Board Question 2

Front 1

The pt in labor has a hx of multiple sclerosis. She becomes hypotensive. What is the agent of choice
to treat this hypotension.

Back 1

A specific interaction b/w multiple sclerosis and the treatment of hypertension is not discussed in
textbooks. Therefore treat the hypotension as you would for the normal OB Pt. 1) LUD 2) IV
hydration 3) Vasopressors

Front 2

What blood products reverses the effects of warfarin therapy?

Back 2

FFP

Front 3

What is the anion gap? What is the utility of measuring the anion gap?

Back 3

AG = major measured cations - major measured anions = Na - Cl - HCO3 = 12 meq/liter (range 9-
15) It is used as differential for met. acidosis as some forms have AG > 25y

Front 4

What are causes of high anion gap metabolic acidoses?

Back 4

1) acids are not excreted by kidney (CRF or uremia) 2) increase in endogenous acid production (both
lactic acidosis and ketoacidosis are assoc with High AG) 3) exogenous acids are ingested (methanol or
ethylene glycol)

Front 5

What are causes of normal AG metabolic acidosis?

Back 5

1) GI loss of bicarb (diarrhea) 2) Renal loss of bicarb (pts taking carbonic anhydrase inhibitors) 3) ECF
volume is expanded rapidly (large infusion of NS) 4) large quantity of ammonium chloride or arginine
hydrochloride is given

Front 6

Heat is lost from the body by conduction, convection, evaporation, and radiation. Rank these from
most to least heat loss.

Back 6

Radiation>convection>evaporation>conduction

Front 7

For each degree celsius decrease in temp, metabolism decreases by what percent?

Back 7

7%

Front 8

During a TURP, confusion and restlessness occur, blood pressure increases to 165/105, ECG changes
are noted (widened QRS and elevated ST segment), and then the pt seizes. What will happen?

Back 8

These are S/S of TURP syndrome and the cause is hyponatremia. Coma and arrest will follow without
treatment.

Front 9

What actions should be initiated if TURP syndrome develops.

Back 9

1) O2 and circulatory support 2) notify surgeon to stop procedure ASAP 3) use invasive monitors if
CV status is instable. 4) send lytes, creatinine, glucose and ABG 5) obtain twelve lead 6) treat severe
symptoms with hypertonic (3%) saline at rate <100ml/hour. (treat mild symptoms with fluid restriction
and loop diuretic)

Front 10

Your healthy young pt is in the sitting position for an open craniotomy under GETA when suddenly
ETCO2 drops, what is the probable cause?

Back 10

sudden drop in ETCO2 followed by sudden rise in nitrogen is cause by VAE

Front 11

What actions should you take with VAE?

Back 11

notify surgeon to flood field, turn off N2O, 100% O2, aspirate air from central line, irrigate op site
with fluid and use bone wax, infuse fluids to increase venous pressure, give pressors, temporarily
compress right and left juglular veins to increase vertebral venous pressure and slow air entrainment,
and place pt in horizontal position if possible.

Front 12

If your initial action to treat VAE fail, what position should you place the pt.

Back 12

LLD with head down (trend)

Front 13

When do S/S of hypocalcemia after thyroidectomy develop?

Back 13

24-72 hours but may manifest 1-2 hours post surgery.

Front 14

Following a parathyroidectomy, your pt becomes dyspneic one day post surgery. What do you
suspect and what do you do?

Back 14

hypocalcemia, give 10 ml of calcium gluconate over several minutes and follow with 1-2 mg/kg/hour
of elemental calcium until symptoms disappear.

Front 15

What are the two causes of stridor after thyroidectomy?

Back 15

hypocalcemia secondary to removal of parathyroid bliateral damage to RLN

Front 16

Why would a pt having undergone thyroidectomy develop laryngospasm?

Back 16

hypocalcemia secondary to removal of parathyroids, laryngeal muscles are very sensitive to
decreased calcium.

