ANESTHESIA 9 TH EDITION
,TABLE OF CONTENTS
Section I: Introduction and Overview
Chapter 1. The History of Anesthesia
Chapter 2. Scope of Practice
Chapter 3. Occupational Health
Chapter 4. Anesthetic Risk, Quality Improvement, and Liability
Chapter 5. Electrical and Fire Safety
Section II: Basic Science and Fundamentals
Chapter 6. Genomic Basis of Perioperative Medicine
Chapter 7. Experimental Design and Statistics
Chapter 8. Inflammation, Wound Healing, and Infection
Chapter 9. The Allergic Response
Chapter 10. Mechanisms of Anesthesia and Consciousness
Chapter 11. Basic Principles of Clinical Pharmacology
Section III: Physiology and Pharmacology
Chapter 12. Cardiac Anatomy and Physiology
Chapter 13. Cardiovascular Pharmacology
Chapter 14. Autonomic Nervous System Anatomy and Physiology
Chapter 15. Respiratory Function in Anesthesia
Chapter 16. Fluids, Electrolytes, and Acid-Base Physiology
Chapter 17. Hemostasis and Transfusion Medicine
Section IV: Anesthetic Agents
Chapter 18. Inhaled Anesthetics
Chapter 19. Intravenous Anesthetics
Chapter 20. Opioids
Chapter 21. Neuromuscular Blocking Agents
Chapter 22. Local Anesthetics
Section V: Preoperative Evaluation and Monitoring
Chapter 23. Preoperative Patient Assessment and Management
Chapter 24. Rare Coexisting Diseases
,Chapter 25. The Anesthesia Workstation and Delivery Systems for Inhaled Anesthetics
Chapter 26. Commonly Used Monitoring Techniques
Chapter 27. Echocardiography
Chapter 28. Airway Management
Chapter 29. Patient Positioning and Potential Injuries
Chapter 30. Monitored Anesthesia Care
Section VI: Specialized Anesthesia Practice
Chapter 31. Ambulatory Anesthesia
Chapter 32. Office-Based Anesthesia
Chapter 33. Nonoperating Room Anesthesia
Chapter 34. Anesthesia for the Older Patient
Chapter 35. Neuraxial Anesthesia
Chapter 36. Peripheral Nerve Blockade
Section VII: Subspecialty Anesthesia
Chapter 37. Anesthesia for Neurosurgery
Chapter 38. Anesthesia for Thoracic Surgery
Chapter 39. Anesthesia for Cardiac Surgery
Chapter 40. Anesthesia for Vascular and Endovascular Surgery
Chapter 41. Obstetric Anesthesia
Chapter 42. Neonatal Anesthesia
Chapter 43. Pediatric Anesthesia
Section VIII: Anesthesia for Surgical Specialties
Chapter 44. Anesthesia for Laparoscopic and Robotic Surgeries
Chapter 45. Anesthesia and Obesity
Chapter 46. The Liver: Surgery and Anesthesia
Chapter 47. Endocrine Function
Chapter 48. Anesthesia for Otolaryngologic Surgery
Chapter 49. Anesthesia for Ophthalmologic Surgery
Chapter 50. The Renal System and Anesthesia for Urologic Surgery
Chapter 51. Anesthesia for Orthopedic Surgery
Chapter 52. Transplant Anesthesia
Chapter 53. Trauma and Burns
Section IX: Recovery, Pain, and Critical Care
,Chapter 54. Postanesthesia Recovery
Chapter 55. Acute Pain Management
Chapter 56. Chronic Pain Management
Chapter 57. Critical Care Medicine
Chapter 58. Cardiopulmonary Resuscitation
Chapter 59. Disaster Preparedness
Total Chapters: 59
Total Questions: 885
Section I: Introduction and Overview
Chapter 1: The History of Anesthesia
Question 1
Which event is most commonly recognized as the beginning of modern surgical anesthesia?
A. Discovery of chloroform by James Young Simpson
B. Public demonstration of ether anesthesia by William T.G. Morton in 1846
C. Introduction of nitrous oxide by Joseph Priestley
D. Development of local anesthesia by Carl Koller
Correct Answer: B
Rationale: The public demonstration of ether anesthesia by William T.G. Morton at
Massachusetts General Hospital on October 16, 1846, is widely considered the birth of modern
anesthesia. The successful use of ether during surgery demonstrated that pain could be
effectively controlled, revolutionizing surgical practice worldwide.
Why not the others?
• A: Chloroform was introduced later.
• C: Priestley discovered nitrous oxide but did not establish surgical anesthesia.
• D: Local anesthesia came decades afterward.
Question 2
Who is credited with discovering the anesthetic properties of nitrous oxide and demonstrating
its ability to reduce pain during dental procedures?
,A. John Snow
B. Horace Wells
C. William Halsted
D. Crawford Long
Correct Answer: B
Rationale: Horace Wells, a dentist, observed the analgesic effects of nitrous oxide and used it for
tooth extraction in 1844. Although his public demonstration was not fully successful, his work
laid the foundation for future anesthetic developments.
Why not the others?
• A: John Snow advanced anesthetic administration.
• C: Halsted pioneered nerve blocks.
• D: Long used ether before Morton.
Question 3
Which physician is credited with performing the first documented surgical procedure using ether
anesthesia in 1842?
A. William T.G. Morton
B. Horace Wells
C. Crawford W. Long
D. Joseph Lister
Correct Answer: C
Rationale: Crawford W. Long used ether during surgical excision of a neck tumor in 1842.
Although he did not immediately publish his findings, historical evidence confirms his priority in
using ether for surgery.
Why not the others?
• A: Morton popularized ether publicly.
