*洪维德主任 <全人麻醉照护>:1-2题 没有考讯 看考古题 *柯玟如医师 <Patient monitors>:6题 1.关於EEG用途的描述 共笔P20 2. pulse oximeter判读 受到哪些因素影响? 共笔P17有原理 以下是网路补充 用来量度的肢体不停震动 有不正常的血红素存在，如 Fetal Hb 、COHb、MetHb（变性血红素） 血液中有染剂存在时，如：甲基蓝、显影剂 皮肤有色素或有指甲油 血循环差，如：低血容性休克 (hypovolemic shock)、周边组织灌流低 测量的时候，暴露在额外的光源下 SpO2值＜70％时，就失去其客观性，需以动脉血氧测量 (ABG) 的PaO2为参考标准。 高胆红素血症 (bilirubin) 可影响SpO2正确的判读。 3. pulmonary artery catheterization 相关问题 共笔P12: cardiac output 测量 共笔P15, mixed venous blood的基本观念 4. a-line相关问题: colateral circulation 的什麽test的基本观念>>Allen’s test , a-line的注意事项(随堂考那一题)共笔P8上 5. CVP技术相关问题 共笔P9-10 : 打完後的确认动作 共笔P10表格最下方 6. 跟眼睛有关的signs 如何判断麻醉深度? 例如 cornea reflex消失(Stage III plane II) eyelash reflex丧失(Stage II), pupil light reflex(Stage III plane III) 老师没上 以下是补充 根据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 *陈在昕医师<Fluid management>:6题 老师出10题 主任挑6题 共笔已上传 礼拜四下午一点在PBL16发放 考古题最後5题特别重要 另外5题应该就是比较colloid 和crystalloid fluid 无法挖更多了XD 还是要读书 *徐士哲医师<吸入性麻醉剂与静脉麻醉剂>:6题 上课附重点 共笔上会标 无其他考讯 如无意外 礼拜四下午一点在PBL16也会发放 *游以舟医师<Pain mechanism>:6题 参考92级考古题 题目有变但题型类似 预估礼拜五发放 其他老师要请北极熊补充啦~~~嘎嘎嘎 --

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