Front 17

Treatment of tetany in the hypoparathyroid pt consists of administering what?

Back 17

calcium gluconate IV

Front 18

After a laryngospasm that was treated with succinylcholine and reintubation, what additional actions
may be beneficial for the patient?

Back 18

assist ventilation and sedation.

Front 19

Postop, your pt develops a laryngospasm which is ultimately treated successfully with
succinylcholine. Pink frothy sputum is now present. What would you expect and what is your course of
action?

Back 19

Negative pressure pulmonary edema increase FiO2, CPAP, PEEP Diuretics and fluid restriction
typically not required as this is usually self correcting within 24 hours.

Front 20

The 78 yr old female pt has a pacemaker. During the case, the ECG reveals a-fib with severe
bradycardia. O2 is given and the airway is controlled, what is your next action.

Back 20

Atropine 0.5 to 1.0 mg repeated up to three times.

Front 21

What is the major concern for noncardiac surgery pt with CHF?

Back 21

increased risk for postop death

Front 22

Your patient had a total knee replacement under spinal with tetracaine. Several hours postop she is
complaining of severe pain in both extremities. You should do what?

Back 22

give pain medicine as this procedure is assoc with significant postop pain.

Front 23

What seven cardiac parameters are observed or estimated with 2D TEE?

Back 23

Ventricular wall motion, valve motion, ejection fraction, CO, Blood flow characteristics, intracardiac
air, intracardiac mass

Front 24

2D TEE is a sensitive indicator of wall motion abnormalities. Furthermore, wall motion abnormalities
may be more sensitive indicators of MIsch than ECG changes. List and define the four types of abnormal
wall motion.

Back 24

Hypokinesis - presence of less than normal ventricular motion Hyperkinesis - presence of greater
than normal motion Akinesis - absence of motion Dyskinesis - paradoxic outward motion of ventricle

Front 25

Where on the capnograph tracing is found dead space plus alveolar ventilation?

Back 25

throughout expiration on the tracing

Front 26

What evoked potential is monitored during transphenoidal surgery?

Back 26

Visual (CN II)

Front 27

The wake up test monitors what region of the spinal cord?

Back 27

ventral cord supplied by anterior spinal artery

Front 28

What 3 antiemetics should be avoided in the parkinson pt? What antiemetic might be used to treat
postperative nausea in parkinsons's patients?

Back 28

inapsine, compazine, reglan


Zofran is acceptable.

Front 29

In a pt with cirrhosis of the liver, why is it impt to maintain BP?

Back 29

BP must be maintained b/c liver does not autoregulate (hepatic artery)

Front 30

What S/S of acute porphyria?

Back 30

acute abdominal pain, neurotoxicity, sensory and other neuropathies

Front 31

Of the following tests, which is best for determining CAD: resting ECG, Holter monitoring, stress ECG
(exercise), stress thallium ECG

Back 31

stress (exercise) test/ecg

Front 32

What four groups of pts are at risk for intraop hypothermia?

Back 32

1) pediatric 2) geriatric 3) hypothyroid 4) those with hypothalamic lesions

Front 33

The gas that enters the bellows during expiration has what composition?

Back 33

During the expiration phase of the ventilatory cycle, exhaled gases from the patient and fresh
anesthetic gases flow into the bellows.

Front 34

Identify the 13 best selling herbal medicines/supplements and also give the scientific name.

Back 34

ginseng - pana ginseng ginkgo - ginkgo biloba garlic - allium sativum glucosamine St. John's wort -
hypericum perforatum Echinacea - echinacea angustifolia, e. purpurae, e. pallida lecithin
chondroitin creatine saw palmetto - serenoa repens ephedra - ma-huang kava kava - piper
methysticum valerian - valeriana officinalis

Front 35

What happens to intrapulmonary pressure during normal inspiration? Expiration? When is
intrapulmonary pressure zero?

