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Basic > Breathing Systems > Flashcards

Breathing Systems Flashcards

1
Q

7 basic components of breathing systems

A
  1. CO2 absorbent
  2. two unidirectional valves
  3. fresh gas inlet
  4. Y connector
  5. resevoir bag
  6. adjustable pressure limiting valve
  7. low resistance tubing
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2
Q

Soda lime

A

Calcium hydroxide, some sodium hydroxide and potassium hydroxide. silica added to decrease dust
water and heat are produced which adds humidity and heat to breathing circuit

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3
Q

Why does color change occur soda lime

A

pH sensitive rxn

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3
Q

L/100g absorbent can soda lime absorb

A

23-26L of CO2 per 100g

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4
Q

size of granules in absorbents

A

smaller granules have great surface area for absorption but increased resistance to air flow

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5
Q

incompetence of either valve causes ____

A

rebreathing

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6
Q

where does fresh gas enter in circle system

A

between absorber and inspiratory valve

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7
Q

what does reservoir bag store

A

O2 and anesthetic gases

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8
Q

where is APL valve positioned

A

near exhalation unidrectional valve, gas scavenging systems collect any gas exiting system via relief valve

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9
Q

safety features in anesthesia breathing system that ensure patient receives adequate oxygen sypply

A
  1. fail safe valve
  2. rotameter
  3. proportioning device
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10
Q

when does fail-safe prevent hypoxic mixture

A

if decreased oxygen supply at flowmetes level
device present in gas lines except for O2 and is controlled by O2 sypply pressure

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11
Q

how does fail safe device work

A

interupts supply of other gases if O2 supply is reduced to a certain level, usually below 30 psi
that level is the opening threshold pressure for the other gases

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12
Q

flowmeters/rotameters control what

A

control gas proprotions and gas flow to common gas outlet

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13
Q

how does rotameter work

A

adjusts gas flow by means of flow control needle valves and flow tubes
gas flow enters at base of glass flow tube and glass tube is tapered in that its diameter increases with height
small metal bobbin rides the gas jet

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14
Q

variables that affect flowmeters

A

temp and altitude (higher altitude, increased flow)

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15
Q

oxygen ratio and proportioning devices

A

links 2 flows to prevent a final inspired O2 conc of less than 25%. 14teeth in gear for nitrous and 29 for O2

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16
Q

gases that ratio and proportioning devices work on

A

ONLY O2 and N2O

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17
Q

rebreathing effect on patient depends on

A

FGF and mechanical dead space

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18
Q

relationship between flow and rebreathing

A

inverse

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19
Q

system with no valves, tubing or reservoir bag, patient has access to atm gases

A

open

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20
Q

system with resevoir but no rebreathing, mapleson circuit or circle at high gas flow

A

semi-open

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21
Q

system with resevoir bag and allows for partial rebreathing

A

semi-closed

22
Q

system with resevoir bag and allows for complete rebreathing, CO2 absorbed

A

closed

23
Q

noncircle systems

A

insufflation, open-drop, draw-over, unidirectional, mapleson

24
Q

insufflation noncircle system

A

open, fire risk, depth of anesthesia unpredictablek insufflated over face

25
Q

open-drop non circle

A

ether, chloroform on gauze

26
Q

draw-over noncircle

A

non rebreathing valve, self inflating bag, vaporization chamber

27
Q

unidirectional valve noncirce

A

Ambubag

28
Q

Mapleson circuit

A

semi-open or semi-closed,

29
Q

Advantages of circle system

A

Maintenance of relatively stable inspired gas conc, conservation of resp moisture and heat, prevention of operating room pollution, closed-system or semi-closed

30
Q

sevo reacts with what to form Compound A

A

soda lime

31
Q

from greatest production of carboxyhemoglobin to least, anesthetic gases

A

des > en > iso > halothane = sevo

32
Q

factors that increase production of carboxyhemoglin

A

inhaled anesthetics, type of absorbent, low FGF, increased absorbent temp, dry absorbent, higher conc of inhaled, size of patient

33
Q

max concentration ppm of halogenated agent alone

A

2

34
Q

max concentration ppm of nitrous alone

A

50

35
Q

max concentration of combined, halogenated agent

A

0.5

36
Q

max concentration of combination, nitrous

A

25

37
Q

scavenging system components

A

gas collecting assembly, transfer tubing (19 or 30mm), scavenging interface, gas disposal tubing, disposal assembly

38
Q

Closing capacity

A

volume in the lungs at which small airways that do not have cartilaginous support begin to close

39
Q

what happens when CC > FRC

A

atelectasis

40
Q

possible trigger variables

A

time, pressure, flow, volume

41
Q

how to avoid breathstacking for COPD on ventilators

A

MV uses higher Vt with decreased RR, avoid high airway pressures, longer expiratory time

42
Q

during negative pressure ventilation (spont breathing) inspiration _____ venous return

A

increases

43
Q

PPV ______ blood return and _____ preload during inspiration

A

reduces, decreases

44
Q

PPV _____ RV afterload

A

increases, because of high intrathracic pressure

45
Q

afterload is ______ in PPV

A

decreased, improves left ventricular emptying

46
Q

what is auto PEEP

A

incomplete exhalation prior to the next inhalation causing progressive air trapping leading to higher alveolar pressure at end expiration

47
Q

assist control ventialtion (CMV)

A

delivers preset volume or pressure at specified rate but allows patient to trigger breath anytime, can be pressure or volume controlled

48
Q

AC rate

A

is the minimum number of full ventilator breaths patient will receive

49
Q

IMV is volume control that delivers ______ volume at _____ rate

A

preset, preset

50
Q

difference between AC and IMV

A

with IMV, if patient takes breath on own they get no addtl support
both need to set FiO2 and PEEP

51
Q

pressure support

A

provides assistance to each spont breath

52
Q

airway pressure release ventilation applies ?

A

continuous postive airway pressure for a prolonged time to maintain adequate lung volume and alveolar recruitment

Basic (8 decks)

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