• B: Wells focused on nitrous oxide.
• D: Lister is known for antiseptic surgery.
Question 4
John Snow's major contribution to anesthesia was:
,A. Discovery of ether
B. Development of antiseptic surgery
C. Scientific administration and monitoring of anesthesia
D. Discovery of neuromuscular blockers
Correct Answer: C
Rationale: John Snow developed techniques for precise anesthetic delivery and patient
observation. He designed inhalers, documented anesthetic effects, and established many
principles that contributed to modern anesthesiology.
Why not the others?
• A: Ether was not discovered by Snow.
• B: Lister developed antiseptic methods.
• D: Neuromuscular blockers were introduced much later.
Question 5
Which anesthetic agent became popular after being introduced by James Young Simpson in
1847?
A. Ether
B. Nitrous oxide
C. Chloroform
D. Cyclopropane
Correct Answer: C
Rationale: James Young Simpson introduced chloroform as an anesthetic in obstetric and
surgical practice. Its rapid onset and pleasant odor made it popular despite later recognition of
significant toxicity risks.
Why not the others?
• A: Ether was already in use.
• B: Nitrous oxide predates Simpson.
• D: Cyclopropane appeared decades later.
Question 6
The acceptance of obstetric anesthesia significantly increased after chloroform was administered
during the delivery of:
,A. Queen Victoria
B. Marie Antoinette
C. Florence Nightingale
D. Queen Elizabeth I
Correct Answer: A
Rationale: John Snow administered chloroform to Queen Victoria during childbirth in 1853. This
event greatly improved public and professional acceptance of obstetric anesthesia.
Why not the others?
• B: No association with anesthesia history.
• C: Nightingale was a nursing pioneer.
• D: Lived centuries before anesthetic development.
Question 7
Which discovery greatly improved patient safety by allowing direct visualization of the airway?
A. Capnography
B. Pulse oximetry
C. Laryngoscopy
D. Echocardiography
Correct Answer: C
Rationale: The development of laryngoscopy enabled direct visualization of the vocal cords,
facilitating endotracheal intubation and improving airway management during anesthesia.
Why not the others?
• A: Monitors ventilation.
• B: Measures oxygen saturation.
• D: Evaluates cardiac function.
Question 8
The introduction of curare into clinical anesthesia primarily enabled:
A. Better analgesia
B. Improved muscle relaxation during surgery
,C. Faster recovery from anesthesia
D. Prevention of postoperative nausea
Correct Answer: B
Rationale: Curare was the first widely used neuromuscular blocking agent. It allowed surgeons
to achieve profound muscle relaxation while reducing the need for deep anesthetic levels.
Why not the others?
• A: Curare has no analgesic properties.
• C: It does not hasten recovery.
• D: It does not prevent nausea.
Question 9
Who is most associated with the development of spinal anesthesia?
A. August Bier
B. William Halsted
C. Joseph Priestley
D. Harvey Cushing
Correct Answer: A
Rationale: August Bier performed pioneering work in spinal anesthesia in the late nineteenth
century and documented its physiologic effects and clinical applications.
Why not the others?
• B: Known for regional nerve blocks.
• C: Discovered nitrous oxide.
• D: Neurosurgery pioneer.
Question 10
Pulse oximetry became a major advancement because it:
A. Measures cardiac output directly
B. Detects tissue oxygen saturation continuously and noninvasively
C. Replaces arterial blood gas analysis
D. Measures anesthetic depth
Correct Answer: B
,Rationale: Pulse oximetry provides continuous monitoring of arterial oxygen saturation, allowing
early detection of hypoxemia and significantly improving patient safety.
Why not the others?
• A: Does not measure cardiac output.
• C: Does not replace blood gas analysis.
• D: Does not assess anesthetic depth.
Question 11
Which organization was established to improve standards and patient safety in anesthesiology?
A. World Health Organization
B. American Society of Anesthesiologists
C. American Heart Association
D. Joint Commission International
Correct Answer: B
Rationale: The American Society of Anesthesiologists (ASA) has played a central role in
education, standards development, patient safety initiatives, and professional advancement of
anesthesiology.
Why not the others?
• A: Global health organization.
• C: Focuses on cardiovascular health.
• D: Accreditation organization.
Question 12
The development of capnography improved anesthetic care primarily by monitoring:
A. Blood pressure
B. Neuromuscular function
C. Ventilation and carbon dioxide elimination
D. Cerebral blood flow
Correct Answer: C
Rationale: Capnography continuously measures exhaled carbon dioxide and provides valuable
information regarding ventilation, airway integrity, and circulatory status.
, Why not the others?
• A: Blood pressure requires separate monitoring.
• B: Neuromuscular monitoring uses nerve stimulators.
• D: Not directly measured.
Question 13
Which pioneer is associated with the development of regional anesthesia using cocaine?
A. Carl Koller
B. John Snow
C. Horace Wells
D. James Simpson
Correct Answer: A
Rationale: Carl Koller demonstrated the use of cocaine for topical anesthesia in ophthalmic
surgery, marking a major advance in regional anesthetic techniques.
Why not the others?
• B: Focused on inhalational anesthesia.
• C: Nitrous oxide pioneer.
• D: Introduced chloroform.
Question 14
The dramatic reduction in anesthesia-related mortality during the twentieth century is most
closely linked to:
A. Elimination of inhalational agents
B. Improved monitoring, training, and safety standards
C. Exclusive use of regional anesthesia
D. Reduction in surgical volume
Correct Answer: B
Rationale: Advances in physiologic monitoring, standardized training, airway management,
equipment design, and patient safety initiatives have substantially reduced anesthesia-related
complications and mortality.
Why not the others?