Surgical anesthesia):
from onset of automatic respirationto respiratory paralysis. It is divided into
four planes:
‧ Plane I - from onset of automatic respiration to cessation of eyeball
movements. Eyelid reflex is lost, swallowing reflex disappears, marked eyeball
movement may occur but conjunctival reflex is lost at the bottom of the plane
‧ Plane II - from cessation of eyeball movements to beginning of paralysis
intercostal muscles. Laryngeal reflex is lost although inflammation of the
upper respiratory tract increases reflex irritability, corneal reflex
disappears, secretion of tears increases (a useful sign of light anesthesia),
respiration is automatic and regular, movement and deep breathing as a response
to skin stimulation disappears.
‧ Plane III - from beginning to completion of intercostal muscle paralysis
Diaphragmatic respiration persists but there is progressive intercostal
paralysis, pupils dilated and light reflex is abolished. The laryngeal reflex
lost in plane II can still be initiated by painful stimuli arising from the
dilatation of anus or cervix. This was the desired plane for surgery when
muscle relaxants were not used.
‧ Plane IV - from complete intercostal paralysis to
diaphragmatic paralysis(apnoea).
Stage IV: from stoppage of respiration till death.
Anesthetic overdose causemedullary paralysis with respiratory arrest and vasomot
or collapse. Pupils are widely dilated and muscles are relaxed.
1st plane The patient does not experience amnesia or analgesia
2nd plane The patient is completely amnesic but experiences
only partial analgesia
3rd plane The patient has complete amnesia and analgesia
*陳在昕醫師<Fluid management>:6題
老師出10題 主任挑6題 共筆已上傳 禮拜四下午一點在PBL16發放
考古題最後5題特別重要 另外5題應該就是比較colloid 和crystalloid fluid
無法挖更多了XD 還是要讀書
*徐士哲醫師<吸入性麻醉劑與靜脈麻醉劑>:6題
上課附重點 共筆上會標 無其他考訊 如無意外 禮拜四下午一點在PBL16也會發放
*游以舟醫師<Pain mechanism>:6題
參考92級考古題 題目有變但題型類似 預估禮拜五發放
其他老師要請北極熊補充啦~~~嘎嘎嘎
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◆ From: 220.140.5.226
※ 編輯: tabo0 來自: 220.140.5.226 (12/09 11:52)