Back 35

Intrapulmonary pressure becomes negative or subatmospheric during inspiration and positive (above
atm pressure) during expiration. Intrapulmonary pressure is zero at end expiration and at end
inspiration.

Front 36

If the patient with cardiac tamponade need to be induced, what agent should be selected?

Back 36

Ketamine and 100% oxygen after decompression of pericardial space.

Front 37

What should the preop eval of the pt with DM focus on? why?

Back 37

End organ complications - predictor of periop M&M

Front 38

How does FRC compare with CC in the morbidly obese pt in supine position?

Back 38

CC exceeds FRC in morbidly obese pt in all positions.

Front 39

How does ERV compare with CV in the morbidly obese individual in the supine position?

Back 39

Closing volume exceeds expiratory reserve volume in the standing, supine and T-burg position.

Front 40

Identify the opioid most likely to be administered epidurally as a bolus for postop pain control after
mixing with 10ml of preservative free saline.

Back 40

Fentanyl. Fentanyl is the most commonly used lipophilic agent administered as a bolus into the
epidural space for analgesia. It is mixed in 10 ml of preservative free normal saline. Other lipophilic
opioids are mixed in the following volumes of preservative free saline: sufenta (10-60ug) in 10-
20ml Demerol (25-100ug) in 10 ml hydromorphone (.5-2 mg) in 10 ml

Front 41

List five adverse effects of mannitol administration.

Back 41

1) pulmonary edema and cardiac decompensation owing to increased (mannitol induced) in
intravascular volume 2) Rebound increase in ICP if BBB is not intact 3) Hypovolemia 4)
Hyperkalemia 5) Hyponatremian.

Front 42

A trauma patient has a fracture of T1, at the time of injury, what happens to BP and heart rate.

Back 42

This is acute spinal shock, hypotension develops because the sympathetic outflow to blood vessels
ceases; blood vessels dilate causing the decrease in blood pressure. Since the cardiac accelerator fibers
are involved (T1-4) bradycardia occurs.

Front 43

Relate "convulsant activity" to the "seizure threshold". How does acidosis affect convulsant activity?
How does acidosis affect seizure threshold.

Back 43

Acidosis increases seizure threshold and decreases convulsant activity.

Front 44

The sympathetic response to spinal anesthesia occurs because LAs act on what neurons?

Back 44

sympathetic PREganglionic EFFerents

Front 45

The anesthetic level reached after SAB is determined by what four factors?

Back 45

1) baricity of solution 2) concentration (increasing concentration increases spread) 3) contour of
spinal canal 4) position of patient in the first few minutes after placement

Front 46

What muscles are innervated by the ulnar nerve?

Back 46

in the foream - flexor carpis ulnaris, medial half of flexor digitorum profundus in the hand - palmaris
brevis, three short muscles of hypothenar eminence, the adductor pollicis and 3rd & 4th lumbricals and
all the interossei

Front 47

When performing an epidural, what should alert the anesthetist to the fact that an intrathecal
injection has occurred?

Back 47

A profound motor block and sensory block soon after an unintended SA injection should alert the
anesthetist to the fact that an intrathecal injection has occurred. The next S/S of high spinal are 1)
dyspnea caused by absence of proprioceptive input from afferent nerves of abdominal and intercostal
muscles, 2) respiratory arrest if block spreads to cervical regions C3-C5, 3) High concentration of LA
reaches cranium and LOC, respiratory arrest and hypotension occur.

Front 48

The ulnar nerve passes distally through the axilla, medial to the distal artery and the brachial artery,
until the middle of the arm. Before passing to the forearm, the ulnar nerve pierces the medial
intermuscular septum and descends in the groove b/w what two stuctures.

Back 48

the medial epicondyle of the humerus and the olecranon process of the ulna.

Front 49

The median nerve innervates what muscles of the forearm.

