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Anesthesiology > Breathing Systems > Flashcards

Breathing Systems Flashcards

1
Q

Which gases can pass through the fresh gas inlet?

A

All of the gases.

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2
Q

The regulator or reduction valve reduces the psi to what value?

A

50 psi

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3
Q

Delivering oxygen and also possibly anesthetic gases as well as eliminating carbon dioxide is done by what system?

A

Patient Breathing System (PBS)

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4
Q

What are the 2 main types of patient breathing systems?

A
  • Rebreathing

- Non-rebreathing

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5
Q

What should be done to a patient breathing system (PBS) prior to use?

A

Leak check

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6
Q

Which patient breathing system has a one-way circular pattern?

A

Rebreathing (circle) system

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7
Q

With which patient breathing system does the patient inhale the same anesthetic as they are exhaling?

A

Rebreathing (circle) system

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8
Q

What is the unit of measurement used in the flowmeter?

A

L/min

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9
Q

Which type of breathing system needs a form of CO2 absorption?

A

Rebreathing (circle) system

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10
Q

Why are rebreathing (circle) systems not good for smaller patients?

A

There are more components so there is an increased resistance for smaller patients.

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11
Q

A build up of CO2 can lead to what?

A

Acidemia

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12
Q

Rebreathing (circle) systems should be used for animals above what weight?

A

3 kg

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13
Q

A pediatric rebreathing hose should be used for patients under what weight?

A

15 lbs

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14
Q

What type of rebreathing hose is used for patients 15-300 lbs?

A

Standard adult circle hose

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15
Q

What are 2 types of hoses used with a rebreathing (circle) system?

A
  • Y

- Universal F

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16
Q

Do circle system valves increase or decrease resistance to breathing?

A

Increase resistance to breathing

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17
Q

Circle system valve incompetence can lead to what?

A

Rebreathing

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18
Q

What can increased rebreathing lead to?

A

CO2 values going up causing an acidosis.

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19
Q

What does APL stand for?

A

adjustable pressure limiting

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20
Q

What is another name for a “pop-off” valve?

A

Adjustable Pressure Limiting Valve

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21
Q

What limits pressure build-up within the circuit?

A

APL/pop-off valve

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22
Q

Does an APL/pop-off valve need to be open or closed when administering a breath?

A

Closed

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23
Q

APL/pop-off valves should always be open except in what circumstances?

A

Delivering manual, controlled or assisted ventilation

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24
Q

What would happen if the APL/pop-off valve were closed when administering a breath?

A

Build up of pressure within the circuit could lead to barotrauma.

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25
Q

What measure pressure within the breathing circuit?

A

Breathing System Pressure Gauge

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26
Q

What is the breathing system pressure gauge typically located next to?

A

Flow meter

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27
Q

A breathing system pressure gauge should always read what unless what two events are occurring?

A
  • Zero

- Performing leak checks or providing IPPV

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28
Q

The breathing system pressure gauge is measured in what units?

A

cm H2O

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29
Q

The oxygen cylinder pressure gauge is measured in what units?

A

PSI

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30
Q

The non-rebreathing system pressure gauge is measured in what units?

A

cm H2O

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31
Q

What type of breathing system is a carbon dioxide absorber used for?

A

Rebreathing (circle) system

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32
Q

How full should a carbon dioxide absorber be filled?

A

One inch from the top.

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33
Q

What is commonly used as a carbon dioxide absorber?

A

Soda Lime

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34
Q

The ingredients of soda lime react with what two types of molecules?

A
  • CO2

- Water

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35
Q

What type of a reaction takes place in a carbon dioxide absorber?
How does this make the canister feel?

A
  • Exothermic reaction

- Warm to the touch

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36
Q

Soda lime removes what from a circle breathing system?

A

CO2

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37
Q

What are 2 precautions to take when handling soda lime?

A
  • Use gloves

- Do not inhale

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38
Q

Soda lime can generally be used for how long with small animals?
With large animals?

A
  • 8 to 12 hours

- 6 to 8 hours

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39
Q

What is something that should be done with the soda lime on a regular basis?
Why?

A
  • Shake the canister

- Get rid of the channels that form from use.

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40
Q

Why is it important to monitor the amount of time soda lime is used?

