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104 Cards in this Set
- Front
- Back
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Since 1988 anesthesia machines have been held to the standards of this body
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American Society of Testing and Materials
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What works on the anesthesia machine when the power is turned off
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outlet plugs
flush valve |
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Allows gas from a cylinder to enter the machine but prevents gas from exiting the machine when there is no cylinder in the yoke
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Check valve
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Kind of cylinder pressure indicator found on the anesthesia machine
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Bourdon tube
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Safety system for pipeline connections
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Diameter indexed safety system
DISS |
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Normal pipeline pressure reading on the pipeline guage
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45-55 PSI
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Amount of leakage allowed in the piping
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150 mL/min or less
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Standards mandate that whenever the oxygen supply is reduced below normal, the set oxygen concentration at the common gas outlet not fall below
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19%
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2 problems with using the flush valve
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barotrauma
dilutes anesthetic |
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How will the flowmeter change in a hyperbaric chamber
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more gas will be delivered than indicated
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How will the flowmeter change at high altitude
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Less gas will be delivered than indicated
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How will the flowmeter change at high altitude
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Less gas will be delivered than indicated
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Absorbs more infrared light. What frequency is this?
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Oxyhemoglobin
940 |
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Absorbs more red light. What frequency is this
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Deoxyhemoglobin
660 |
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What are three things that can cause pulse oximetry artifact
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bright light
motion electrocautery |
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Under what circumstances will the pulse ox give a falsely elevated reading
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Carboxyhgb
CO HgB S |
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Under what circumstances will the pulse ox read 85%
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Methgb
anemia |
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What might pulse ox fluctations with ventilation indicate
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hypovolemia
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What is the NIABP most accurate at determining
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MAP
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What can lead to overdampening (false low SBP)
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too much tubing
too many stop cocks air in tubing |
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Infection risk per day with an A-line
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0.7%
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What does the A-line upstroke indicate
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contractility
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What does the A-line downstroke notch indicate
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SVR
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A-line notch is far away from the downstroke
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low SVR
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A-line notch is close to the downstroke
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high SVR
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A-line area under the curve
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MAP
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What is the maximal O2 pressure
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2200 PSI
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What is the maximal N2O pressure
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745 PSI
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Clockwise turn increases gas flow
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electronic flow control device
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Counterclockwise turn increases gas flow
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mechanical flow control device
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High flow metering is primarily determined by this property of the gas
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density of the gas (graham's)
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Low flow metering is more dependent on which element of the gas
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viscosity of the gas
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What FGF guarantees no rebreathing
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2.5 X MV
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Circuit setup with no resevoir bag
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Mapleson E
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Circuit setup with an open tail on the bag
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Mapleson F
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Uses positively charged ions to detect gas concentrations
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Mass Spec
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Uses lasers to detect gas concentrations
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Ramen Scattering
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What kind of molecules can infrared absorption detect
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asymmetrical
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Where are oxygen analyzers found in the breathing circuit
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inspiratory limb
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What is the normal PaCO2 - ETCO2
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2-5 mmHg
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What is PaCO2- ETCO while under anesthesia
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5-10 mmHg
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Which form of mismatch responds better to supplemental oxygen
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shunt
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PaCO2 =
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CO2 production/ alveolar ventilation
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Capnograph- no plateau
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COPD
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Capnograph- failure of inspired CO2 to return to 0
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incompetant expiratory valve
exhausted absorber |
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Capnograph- persistance of exhaled gas during the first part of inspiration
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incompetant expiratory valve
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What will happen to the BP if the atmospheric pressure increases
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it will increase
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As temperature increases, vapor pressure will
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increase
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In which three conditions is the positive pumping effect more prone to increase output
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low FGF
low anesthetic High and frequent pos pressure |
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VP depends on
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temperature
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What does an increase in the pressure of the vaporizing chamber do (pressurizing effect)
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increases the molecules of carrier gas- dilute the gas