Back 49

pronator teres, flexor carpi radialis, palmaris longus, flexor digitorum superficialis

Front 50

What nerve is least likely to be blocked with the axillary approach to the brachial plexus? Why?

Back 50

The musculocutaneous nerve is least likely to be blocked with the axillary approach to the brachial
plexus b/c within the axilla, this nerve has already left the sheath and lies within the coracobrachialis
muscle.

Front 51

What local anesthetics are used for IVRA of the upper arm? What volume and what concentrations
are administered?

Back 51

40-50 ml of 0.5% lidocaine or 0.5% prilocaine are usually injected

Front 52

Which three of the five sensory nerves of the foot are usually blocked by the superficial infiltration.

Back 52

superficial peroneal, sural, and the saphenous

Front 53

While performing an epidural, what signs and symptoms would lead the anesthetist to suspect that
an intrathecal injections has occurred?

Back 53

1) dyspnea with levels higher than T2 secondary to absence of proprioceptive input from the afferent
fibers in the abdomen and intercostals 2) respiratory arrest if C3-5 affected 3) profound hypotension if
LA passes through foramen magnum and blocks the cranial nerves, a "total spinal"

Front 54

Complications of epidural block differ from SAB in what way?

Back 54

There is increased likelihood of intravascular injection and systemic toxicity with epidural block.

Front 55

What causes the backache associated with epidural anesthesia?

Back 55

unclear, but could be needle trauma, local anesthetic irritation, ligamentous strain secondary to
muscle relaxation

Front 56

What prophylactic treatments should be given in an emergency appendectomy?

Back 56

1) antacid 2) H2 blocker 3) reglan 4)RSI/C

Front 57

How does the intrapleural pressure fluctuate during normal tidal breathing?

Back 57

Intrapleural pressure is negative at the onset of inspiration and becomes more negative during
inspiration. During expiration, intrapleural pressure becomes less negative.

Front 58

Which zone of the lung (1,2,3) has the greatest alveolar oxygen partial pressure and which zone has
the greatest alveolar CO2 partial pressure when the patient is upright?

Back 58

Zone 1 the non dependent lung has the highest PaO2 and zone 3 the dependent lung has the highest
PACO2.

Front 59

Compare intrapleural pressure in the dependent versus nondependent lung?

Back 59

Intrapleural pressure is less negative (or greater) in the dependent lung and more negative (lower) in
the nondependent lung

Front 60

How does the alveolar partial pressures of O2 and CO2 vary from base to apex when the patient is
upright?

Back 60

The alveolar partial pressure of O2 (PAO2) is higher in the apex and lower in the base, and the
alveolar partial pressure of CO2 (PACO2) is lower in the apex and higher in the base.

Front 61

Compare Pulmonary arterial blood pressur and intrapulmonary pressure in Zone 2 of the lung. Is Zone
2 perfused? What is the perfusion pressure gradient in Zone 2

Back 61

PABP is higher than alveolar pressure in Zone 2. Zone 2 is perfused. The perfusion pressure gradient
in Zone 2 is PABP minus PA.

Front 62

Compare pulmonary arterial blood pressure and intrapulmonary pressure in Zone I. Is Zone 1
perfused? Why or Why not?

Back 62

Intrapulmonary pressure exceeds pulmonary arterial blood pressure in Zone 1. Zone 1 is not perfused
because pulmonary artery pressure is less than alveolar pressure. The alveolar capillaries are collapsed.

Front 63

How do pulmonary arterial and venous blood pressures compare to intrapulmonary pressure in Zone
3 of the lung? What is the perfusion pressure gradient in Zone 3?

Back 63

Pulmonary arterial and venous pressures exceed alveolar pressure in Zone 3. The perfusion pressure
gradient in Zone 3 is the difference between the pulmonary arterial blood pressure and the venous
blood pressure.

Front 64

What is the normal venous-arterial CO2 content difference (CvCO2-CaCO2)? How many ml of CO2
are eliminated from each 100ml of blood?