A

It ceases to absorb CO2 after a while.

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41
Q

What is the color change seen with soda lime?

What is this due to?

A
  • Changes to purple/pink

- Due to a chemical reaction

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42
Q

What can happen with a rebreathing system if the oxygen is left on after a procedure?

A

Carbon monoxide can be given off and kill the patient.

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43
Q

What are 4 signs that the carbon dioxide absorber has been exhausted?

A
  • Increased EtCO2 and InCO2
  • Increase ventilation
  • Increase in HR and BP initially (then drops)
  • Red mucous membranes
44
Q

How do you calculate what size reservoir/rebreathing bag to use?

A

Body weight x Tidal volume x 5

45
Q

What is the normal tidal volume range?

A
  • 10-20 mL/kg
46
Q

What are 3 uses for a reservoir/rebreathing bag?

A
  • Respiratory monitor
  • IPPV
  • Inspiratory reserve
47
Q

When manually squeezing a reservoir/rebreathing bag, what is the rate on the breathing system pressure gauge that is trying to be reached?

A
  • 20 cm H2O
48
Q

What is the high flow rate for a rebreathing system?

When is this used?

A
  • 50-100 mL/kg/min

- Start and end of inhalation anesthesia

49
Q

What is a benefit of using a high flow rate at the start of inhalation anesthesia with a rebreathing system?

A

Decreased time required to achieve ideal anesthetic concentration.

50
Q

What are the 2 flow rates that can be used for maintenance during inhalation anesthesia with a rebreathing system?

A
  • Semi-closed: 20-50 mL/kg/min

- Low flow: 10-20 mL/kg/min

51
Q

What type of breathing system is used for patients weighing 3 kg or less?

A

Non-rebreathing system

52
Q

Do non-rebreathing systems have carbon dioxide absorbers?

A

No

53
Q

What washes out the CO2 in a non-rebreathing system?

What does this require?

A
  • Fresh gas

- Higher O2 flow rate

54
Q

Which breathing system has less resistance and fewer components?

A

Non-rebreathing system

55
Q

Which breathing system has more gas waste and atmosphere pollution due to high flow rates?

A

Non-rebreathing system

56
Q

What can a high flow rate contribute to?

A

Hypothermia

57
Q

Do you find little to no dead space with a low or high flow rate?

A

High flow rate

58
Q

What are 2 examples of non-rebreathing hoses used at Ross?

A
  • Mapleson D

- Mapleson F

59
Q

What is the flow rate used with a non-rebreathing system?

A

200-300 mL/kg/min

60
Q

What is the minimum flow rate needed for a non-rebreathing system?
What can be seen if this minimum is not met?

A
  • 1 L/min

- Elevations of inspiratory CO2

61
Q

T/F: Flow meters are set up to deliver more gas than a patient can take up.

A

True

62
Q

T/F: In the absence of scavenging, gases will remain circulating in the system.

A

False - In the absence of scavenging, gases will flow into the room.

63
Q

Pollution from poor scavenging can cause what?

A

Spontaneous abortion and fetal injury

64
Q

According to NIOSH standards, what is the recommended level that occupational exposure to halogenated anesthetic agents should be kept below?

A

2 ppm

65
Q

How many ppm is 100% gas?

1% gas?

A
  • 1,000,000 ppm

- 10,000 ppm

66
Q

At what ppm can we smell anesthetic gases?

A

About 125 ppm

67
Q

As long as a leak is under what value, the machine can still be used?

A

Less than 300 mL

68
Q

A minimum of how many air changes should be made per hour?

A

15 air changes per hour

69
Q

What are 3 examples of passive scavenging systems?

A
  • Floor drop
  • Charcoal absorption
  • Outside wall or window
70
Q

What is an example of an active scavenging system?

A

Vacuum collection

71
Q

What is an advantage to charcoal absorption?

A

Absorbs halogenated anesthetic gases

72
Q

What are 4 disadvantages to charcoal absorption?

A
  • Does not absorb N2O or CO2
  • Must be replaced often, so increased cost over time
  • Flow limited
  • Added resistance
73
Q

What should be done before a new charcoal absorber is used?

A

It should be weighed and the weight recorded in grams.

