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54 Cards in this Set
- Front
- Back
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Spectrophotometry
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The ability to perform quantitative measurements about light absorption as it passes through a substance
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Lambert-Beer law
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The absorption of light as it passes through a clear nonabsorbing solvent is proportional to the concentration of the solute and the length of the path the light has to travel in that solvent
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Red Light wavelength
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660 nm
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Infrared wavelength
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920 nm
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How does oximeter technology work?
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Oxyhemoglobin absorbs IR light/Not much red light
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How are dyshemoglobins monitored?
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CO- oximetry
(functional pulse ox will give a falsely high reading) |
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What can cause a false reading in an oximeter?
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carbon monoxide
dyshemoglobinemias hypothermia motion poor perfusion dyes anemia |
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If the BP cuff is too large you would expect the BP to be :
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Low
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How do you calculate MAP?
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(SBP)+2(DBP) / 3
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Artline contraindications
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- Raynauds
- Lack of artery - Poor allen's test |
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How is MAP calculated in an art line?
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Mean = Area / Base
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What are the names of the different parts of the arterial waveform?
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Anacrotic limb
Dicrotic limb Dicrotic notch Area Base |
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What is the anacrotic limb?
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inotropic state of the left ventricle
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what is the dicrotic notch?
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closure of the aortic valve (onset of diastole)
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what is the dicrotic limb?
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assessment of afterload or SVR
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what happens to the arterial pulsations as it travels away from the heart?
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Systole gets higher
Diastole gets lower MAP stays same |
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What is the preferred vein for CVC placement?
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Basilic Vein
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Distances from site to Vena Cava
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Internal Jugular 15-20 cm
Femoral Vein 30 cm R Antecubital 40 cm L Antecubital 50 cm |
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what are the problems associated with left IJ placement?
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thoracic duct problems
more difficult |
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complications of CVC placement
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Carotid artery puncture; most common
Can lead to hemorrhage needing surgical intervention Pneumothorax Infection Nerve damage Venous air embolim Thoracic duct injury (left) |
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What is no a wave indicative of in a CVP monitor?
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atrial fibrillation
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what is a large A wave indicative of in CVP monitoring?
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tricuspid stenosis, right ventricular failure, pulmonary stenosis, pulmonary hypertension
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What is a giant a or canon a indicative of in CVP monitoring?
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right atrium contracts with closed tricuspid,
nodal rythm, ventricular dysrythmias, heart block |
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What is no x or large v indicative of in CVP monitoring?
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tricuspid regurgitation
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What does PAC assess?
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left ventricular function
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PA catheter wave progression
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What are complications specific to PA catheter placement?
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Misplacement
Cardiovascular Stress Dysrhythmias Knotting Thromboemboli Infection Cardiac trauma Data misinterpretation PA perforation |
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With low cardiac output would you expect the tracing to be larger or smaller
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Larger. less dilution of cold injectate
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What are some uses for TEE
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Early ischemia and air embolus
Evaluation of hypovolemia Evaluation of intracardiac valve repairs Diagnostic for aortic disease and dissection Assess intracardiac mass |
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What modifications to inhaled anesthetics is required during SSEP?
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0.5-0.75 MAC
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What effect does NMB's have on MEP's?
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Obliterates recording
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What is the desired BIS range during GA?
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40-60
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Capnometry
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the measurment of CO2
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Capnography
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the recording and dispaying of CO2
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Mass Spectrometry
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seperating ions by their mass to analyze
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Raman scattering spectrometry
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beam of light collides with gas molecules
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Infrared spectrometry
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infrared beam absorbs spectrum of agents
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what are the two types of gas sampling?
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Diverting(most seen in clinic) and non- diverting.
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What phase does the ET CO2 Number come from?
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end of phase III
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What are possible causes for CO2 tracing to be above zero in phase I?
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rebreathing
exhausted CO2 absorber |
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What are some causes for slanted upstroke in phase II?
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prolonged expiratory time
bronchospasm, wheezing, COPD |
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What causes camel upstroke in phase II?
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uneven lung emptying
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What could cause sudden high plateau in phase III?
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tourniquet release
bicarb administration repurfusion during vascular graft |
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What could cause gradual increase in plateau of phase III?
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hypoventilation
excessive production absorption of insufflate |
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What could cause low plateau in phase III?
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Sudden (close to zero) IMMINENT DISASTER
Complete OT disconnection OT obstruction / kinked tube Ventilator malfunction Esophageal intubation Capnograph malfunction Consider last |
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What could cause an exponential decrease in CO2? (2-3 mins)
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Usually catastrophic CV event!
(sudden increase in dead space) PE Severe Hypotension Cardiac arrest |
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What causes sustained low CO2?
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emphysema
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What are some causes for irregular plateau in phase III?
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Poor mask fit
surgeon bumping chest respiratory effort (curare clefts) Slanted: asthma or bronchospasm |
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What causes slanted downstroke in phase IV?
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Abnormally slow inspiration
CO2 in inspired gas Malfunction of inspiratory valve of circle system |
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5 A's of GA
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Analgesia
Akinesia ANS control Altered LOC Amnesia |
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Stages of anesthesia
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What is 1 MAC?
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ED50
(50% of pt do not move to noxious stimuli) |
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What is 1.3 MAC?
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ED95
(90% pts dont move to noxious stimuli) |
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What is MAC BAR?
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1.7-2 MAC blocks autonomic response to noxious stimuli
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