Back 64

The normal difference is 4mlCO2/100ml blood. Hence 4ml CO2 are eliminated per 100 ml of blood.

Front 65

What is the difference between physiologic and anatomic dead space?

Back 65

Physiologic dead space is the sum of anatomic dead space and alveolar dead space. Physiologic dead
space minus anatomic dead space is therefore alveolar dead space. Alveolar dead space is caused by
unperfused or poorly perfused alveoli. Hence, the difference between physiologic dead space and
anatomic dead space is unperfused or underperfused alveoli. Vd(phys) = Vd(anat) + Vd(alveolar)

Front 66

What intrinsic laryngeal muscle dilates the cords?

Back 66

PCA (post. cricoarytenoids)

Front 67

Injury to what nerve will prevent the vocal cords from coming together? What intrinsic laryngeal
muscles are involved?

Back 67

RLN, the paralyzed cords assume a position intermediate b/w the abducted and adducted states.
The lateral cricoarytenoids causes adduction of the cords.

Front 68

If you have a known difficult airway with an aspiration risk, what steps can be taken to minimize
problems during intubation?

Back 68

1) gastric prep 2) robinul 3) awake intubation with topicalization of airway (topical LA should be
limited to above the glottis in order to maintain airway reflexes

Front 69

What lab value would you order for a healthy 35 y/o male scheduled for hernia surgery?

Back 69

None for healthy males less than 40 and HgB/BHCG for females less than 40.

Front 70

Cryoprecipitate is derived from what?

Back 70

It is the fraction of plasma that precipitates when FFP is thawed at 4 degreees Celsius.

Front 71

What does citrate do in stored blood?

Back 71

Anticoagulant by binding calcium (results in lack of ionized calcium)

Front 72

What volume expander expands volume for 36 hours?

Back 72

Hetastarch (Hespan)

Front 73

Intraop the surgeon order Dextran 40. What are the indications for dextran 40, what is the
appropriate dose, and what are the potential complications?

Back 73

Improves blood flow through the microcirculation presumably by decreasing blood viscosity.
Thereby, it is used most often to prevent thromboembolism. Max dose is 20ml/kg/day or about
58ml/hour for typical 70 kg patient. SEs - interference with blood typing, prolong bleeding time, renal
failure, anaphylactoid rxn,

Front 74

Which local amide is most cardiotoxic? Why?

Back 74

Marcaine, Fast in/ Slow out kinetics and binds avidly to sodium
channels. Marcaine>etidocaine>ropivicaine>

Front 75

What are the three most cardiotoxic LA?

Back 75

Marcaine>etidocaine>ropivicainem

Front 76

An anticholinesterase such as neostigmine is accidently infused continously in high doses. In addition
to profound parasympathetic effects what else could conceivably happen?

Back 76

Depolarizing muscle blockade

Front 77

Of the following drugs, which increases GI tone and motility? atropine, demerol, neostigmine,
epinephrine

Back 77

Neostigmine (all the others depress GI tone and motility)

Front 78

What is accomplished when drugs undergo biotransformation reactions?

Back 78

They often become more water soluble and inactive which permits excretion in the urine or bile.

Front 79

The cytochrome P450 system is responsible for metabolizing more than one half of all currently
available drugs. List six groups of drugs metabolized by the cytochrome p450 system?

Back 79

barbs, opioids, amide LA, TCAs, antihistamines, BDZs?

Front 80

List three factors that stimulate secretion of renin.

Back 80

1) decreased renal perfusion r/t hemorhagge, hypovolemia, or renal artery stenosis 2) beta 1
agonism 3) HYPONATREMIA

Front 81

Where is alkaline phosphatase normally excreted in large amounts?

Back 81

In the bile, since large amounts are found in the biliary duct cells

Front 82

How many ml of CO2 are expired from the lungs per 100ml blood?