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How does rebreathing influence emergence
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causes an increased inspired concentration
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How does rebreathing influence induction
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causes a decreased inspired concentration
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What is the most common cause of vaporizer leaks
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failure to replace the filler valve
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low-pressure system, vacuum-insulated vessel containing gas in liquid form
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medical gas container
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A tank containing a high-pressure gas or gas mixture at a high pressure
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medical gas cylinder
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For liquefied gases ie N2O and CO2, requires ½ - ¾ turns to open
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diaphram or indirect acting valve
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Frangible disc protects against
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high pressure
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fusible plug protects against
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high temperature
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Allows small amounts of gas to exit cylinder if high pressures occur
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safety relief valve
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green shoulder
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oxygen
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gray shoulder
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CO2
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blue shoulder
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N20
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yellow shoulder
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air
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brown shoulder
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helium
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black shoulder
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nitrogen
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Formula for functional saturation
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oxyhemoglobin/ O2Hb + Hb
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Formula for fractional saturation
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oxyhemoglobin/ all hgb
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carboxyhgb + methgb is normally
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< 5%
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What 3 factors can falsely elevate BP
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too tight cuff
arterial stiffness hyperthermia |
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3 factors that can falsely lower BP
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too large cuff
poor tissue perfusion false ID sounds |
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What does the oxygen fail safe device operate on
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pressure
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What is the flow rate of the oxygen flush valve
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35-75 L/min
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What factors increase the likelihood of Compound A production
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Low gas flows
High Temp Desiccated absorbent Small patients Longer cases |
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In what kind of patient does CO have a more profound affect
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small
low Hgb |
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What are 3 signs of CO production
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failed induction
unpredicted fall in anesthetic conc. FI<vaporizer setting |
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When this unidirectional valve malfunctions the baseline will not return to zero during expiration
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inhalation valve
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Unidirectional valve that fails most often
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exhalation valve
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When this unidirectional valve fails the plateau phase is prolonged and there is a slanted inspiratory downstroke
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inhalation valve
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Mapleson system with FG near bag
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A
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Mapleson system without corrugated tubing
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C
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Two Mapleson systems with valve away from the patient
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D
E |
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Mapleson system with no valve
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F
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What happens to VP if the liquid is cooled
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it will decrease
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Which anesthetics are most affected by changes in atmospheric pressure
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those with low BP
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What are 3 things that increase the pressurizing effect
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high flow rates
large pressure fluctuations low anesthetic levels |
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Number of liters in a N2O tank
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1590
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Number of liters in an O2 tank
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660
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Which non-liquified gases can exceed the service pressure marked on a medical gas cylinder
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Oxygen (by 10%)
CO2/O2 mixtures Helium Helium/O2 mixtures |
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Complete nerve disruption
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neurotmesis
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Disruption of an axon within an intact nerve sheath
Complete recovery is unlikely |
axonotmesis
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Demyelination of peripheral fibers
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Neurapraxia
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Most common cause of brachial plexus damage
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Cardiothoracic surgery with sternotomy
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Persons most likely to suffer from ulnar neuropathy
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Very thin or obese male with prolonged hospital stay
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Nerve that accounts for the majority of lower extremity neuropathies
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Peroneal nerve
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What is the change in perfusion pressure per 2.5 cm
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2 mmHg
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What is the best position for shock
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lawn chair
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Damage to the obturator nerve may occur when the patient is placed in this position
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frogleg supine
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What is done to relieve aortocaval syndrome
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a tilt to the left
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The lateral decubitus position can put stress on which nerve
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suprascapular nerve
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What are the CV effects of prone positioning
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decreased stroke volume (CO)
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Main cause of of ischemia resulting in nerve dysfunction
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duration of pressure
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Nerves that are more susceptible to pressure injury
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motor
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What 5 things should you do in response to an air embolus
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support CO
aspirate central line lower head under heart turn off nitrous oxide add PEEP |
