1) Topic: anaesthesia
Which of the following is seen in raised intra cranial tension:
reference: Lee 12th edition pg 442
Raised ICP causes headache, vomiting, papilloedema, drowsiness, bradycardia & hypertension.
Neurogenic pulmonary edema may occur.
a)hypotension : Due to Cushings reflex, there is hypertension;wrong choice!
b)bradycardia : due to compression of the vasomotor center in medulla,we get bradycardia in raised ICT;correct option.
c)tachycardia : not seen; wrong option.
d)tachypnoea : again there is depression of respiration in raised ICP;
correct choice: (b) bradycardia
Blood transfusion reaction in a patient under general anesthesia is charcterised by all except:
c)increased oozing from the wound
reference:Lees 12th edition pg 30
signs of incompatible transfusion in a patient under anesthesia are :
1)immediate rapid severe & progressive hypotension
3)oozing from wound
5)bronchospasm,raising airway pressures on IPPV.
6)later,jaundice & oliguria in 5-10% of these patients.
This strongly resembles anaphylactic reactions.
correct choice: (d) increased cyanosis
The local anesthetic associated with vasoconstriction & mydriasis :
reference:Lees synopsis 12th edition pg :592
cardiovascular effects of cocaine:
· small doses increase pulse rate,raises blood pressure
· potentiate the effects of adrenaline on capillaries.
· cutaneous vasoconstriction prevents heat loss.
· hypertension & vasospasm may lead to vascular accidents.
effects on eye:
· mydriasis due to sympathetic stimulation.
· blanching of conjunctiva from vasocnstriction
· clouding of corneal epithelium.
· ulceration of cornea,together with excellent analgesia
correct choice: (c) cocaine
Pes anserinus is related to :
a) cervical sympathetic trunk
b) facial nerve
c) trigeminal nerve
d) chorda tympani
reference:keith l.moore 3rd edition,pg 482
Pes anserinus(feet of a goose) is referred to the terminal branching pattern of the facial nerve in the substance of the parotid gland,forming a surgical plane (FACIO VENOUS PLANE OF PATEY),dividing the parotid into a superficial and a deep lobe.
1) cervical sympathetic trunk : is known as ansa cervicalis.
2) facial nerve : correct choice;explained above.
3) trigeminal nerve :wrong option
4) chorda tympani : its a branch of facial nerve,which is secretomotor to the submandibular and sublingual glands;and also carries taste sensation from anterior 2/3rd of the tongue.not related to pes anserinus.
correct choice:(b) facial nerve
Not attached to mastoid process is :
reference:osteology by poddar,pg 52
The mastoid is divided into following parts for convenience :
I)External surface: It gives insertion to Sternocleidomastoid,Splenius capitis and longissimus capitis muscles.
II)Mastoid Notch : a deep notch which lies on the medial aspect of the process;the notch and the part below it gives origin to the Posterior belly of diagastric muscle.
III)Occipital groove: a shallow groove below the notch;lodges the occipital artery.
correct choice:(b) temporalis