Back 82

4ml Normally, CO2 excretion is 200ml/min, since CO is 5L/min or 5000ml/min the CO2 excretion per
100 ml of blood is 200ml CO2/5000 ml blood or 4 ml/100ml

Front 83

How much CO2 normally is produced and eliminated per minut? How much CO2 is produced and
eliminated in ml/kg/min?

Back 83

CO2 is produced and eliminated at a rate of 200ml/min or 2.4-3.2 ml/kg/min

Front 84

What determines mixed venous oxygen content? (MvO2)

Back 84

1) oxygen delivery to tissues - CO, HgB 2) oxygen consumption - MH, thyroid storm, fever, shivering

Front 85

What two changes can cause SaO2 to remain normal and SvO2 to decrease?

Back 85

1)decrease in O2 delivery (decreased CO, decreased HgB) with resulting increased O2 extraction from
blood 2) an increase in O2 consumption (Fever, shivering, MH, thyroid storm)

Front 86

In a young, normal healthy adult, what is the difference between PaO2 an PvO2: 20, 40, 60, 80, or
100mmHg?

Back 86

60 mmHg PaO2 roughly 100mmHg PvO2 roughly 40mmHg

Front 87

What is the principle reason blood flow to dependent lungs is greater than flow to nondependent
lung?

Back 87

Gravity

Front 88

What is the most common reason for a backache after epidural or spinal anesthesia?

Back 88

It is generally accepted that backache most commonly occurs after procedures in which there is
flattening of the normal lumbar curve owing to RELAXATION OF THE PARASPINOUS muscles allowing for
stretch of the joint capsules and spinous ligaments.

Front 89

After a mediastinal resection, the patient presents with SOB, unilateral breath sound, tracheal
deviation, and an increased PIP. What has occurred? What do you prepare to do?

Back 89

The S/S suggest pneumonthorax, the second most common complication of mediastinoscopy
(hemorhage is most common). The hallmark signs of tension pneumothorax are hypotension,
hypoxemia, tachycardia, increased central venous pressure, and increased PIP. Other findings include
absence of breath sounds on the affected side, asymmetric chest wall movement, tracheal shift,
displacement of the cardiac impulse, hyperresonance to percussion, and extreme anxiety. Tension
pneumothorax is potentionally lethal; therefore immediate treatment is essential. Chest decompression
should be accomplished by placing a large bore needle through the chest wall in the second intercostal
space midclavicular line. The needle should be left in place until a tube thoracotomy is performed.

Front 90

During resuscitation, if venous access has not or cannot be established, what route of administration
can result in high peak plasma drug levels?

Back 90

Intratracheal administration of resuscitative drugs through an endotracheal tube results in high peak
plasma drug levels, nearly identical to IV route.

Front 91

What is the most reliable way to assess cerebral perfusion during a CEA?

Back 91

Keeping in mind that the purpose of neurologic monitoring is to identify patients at risk for adverse
neurologic outcome due to the development of cerebral ischemia, particularly during carotid crossclamping,
an awake patient represents the most sensitive and least expensive neurologic function
monitor during CEA. Other monitoring techniques (SSEP, EEG, stump pressure, transcranial doppler) can
identify significant decreases in cerebral perfusion. There is, however, controversy about how well these
more sophisticated techniques predict outcome.

Front 92

In the patient with PVD, the most common complications are related to what organ: liver, heart,
lungs, kidneys? explain your answer

Back 92

Complications associated with surgery in the patient with PVD are r/t the heart (cardiac). CAD is the
leading cause of periop mortality at the time of peripheral vascular surgery. About 5% of patients with
PVD have a myocardial infarction in the periop period and 1.6% die. More than 50% of patients with
atherosclerotic disease have an advanced or severe CAD while less than 10% have normal coronary
arteries

Front 93

Your patient is having a cerebral vasospasm. What should be done first? What additional actions
may be necessary?

