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Principles 1 > Anesthesia Breathing Systems > Flashcards

Anesthesia Breathing Systems Flashcards

1
Q

Links patient to anesthesia machine, delivers oxygen

and anesthetic gases, eliminates carbon dioxide

A

breathing system

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2
Q

what DECREASES resistance of breathing system?

A 
Decreased circuit length
Increased circuit diameter
Avoiding sharp bends
Eliminating valves
Maintaining laminar flow
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3
Q

increased fresh gas flow causes a decrease of …

A

rebreathing and time equilibration

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4
Q

You should have __ flows for induction, ___ flows for maintenance and ___ flows for emergence

A

high, low, high

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5
Q

Blowing gas across the face

More a technique than a circuit

A

insufflation

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6
Q 
Patient inhales →
air passing through →
vaporizes the liquid agent →
mask gets cold →
condensation and decreased
vapor pressure (proportionate
to temperature)
no longer in use bc ether and chloroform are highly ..
A

open drop anesthesia

flammable

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7
Q

Ambient air is inhaled over liquid agent, flow DEPENDENT

simple, portable, no need for compressed gases

A

draw over anesthesia

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8
Q

Portable, self filling with O2 or ambient air, valve to allow for pos pressure, must have high flows

A

resuscitation, ambu bag

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9
Q

What is the nonrebreathing system we need to be familiar with called?

A

Mapleson (bain)

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10
Q

What components create a mapleson system?

A

Breathing tube, fresh gas inlet, adjustable pressurelimiting valve (APL), reservoir bag

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11
Q

long tubes and/or high compliance result in ?

A

larger gradient between gas delivery to circuit and to patient

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12
Q

large in diameter (22 mm), rubber/corrugated

A

mapleson breathing tube component

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13
Q

High flow required to prevent significant rebreathing and during spontaneous ventilation fresh gas flow must at least equal minute ventilation

A

maplesons

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14
Q

with mapleson during controlled (pos) pressure ventilation, what minute ventilation is required?

A

2-3 x minute ventilation

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15
Q 
Anesthesia gases (volatiles, N2O) + O2 + air from
anesthesia machine enter the Mapleson through
A

fresh gas inlet

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16
Q

Controls pressure build-up in the circuit (vents or pops off when a set pressure is reached

A

APL valve

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17
Q

2 functions of the reservoir bag

A

anesthetic gas reservoir and pos pressure ventilation

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18
Q

components of circle system

A

CO2 absorber, FGI, unidirectional limbs
and valves (I & E), Y-connector, APL valve,
reservoir bag

19
Q

what keeps flow moving forward

A

check valves

20
Q

what causes valve incompetency?

A

Warped disk
“Stuck” in up position
Condensation
Malfunction of either side can lead to CO2 rebreathing and hypercapnia

21
Q

best circle set up

A

-Valves near patient (prevents backflow when circuit leaks)
-FGI between absorber and inspiratory valve (less wasted fresh gas)
-APL between absorber and expiratory valve (conserves absorbent and less venting of
fresh gas)
-Reservoir bag in expiratory limb
(decreases resistance to exhalation and conserves
absorbent)

22
Q

allows for rebreathing of all gases with disposal of CO2

A

circle system

23
Q

with absorber, CO2 rebreathing is __ even at low flows

A

prevented

24
Q

the gradient increases between delivered and expired with

A

low flows

25
Q

Tidal volume that does not move into alveoli

A

dead space

26
Q

where is dead space?

A

distal to y piece

27
Q

disadvantages of circle system

A

Less portable, increased risk of malfunction, problems with absorber, less predictability with low flows

28
Q

what are the 2 methods for CO2 elimination

A

CO2 absorber

high fresh gas flow

29
Q

rebreathing conserves:

A

heat, humidity, volatiles

30
Q

neutralize H2CO3 to water and

energy (heat)

A

Soda lime or Ca2+ lime (salts)

31
Q

when should absorbent be replaced

A

50-70% color change

32
Q

dry absorbent

A

dessication

33
Q

breakdown of volatile gases

A

degredation

34
Q

when is degredation highest?

A

desflurane

35
Q

CO2 absorbent

resulting in less degradation

A

amsorb

36
Q

what is the worst degredation?

A

KOH

37
Q

By-product of sevoflurane degradation by
absorbent
-Nephrotoxic at 25-50 ppm (easily created in
extreme low flows)

A

compound A

38
Q

what increases risk of compound A

A
  • High concentration
  • Long anesthesia time (>2 MAC hours)
  • Low-flow technique (< 2 L/min)
39
Q

Alveolar concentration that prevents movement in 50%

of patients in response to surgical stimuli (incision)

A

MAC - mean alveolar concentration

40
Q

Absorbent exhaustion in areas where gas enters the absorber and along the canister walls

A

channeling

41
Q

what is places in cannister to prevent channeling

A

baffles

42
Q

avoid absorbents with ___

A

KOH

43
Q

What does a circle system have that the maplesons does not?

A

Co2 absorber, unidirectional limbs and valves, y connector

Principles 1 (12 decks)

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