74
Q

When should a charcoal absorber be discarded?

How long does this usually take?

A
  • When it has gained 50 grams from its original weight.

- Usually 8-12 hours

75
Q

What are 4 other possible sources of gas pollution?

A
  • Gas sampling monitors (capnograph)
  • Filling vaporizers
  • Recovery rooms
  • Induction chambers/face masks
76
Q

What should be worn when filling a vaporizer?

A

Charcoal mask

77
Q

Don’t forget to do what once done filling a vaporizer?

A

Put cap back on liquid anesthetic container.

78
Q

Which is safer, a funnel/pour fill or a key fill?

A

Key fill

79
Q

What needs to be done to the vaporizer before beginning filling?

A

Turn vaporizer dial off

80
Q

The O2 flow that is passing through the vaporization chamber will exert sufficient pressure on anesthetic liquid causing it to flow out of the port if what is done?

A

Vaporizer left on during filling

81
Q

How many air changes should there be in a recovery room?

A

15-20 air changes/hour

82
Q

T/F: A patient can be kept on oxygen and the breathing circuit utilized to scavenge the patient’s lungs at the beginning of recovery.

A

True

83
Q

It is recommended that detection badges are used to test a minimum of two sights how often?

A

Twice per year

84
Q

What is used for the purpose of administration of inhalation anesthesia with reduced waste gas pollution?

A

Endotracheal tubes

85
Q

Do endotracheal tubes reduce or increase the risk of saliva or regurgitated contents of the stomach being inhaled?

A

Reduce the risk

86
Q

What can be administered through an endotracheal tube?

A

Oxygen

87
Q

What can an endotracheal tube allow for?

A

IPPV

88
Q

What is the most common material used for endotracheal tubes?

A

PVC

89
Q

Which tubes have thicker walls, oral or nasal?

A

Oral

90
Q

Which type of tube is used more frequently in animals, cuffed or uncuffed?
Which species is the exception to this?

A
  • Cuffed

- Birds

91
Q

What can cause pressure ischemia or respiratory obstruction when collapse occurs?

A

Over pressured cuffs

92
Q

Tracheal ischemia can occur at what level?

A

27 cm H2O

93
Q

Which type of tube as an oval hole positioned on the bevel facing the opening of the tube?

A

Murphy tubes

94
Q

What does a “Murphy’s eye” help to prevent?

A

Obstruction

95
Q

Armored, wire-reinforced or spiral embedded tubes resist what?
What type of procedures are these good for?

A
  • Kinking

- Head or neck procedures

96
Q

What type of tube is uncuffed and characterized by a “shoulder” near the distal end?

A

Cole tubes

97
Q

Why should the largest diameter possible be used for an endotracheal tube?

A

Decreased airway resistance

98
Q

An endotracheal tube should extend to what anatomical location in the patient?

A

Thoracic inlet

99
Q

What are 2 things that can happen in an endotracheal tube is too long for the patient?

A
  • Increased resistance

- One lung ventilation

100
Q

What is the term that describes portions of the breathing passages that contain air but here is no gas exchange?

A

Dead space

101
Q

What are 5 examples of dead space?

A
  • Mouth
  • Nasal passages
  • Pharynx
  • Trachea
  • End of ET tube/Y piece of PBS
102
Q

What allows for visualization, provides a light source and allows increased accessibility to the airway?

A

Laryngoscope

103
Q

Where should pressure be applied with a laryngoscope?

A

Light pressure to the base of the tongue, just underneath the epiglottis.

104
Q

There should be no gas escaping around the ET tube at what level to make sure the cuff is not under-inflated?
The gas should be able to escape again at what level to make sure the cuff is not overinflated?

A
  • 20 cm H2O

- 30 cm H2O

105
Q

What can be used to check a cuff for over/under inflation?

A

Posey cufflator

106
Q

What are 2 different ways to tie in an ET tube?

A
  • Around the ears

- Around the maxilla

107
Q

What are 5 possible complications that can be seen with using an ET tube?

A
  • Damage to larynx
  • Damage to trachea
  • ET tube lumen obstruction
  • Endobronchial intubation (one lung ventilation)
  • ET tube damage

Anesthesiology (19 decks)

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