Back 93

The initial approach to the patient involves fluid and blood pressure managment. It the patient has
evidence of evolving vasospasm and is not symptomatic, intravascular volume should be expanded and
blood pressure should be increased to the upper extreme of the patients blood pressure.

Front 94

If the patient with a cerebral vasospasm develops neurologic deficits, what additional two therapies
may be instituted?

Back 94

1) the institution of hypertensive-hypervolemic-hemodilution thereapy may ve warranted 2) the next
phase of patient management involves the use of drugs aimed at lessening brain ischemia. This goal is
best achieved by the use of the CCB nimodipine

Front 95

What is the name of the regulator that is found on cylinder tanks?

Back 95

Bourdon gauges

Front 96

What do pressure reducing devices (regulators) do?

Back 96

Pressure reducing regulators reduce the high and variable pressure in a cylinder to a lower pressure
(40-48 psig). Gas flow is maintained constant without changing the supply pressure.

Front 97

What do second stage reducing devices (regulators) do?

Back 97

Second stage regulators receive gas from either the pipeling or the cylinder reducing device
(regulator) and reduce the pressure to 26 psig for nitrous and 14 psig for oxygen. The purpose of the
second stage regulators is to eliminate fluctuations in pressure, so flow remains constant.

Front 98

What are the components of the low pressure system of the anesthesia machine?

Back 98

Components found in the low pressure system include 1) flow indicators, 2) vaporizers, 3) vaporizer
circuit control valves, 4) back pressure safety devices, 5) low pressure safety devices, and 6) CGO

Front 99

Which sleeping aid supplement can readily cross the BBB and may interact with other CNS agents,
including hypnotics, sedatives, or psychotropics? What are other common uses of this supplement?

Back 99

Melatonin crosses BBB and increases BDZs binding to receptors enhancing activity. In addition to
being sold as a sleep aid, melatonin is also sold as a remedy for jet lag, shift work, and depression NOTE:
recent studies indicate that preop use of melatonin rivals effectiveness of versed.

Front 100

During an anesthetic the fail safe shuts down all non oxygen gas flow. What happened?

Back 100

The oxygen pressure fell below 25-30 psi. When oxygen pressure falls below 25-30 psi (roughly 50%
of normal) a fail safe valve automatically closes the nitrous oxide and other gas lines to prevent
accidental delivery of a hypoxic gas mixture to the patient. A gas whistle or electric alarm sounds to alert
the anesthetist to this occurrence.

Front 101

What are the three characteristics of the high freq jet ventilator?

Back 101

1) small tidal volumes (less than dead space) 2) high ventilation rate (60-3600 breaths per minute) 3)
low airway pressure

Front 102

How is transtracheal ventilation performed?

Back 102

Transtracheal ventilation is performed by inserting a large catheter through the cricothyroid
membrane connecting it to a source of oxygen under pressure.

Front 103

Describe three systems that work reliably and can easily and inexpensively assemble for TTJV

Back 103

1) a jet injector (blow gun) is powered by regulated or unregulated pipeline oxygen pressure 2) a jet
injector is powered by an oxygen cylinder regulator 3) the anesthesia machine flush valve is used. The
fresh gas outlet of the anesthesia machine is connected to noncompliant tubing by standard 15mm
tracheal tube connector. The other end of the tubing is connected to the transtracheal catheter. NOTE:
Using the anesthesia breathing system or a self inflating resuscitation bag with a transtracheal catheter
will not produce effective ventilation

Front 104

If the oxygen partial pressure in arterial blood increases from 50 mmHg to 350 mmHg, the amount of
dissolved oxygen increases by how much?

Back 104

(.003*350)-(.003*50)= 0.90ml/100ml blood Be prepared to calculate an increase in dissolved O2
associated with an increase in PaO2

Front 105

How are flow and resistance related?

Back 105

Flow through a tube is inversely proportional to resistance. For example, if resistance doubles, flow is
halved. If resistance is halved, flow is doubled.