Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Principles of anaesthesia > Anaesthetic monitoring > Flashcards

Anaesthetic monitoring Flashcards

1
Q

Basic monitoring of cardiovascular function

A

Clinical monitoring (pulse, MM, CRT, heart ausculation)

Arterial blood pressure measurement

Pulse oximetry (pulse frequency)

Electrocardiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Advanced monitoring of cardiovascular function

A

Cardiac output measurement

Perfusion indexes

New generation pulse oximetry (Masimo technology)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Clinical monitoring of CV function

A

Quality, rhythm, and frequency of peripheral pulse to assess volume status and detect arrhythmias

Auscultation of heart sounds

MM colour and CRT as indicators of tissue perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Mean arterial blood pressure calculation

A

MAP = CO (cardiac output) x SVR (systemic vascular resistances)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is MAP an indicator of?

A

Parenchymal/muscle perfusion (>70-80mmHg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is SAP an indicator of?

A

Ejection volume (>90-100mmHg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is DAP an indicator of?

A

Coronary perfusion (>40mmHg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Methods of measurement of arterial blood pressure

A

Sphygmomanometry (Riva-Rocci cuff)

Oscillometry (standard and high definition)

Doppler

Invasive method (via arterial catheterisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Oscillometry - principles of measurement

A

Reasds SAP, MAP, and DAP

Needs appropriate sized inflatable cuff

Flow restoration generates oscillations whose frequency is proportional to the MAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Advantages of oscillometry

A

Relatively cheap and easy to use

Non-invasive

Usually incorporated in multiparametric modules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Disadvantages of oscillometry

A

Reliability decreases in case of arrhythmias or extreme values (hyper/hypo-tension)

Measurement is intermittent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Prinicples of doppler measurement

A

Flow sensor equipped with piezoelectric crystal, and an inflatable cuff connected to a manual manometer

Cuff inflation occludes artery

Flow restoration results in audible signal from flow sensor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Advantages of doppler

A

Monitor in real time of pulse (audible signal)

Useful and reliable in dogs, cats, and rabbits

Not affected by pulse/heart rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Disadvantages of doppler

A

Flow sensor is easy to break/damage

Reads MAP in cats, SAP in other species (less reliable in cats)

Electric noise/interference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Principles of invasive blood pressure measurement

A

Based on pressure transducer, converts mechanical energy to electrical signal

Gives pressure reading and pulse wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Advantages of invasive blood pressure monitoring

A

Gold standard

Reliable in all species

Allows measurement of arterial blood gases (respiratory and acid-base assessment)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Disadvantages of invasive blood pressure measurement

A

Invasive (requires catheterisation of a peripheral arttery)

Potential complications: vasculitis, haemorrhage

Expensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Principles of pulse oximetry

A

Percentage of saturation of haemoglobin with oxygen <97% when breathing room air)

Pulse frequency (audible signal)

Pulse waveform (amplitude and morphology)

19
Q

Advantages of pulse oximetry

A

Easy to use

Allows monitoring of cardiovascular and also respiratory variables

20
Q

Disadvantages of pulse oximetry

A

Inaccurate in case of severe anaemia, pigmented MM and carbon monoxide intoxication

False sense of security

Data/reading misinterpretation is common

21
Q

Common arrhythmias during anaesthesia

A

Vagal stimulation (drug induced- opioids, intestinal/oesophageal/ocular manipulation)

Hypothermia (bradyarrhythmias)

Electrical currents applied in proximity of the heart

Mechanical stimulation of heart and vessels (thoracotomies, heart surgery)

Hypoxaemia and hypercapnia

22
Q

Basic monitoring of respiratory function

A

Clinical monitoring (resp rate, breathing patter, lung ausculation)

Capnography

Pulse oximetry

23
Q

Advanced monitoring of respiratory function

A

Spirometry

Arterial blood gases analysis

24
Q

Why is CO2 so important?

A

Metabolism

Cardio-circulatory system

Respiratory system

25
Q

CO2 and metabolism

A

Produced during cellular metabolism

Its production increases during high metabolic states (e.g. fever, exercise) and decreases during phases of low metabolism (e.g. hypothermia, sleep)

26
Q

Co2 and cardiocirculation

A

Produced by cellular metabolism

Taken up by venous blood and transported through CV system to the lungs (where its removed)

27
Q

CO2 and respiration

A

Rate of elimination of CO2 from the lungs (parameter measured by capnography) ultimately tells about the efficiency of ventilation

A decrease is one of the first signs of cardiac arrest

28
Q

Methods of capnography measurement

A

Laser
Spectrography
Gas-chromatography
Colorimetric technique

29
Q

Sidestream method of capnography measurement

A

Exhaled gases are sampled at patient’s airways and analysed in the control unit (diverted by a sampling line)

Sampling rate: 70-200ml/min (technical problems if used in patients with small tidal volumes)

No dead space

30
Q

Mainstream method of capnography measurement

A

Analysis of exhaled gases occurs directly at patient airways

Considerable dead space

No sampling rate

Generates heat (burns are possible)

31
Q

Clinical use of capnography

A

CO2 value should be 35-45 mmHg

Lower values = hyperventilation (hypocapnia)

Higher values = hypoventilation (hypercapnia)

32
Q

What does a rebreathing capnography waveform look like?

A

Elevated baseline

33
Q

What does an upper airway obstruction capnography waveform look like?

A

Shark fin shaped curve

34
Q

What does an abnormal plateau on a capnography waveform look like?

A

Gas sampling issues- technical problem of device

35
Q

Clinical significance of spirometry

A

Allows evaluation of lung volumes and pressures and their relationship

36
Q

What do low pressures applied to the airway, generating high lung volumes indicate on spirometry?

A

Good/high compliance (distensibility) of the lung parenchyma

37
Q

What do high pressures applied to the airway, generating low lung volumes indicate on spirometry?

A

High resistance to flow or poor lung compliance (e.g. elderly, pneumonia)

38
Q

What can result in hypothermia during anaesthesia?

A

Decreased liver perfusion and metabolism (liver metabolism generates heat)

Myorelaxation (muscles generate heat)

Decreased cellular metabolism (sleep mode)

Drug-induced impaired thermoregulation (e.g. opioids)

Surgical preparation (clipping and disinfection)

Opening of body cavities (laparotomies, thoracotomies)

39
Q

Consequences of hypothermia

A

Increased morbidity

Increased rate of infections

Impaired coagulation

Cardiac arrhythmias

Seizures

Pain

Death

40
Q

Prevention of hypothermia

A

Active warming devices (hot-dog, bari-hugger)

Heat and moisture exchanger filters (HME)

Passive warming devices (blankets)

Use of warm fluids for lavage of body cavities

Decrease the fresh gas flow of breathing gases

When possible limit the duration of anaesthesia

41
Q

Ventrally rotated eye with slow pupillary reflex and mild palpebral reflex

A

Surgical anaesthesia achieved

42
Q

Centrally positioned eye with mydriasis, absent pupillary and palpebral reflexes

A

Anaesthesia level is too deep

43
Q

Centrally positioned eye with normal pupillary and palpebral reflexes, swallowing possibly observed

A

Too superficial anaesthetic plane

44
Q

Nociception to determine plane of anaesthesia

A

Deep pain can be used to evaluate opioid induced analgesia

Autonomic reflexes more commonly used in clinical practice (e.g. increased heart rate and blood pressure following surgical stimulation)

Principles of anaesthesia (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions